Effects of long-term treatment with testosterone on weight and waist size in 411 hypogonadal men with obesity classes I-III: observational data from two registry studies

Abstract

Background/Objectives:Long-term testosterone replacement therapy (TRT) up to 5 years has been shown to produce progressive and sustainable weight loss (WL) in hypogonadal men. This study investigated effects of long-term TRT up to 8 years in hypogonadal men with different obesity classes.Subjects/Methods:From two independent observational registries we identified a total of 411 obese, hypogonadal men receiving TRT in urological clinics. The effects of TRT on anthropometric as well as metabolic parameters were studied for a maximum duration of 8 years, mean follow-up: 6 years. All men received long-acting injections of testosterone undecanoate in 3-monthly intervals.Results:In all three classes of obesity, T therapy produced significant WL, decrease in waist circumference (WC) and body mass index (BMI). In patients with class I obesity, mean weight decreased from 102.6±6.4 to 84.1±4.9 kg, change from baseline: −17.4±0.5 kg and −16.8±0.4%. WC in this group of patients decreased from 106.8±7.4 to 95.1±5.3 cm, change from baseline: −10.6±0.3 cm. BMI decreased from 32.69±1.4 to 27.07±1.57, change from baseline: −5.52±0.15 kg m−2. In patients with class II obesity, weight decreased from 116.8±6.9 to 91.3±6.3 kg, change from baseline: −25.3±0.5 kg and −21.5±0.4%. WC decreased from 113.5±7.5 to 100.0±5.4 cm, change from baseline: −13.9±0.4 cm. BMI decreased from 37.32±1.45 to 29.49±1.71, change from baseline: −8.15±0.17 kg m−2. In patients with class III obesity, weight decreased from 129.0±5.6 to 98.9±4.8 kg, change from baseline: −30.5±0.7 kg and −23.6±0.5%. WC decreased from 118.5±5.6 to 103.8±4.9 cm, change from baseline: −14.3±0.4 cm. BMI decreased from 41.93±1.48 to 32.46±1.59, change from baseline −9.96±0.29 kg m−2.Conclusions:Testosterone therapy appears to be an effective approach to achieve sustained WL in obese hypogonadal men irrespective of severity of obesity. Based on these findings we suggest that T therapy offers safe and effective treatment strategy of obesity in hypogonadal men.

Testosterone undecanoate improves lipid profile in patients with type 1 diabetes and hypogonadotrophic hypogonadism

“…With respect to triglycerides, in type 2 diabetic patients with hypogonadism, TU therapy produced a decrease of 62 mg/dL at 12 months [7], and up to 138 mg/dL at 8 years [9]. In the present study, the drop observed at 22 weeks versus placebo was 59.9 mg/dL, a figure similar to that found in type 2 diabetes.…”

“…Testosterone replacement therapy in type 2 diabetes patients with hypogonadism produced a significant reduction in insulin resistance and glycosylated hemoglobin [6][7][8] as well as an improvement in anthropometric parameters and a drop in blood pressure [9,10], being controversial the impact on lipid profile [6,7,9,[11][12][13][14].…”

Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

“…The last 2 decades have witnessed a revolution in medical management of men with testosterone (T) deficiency (TD; also known as hypogonadism) [123456789101112131415]. TD has been recognized for more than 7 decades [161718] and T therapy has been used clinically, as early as 1940, both in men and women [161718].…”

Testosterone deprivation accelerates cardiac dysfunction in obese male rats

“…Furthermore, patients suffering from congestive heart failure (Jankowska et al 2006) and coronary artery disease (Li et al 2012) have been shown to have lower levels of testosterone compared with healthy men, and the severity of these conditions had a strong correlation with the degree of testosterone deficiency (Li et al 2012, Oskui et al 2013. Recent clinical studies demonstrated that testosterone replacement could improve insulin sensitivity, increase lean mass, and decrease subcutaneous fat (Dhindsa et al 2016) and also improve cardiometabolic parameters in type 2 diabetes men with testosterone deprivation (Hackett et al 2014) and in hypogonadal men with metabolic syndrome (Saad et al 2016).…”