Abstract
Background and significanceObesity is a chronic disease, warranting long-term medical intervention. We evaluated effects of testosterone (T) therapy (Th) in men with T deficiency with normal weight, overweight and obesity on anthropometric and metabolic parameters, compared with untreated men.MethodsHypogonadal men (n = 823) with total T ≤ 12.1 nmol/L (age: 60.6 ± 7.0 years) participated in an ongoing registry study. Among these men 474 (57.6%) were obese, 286 (34.8%) overweight and 63 (7.7%) had normal weight. T undecanoate injections were administered to 428 men and 395 remained untreated. Anthropometric and metabolic parameters were measured at least twice a year and changes adjusted for confounding factors to account for baseline differences between groups.ResultsLong-term TTh in hypogonadal men, irrespective of weight at baseline, produced improvements in body weight, waist circumference (WC) and body mass index (BMI). Furthermore, TTh decreased fasting blood glucose and HbA1c and improved lipid profiles. Gradual decreases in blood pressure (systolic and diastolic) and pulse pressure occurred in men treated with T in each group. Marked reductions in mortality and major cardiovascular events were recorded in men receiving TTh.ConclusionsOur findings demonstrate that TTh produces reductions in weight, WC, and BMI. There were 77 (19.5%) deaths in the untreated groups and 23 (5.4%) in the T-groups. Based on these findings we suggest that long-term TTh in overweight and obese hypogonadal men produces progressive and sustained clinically meaningful weight loss and that TTh may contribute to reductions in mortality and incident major adverse cardiovascular events.
Highlights
Supplementary information The online version of this article contains supplementary material, which is available to authorized users.School of Public Health, Boston, MA, USA 4 Private Urology Practice, Bremerhaven, GermanyObesity is a serious public health concern, impacting healthcare systems worldwide [1,2,3,4,5], and warrants longterm medical intervention [4,5,6,7]
Diagnosis of hypogonadism was made based on low T concentrations and clinical signs and symptoms associated with low T, as described by the European Association of Urology (EAU) guidelines
At 11 years, in 26 men with normal weight receiving TTh, weight decreased by 3.4 ± 1.2 kg (p < 0.005) and increased by 6.1 ± 0.7 kg (p < 0.0001) in 37 men with normal weight who remained untreated (Fig. 1a, left panel)
Summary
Herrick et al reported that the age-adjusted percentage of adults aged ≥ 20 years trying to lose weight during the past 12 months, by sex, increased from 43.3% to 49.3%. This increase was seen among both men (35.5% to 42.2%) and women (51.2% to 56.3%) [11]. Methods Hypogonadal men (n = 823) with total T ≤ 12.1 nmol/L (age: 60.6 ± 7.0 years) participated in an ongoing registry study. Among these men 474 (57.6%) were obese, 286 (34.8%) overweight and 63 (7.7%) had normal weight. Marked reductions in mortality and major cardiovascular events were recorded in men receiving TTh
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