Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial

Abstract

Background: The combination of male gender, obstructive sleep apnoea (OSA) and obesity magnifies cardiometabolic risk. There has been no systematic study evaluating whether testosterone therapy can improve cardiometabolic health in obese men with OSA by improving body composition, visceral abdominal fat and insulin sensitivity. Objective: To assess body compositional and cardiometabolic effects of testosterone treatment in obese men with severe OSA. Design: An 18-week randomised, double-blind, placebo-controlled and parallel group trial in 67 men. Methods: Participants (ageZ49G12 years, apnoea hypopnoea indexZ39.9G17.7 events/h, BMIZ31.3G5.2 kg/m

THERAPY OF ENDOCRINE DISEASE: Testosterone supplementation and body composition: results from a meta-analysis study

“…Based on this report, results with TU in LOH-associated obesity seem superior to other lifestyle or medical interventions (see before) and comparable to those obtained with the most invasive therapies, such as bariatric surgery (21). However, randomized controlled trials (RCTs) showing TS-induced weight loss as the (22,23), others weight gain (24,25) and the vast majority a non-significant effect (26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52). Similar information can be obtained by scrutinizing observational and registry studies (53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,…”

Low testosterone in men predicts impaired arterial elasticity and microvascular function

“…In a small study, testosterone replacement actually improved PWV in men with hypogonadism [48]. In men with obstructive sleep apnea, eighteen weeks of testosterone therapy decreased AIX [49]. Our data demonstrates for the first time an inverse relationship between AIX and testosterone levels in a population of men with a few co-morbidities.…”

Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, Adiponectin, and Visceral Adipose Fat

“…The squares represent the individual studies increase in weight with CPAP may also reflect an increase in lean mass, which has been shown in two recent studies. 49,50 This increase in lean mass may by itself explain the overall improvement in insulin sensitivity following CPAP treatment. However, longer-term randomized trials that quantify both fat and lean mass changes with CPAP together with changes in insulin resistance are required to clarify mechanisms.…”