Long-term testosterone therapy in hypogonadal men ameliorates elements of the metabolic syndrome: an observational, long-term registry study

Int J Clin Pract. 2014 Mar;68(3):314-29. doi: 10.1111/ijcp.12319. Epub 2013 Oct 15.

Abstract

Aim: The goal of this study was to determine if long-term testosterone (T) therapy in men with hypogonadism, henceforth referred to as testosterone deficiency (TD), ameliorates or improves metabolic syndrome (MetS) components.

Methods: We performed a cumulative registry study of 255 men, aged between 33 and 69 years (mean 58.02 ± 6.30) with subnormal plasma total T levels (mean: 9.93 ± 1.38; range: 5.89-12.13 nmol/l) as well as at least mild symptoms of TD assessed by the Aging Males' symptoms scale. All men received treatment with parenteral T undecanoate 1000 mg (Nebido(®) , Bayer Pharma, Berlin, Germany), administered at baseline and 6 weeks and thereafter every 12 weeks for up to 60 months. Lipids, glucose, liver enzymes and haemoglobin A1c analyses were carried out in a commercial laboratory. Anthropometric measurements were also made throughout the study period.

Results: Testosterone therapy restored physiological T levels and resulted in reductions in total cholesterol (TC) [7.29 ± 1.03 to 4.87 ± 0.29 mmol/l (281.58 ± 39.8 to 188.12 ± 11.31 mg/dl)], low-density lipoprotein cholesterol [4.24 ± 1.07 to 2.84 ± 0.92 mmol/l (163.79 ± 41.44 to 109.84 ± 35.41 mg/dl)], triglycerides [3.14 ± 0.58 to 2.16 ± 0.13 mmol/l (276.16 ± 51.32 to 189.78 ± 11.33 mg/dl)] and increased high-density lipoprotein levels [1.45 ± 0.46 to 1.52 ± 0.45 mmol/l (56.17 ± 17.79 to 58.85 ± 17.51 mg/dl)] (p < 0.0001 for all). There were marked reductions in systolic and diastolic blood pressure, blood glucose, haemoglobin A1c , C-reactive protein (6.29 ± 7.96 to 1.03 ± 1.87 U/l), alanine aminotransferase and aspartate aminotransferase (p < 0.0001 for all).

Conclusions: Long-term T therapy, at physiological levels, ameliorates MetS components. These findings strongly suggest that T therapy in hypogonadal men may prove useful in reducing the risk of cardiometabolic diseases.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Androgens / therapeutic use*
  • Blood Glucose / metabolism
  • Blood Pressure / drug effects
  • C-Reactive Protein / metabolism
  • Cholesterol, HDL / metabolism
  • Cholesterol, LDL / metabolism
  • Fasting / blood
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypogonadism / blood
  • Hypogonadism / drug therapy*
  • Hypogonadism / physiopathology
  • Lipid Metabolism / drug effects
  • Long-Term Care
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / physiopathology
  • Metabolic Syndrome / prevention & control*
  • Middle Aged
  • Obesity / prevention & control
  • Organ Size / drug effects
  • Prostate / anatomy & histology
  • Registries
  • Testosterone / analogs & derivatives*
  • Testosterone / therapeutic use
  • Treatment Outcome
  • Triglycerides / metabolism

Substances

  • Androgens
  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • Triglycerides
  • Testosterone
  • C-Reactive Protein
  • testosterone undecanoate