Testosterone treatment, weight loss and health-related quality of life and psychosocial function in men: a two-year RCT

Mathis Grossmann; Kristy P Robledo; Mark Daniel; David J Handelsman; Warrick J Inder; Bronwyn G A Stuckey; Bu B Yeap; Mark Ng Tang Fui; Karen Bracken; Carolyn A Allan; David Jesudason; Jeffrey D Zajac; Gary A Wittert

doi:10.1210/clinem/dgae085

Testosterone treatment, weight loss and health-related quality of life and psychosocial function in men: a two-year RCT

J Clin Endocrinol Metab. 2024 Feb 9:dgae085. doi: 10.1210/clinem/dgae085. Online ahead of print.

Authors

Mathis Grossmann^{1

2}, Kristy P Robledo³, Mark Daniel⁴, David J Handelsman⁵, Warrick J Inder⁶, Bronwyn G A Stuckey⁷, Bu B Yeap⁸, Mark Ng Tang Fui^{1

2}, Karen Bracken³, Carolyn A Allan⁹, David Jesudason¹⁰, Jeffrey D Zajac^{1

2}, Gary A Wittert¹¹

Affiliations

¹ Department of Medicine (Austin Health), The University of Melbourne, Victoria, Australia.
² Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia.
³ NHMRC Clinical Trials Centre, University of Sydney, New South Wales, Australia.
⁴ Department of Population Health, Dasman Diabetes Institute, Kuwait.
⁵ ANZAC Research Institute, University of Sydney and Department of Andrology, Concord Hospital, Sydney New South Wales, Australia.
⁶ Princess Alexandra Hospital and the University of Queensland, Queensland, Australia.
⁷ Keogh Institute for Medical Research, Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital and Medical School, University of Western Australia, Western Australia, Australia.
⁸ Medical School, University of Western Australia and Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁹ Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, School of Clinical Sciences at Monash Health, and Faculty of Medicine, Nursing and Health Sciences, Monash University.
¹⁰ University of Adelaide, Adelaide, South Australia, Australia, and The Queen Elizabeth Hospital, South Australia, Australia.
¹¹ Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia, Australia, and The Queen Elizabeth Hospital, South Australia, Australia.

PMID: 38335137
DOI: 10.1210/clinem/dgae085

Abstract

Objective: To determine the effect of testosterone vs placebo treatment on health-related quality of life (HR-QOL) and psychosocial function in men without pathologic hypogonadism in the context of a lifestyle intervention.

Design, setting, participants: Secondary analysis of a 2-year, randomised controlled, testosterone therapy trial for prevention, or reversal of newly diagnosed, type 2 diabetes, enrolling men > 50 years at high risk for type 2 diabetes from six Australian centers.

Interventions: Injectable testosterone undecanoate or matching placebo on the background of a community-based lifestyle program.

Main outcomes: Self-reported measures of HR-QOL/psychosocial function.

Results: Of 1007 participants randomised into T4DM, 648 (64%) had complete data available for all HR-QOL/psychosocial function assessments at baseline and two years. Over 24 months, while most measures were not different between treatment arms, testosterone treatment, compared with placebo, improved subjective social status and sense of coherence. Baseline HR-QOL/psychosocial function measures did not predict the effect of testosterone treatment on glycemic outcomes, primary endpoints of T4DM. Irrespective of treatment allocation, larger decreases in body weight were associated with improved mental quality of life, mastery, and subjective social status. Men with better baseline physical function, greater sense of coherence, and less depressive symptoms experienced greater associated decreases in body weight, with similar effects on waist circumference.

Conclusions: In this diabetes prevention trial, weight loss induced by a lifestyle intervention improved HR-QOL and psychosocial function in more domains than testosterone treatment. The magnitude of weight and waist circumference reduction were predicted by baseline physical function, depressive symptomology, and sense of coherence.

Keywords: T4DM; psychosocial health; quality of life; testosterone.