Effects of three different medications on metabolic parameters and testicular volume in patients with hypogonadotropic hypogonadism: 3‐year experience

Aydoğdu, Aydoğan; Bolu, Erol; Sönmez, Alper; Taşçı, İlker; Haymana, Cem; Acar, Ramazan; Meriç, Coşkun; Taşlıpınar, Abdullah; Özgürtaş, Taner; Azal, Ömer

doi:10.1111/cen.12135

Cited by 15 publications

(27 citation statements)

References 43 publications

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“…Most of these studies showing adverse effects of TRT were by and large performed on frail elderly populations with several confounders. However, we also reported endothelial dysfunction, inflammation and insulin resistance after TRT in unconfounded, young hypogonadal patients [18][19][20]. To our knowledge, the present study is the first to search for the effect of TRT on 25(OH)D3 and FGF-23 levels .…”

Section: Discussionsupporting

confidence: 54%

“…In our CHH group, the secondary sexual characteristics significantly improved, but the BMI and WC were increased after the TRT. A general response that we observed in this study population is a significant improvement in the secondary sexual characteristics along with a significant increase in BMI and WC [17][18][19][20]. It is likely that TRT ignites pubertal growth in these young patients, which is not seen in elderly hypogonadal patients of other aetiologies This may partly explain the rapid increase in BMI and waist circumference of these patients.…”

Section: Prace Oryginalnementioning

confidence: 50%

“…Some of these hypogonadal patients, generally the ones living in the rural regions, have never been treated before. Information about the enrolment criteria and the testosterone replacement procedures of our hypogonadal cohort were given in detail in previous articles [18][19][20]. Briefly, young patients diagnosed as CHH, who were not treated with testosterone replacement and who did not have any other chronic diseases, were enrolled.…”

Section: Methodsmentioning

confidence: 99%

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Wpływ testosteronowej terapii zastępczej na stężenia witaminy D i FGF-23 w hipogonadyzmie wrodzonym

Haymana¹,

Sönmez²,

Aydoğdu³

et al. 2017

Endokrynologia Polska

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Introduction: Patients with hypogonadism are at increased risk of cardiac and metabolic diseases and osteoporosis. Vitamin D and fibroblast growth factor-23 (FGF-23) play a role in the regulation of bone mineral metabolism and endothelial functions. Low vitamin D levels are reported in hypogonadism, while there is no data about the effect of testosterone replacement therapy (TRT). We investigated the effect of TRT on vitamin D and FGF-23 levels along with endothelial functions and insulin resistance in hypogonadal patients. Material and methods:Patients with congenital hypogonadotrophic hypogonadism (CHH) (n = 32, age 20.6 ± 1.58 years) were enrolled. TRT was implemented in transdermal form. The demographic parameters, FGF-23, 25(OH)D3, asymmetric dimethylarginine (ADMA), and homeostatic model assessment of insulin resistance (HOMA-IR) levels, were measured both before and after TRT. Results: After a follow-up period of 3.63 ± 1.33 months, ADMA and FGF-23 levels were significantly increased (p = 0.03 and p = 0.005 respectively), while 25(OH)D3 and HOMA-IR index were not significantly changed. The body mass index and waist circumference levels of the patients were also increased (p < 0.001 and p = 0.02) along with a significant decrease in the HDL cholesterol levels (p = 0.006). Conclusions:The results show that short-term TRT increases plasma FGF-23 and ADMA levels but does not alter the vitamin D levels in young, treatment naive patients with CHH. Whether this is an early implication of TRT-related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardiometabolic morbidity and mortality in this specific population. (Endokrynol Pol 2017; 68 (3): 311-316)

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Section: Discussionsupporting

confidence: 54%

Section: Prace Oryginalnementioning

confidence: 50%

Section: Methodsmentioning

confidence: 99%

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Wpływ testosteronowej terapii zastępczej na stężenia witaminy D i FGF-23 w hipogonadyzmie wrodzonym

Haymana¹,

Sönmez²,

Aydoğdu³

et al. 2017

Endokrynologia Polska

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“…Recently, in our database of young, treatment naïve CHH patients, we noticed that the metabolic parameters do not improve but worsen in about six months of TRT with triweekly injection of testosterone esters [5,17]. Whether these unfavorable metabolic effects of TRT in this specific population of hypogonadism increase the cardiovascular risk is not known.…”

Section: Sample Collection and Laboratory Measurementsmentioning

confidence: 99%

Endothelial dysfunction, insulin resistance and inflammation in congenital hypogonadism, and the effect of testosterone replacement

Sönmez¹,

Haymana²,

Aydoğdu³

et al. 2015

Endocr J

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Patients with hypogonadism not only present with poor libido, loss of energy, muscle atrophy and depression but also with chronic metabolic disorders such as dyslipidemia, obesity, hypertension and type 2 diabetes mellitus (T2DM) [1][2][3] and increased mortality [4]. The dysmetabolic features of hypogonadism are present even in the very young age, in patients with congenital hypogonadotrophic hypogonadism (CHH) [5].Endothelial dysfunction, insulin resistance and inflammation in congenital hypogonadism, and the effect of testosterone replacement (TRT) is not clear. We investigated the presence of inflammation, insulin resistance and endothelial dysfunction in an unconfounded population of congenital hypogonadotrophic hypogonadism (CHH) and the effect of TRT on these subjects. A total of 60 patients with CHH (mean age 21.82±2.22 years) and 70 healthy control subjects (mean age 21.32±1.13 years) were enrolled. The demographic parameters, Asymmetric dimethylarginine (ADMA), TNF-like weak inducer of apoptosis (TWEAK), high sensitive C reactive protein (hs-CRP) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured before and after TRT. The patients had higher Waist Circumferences (WC) (p=0.009), Diastolic Blood Pressures (p=0.02), Triglycerides (p=0.03), ADMA, insulin and HOMA-IR levels (p<0.001 for all) and lower TWEAK levels (p<0.001), compared to the healthy controls. After 5.56 ± 2.04 months of TRT, the patients had significantly elevated systolic blood pressures (p=0.01), body mass indexes and WC (p<0.001 and p=0.001 respectively) and decreased total and HDL cholesterol levels (p=0.032 and p<0.001 respectively). ADMA levels significantly increased (p=0.003), while the alterations in TWEAK, hsCRP and HOMA-IR were not significant. The results of the present study show that endothelial dysfunction, inflammation and insulin resistance are prevalent even in the very young subjects with CHH, who have no metabolic or cardiac problems at present. This increased cardiometabolic risk however, do not improve but even get worse after six months of TRT. Long term follow-up studies are warranted to investigate the unfavorable cardiometabolic effects of TRT. Key words: Endothelial dysfunction, Insulin resistance, Inflammation, HypogonadismHowever, whether the testosterone replacement treatment (TRT) improves the metabolic and cardiovascular risks of patients with hypogonadism is not clear. Several reports mention favorable metabolic effects of TRT [6-9] while others do not confirm these data [10][11][12][13]. The meta-analyses show no significant metabolic benefit but a tendency towards increased cardiovascular events due to TRT [14][15][16]. Meanwhile, a prospective cohort of elderly hypogonadal men was recently terminated due to the increased cardiovascular mortality in the testosterone replacement arm [13]. There may be several reasons for the inconsistencies of the previous reports. Most of these studies were per-

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“…Male hypogonadism is an endocrine disorder defined with the presence of typical clinical signs and symptoms plus laboratory confirmation of serum testosterone (T) levels lower than 300 ng/dl [1,2]. Serum luteinizing hormone (LH) and folliclestimulating hormone (FSH) levels differentiate between hypergonadotropic (primary) and hypogonadotropic (secondary) hypogonadism [1].…”

Section: Introductionmentioning

confidence: 99%

Effects of androgen replacement therapy on cornea and tear function in men with idiopathic hypogonadotropic hypogonadism

Gökçe

Hürmeriç²,

Mumcuoğlu

et al. 2015

Postgraduate Medicine

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Effects of three different medications on metabolic parameters and testicular volume in patients with hypogonadotropic hypogonadism: 3‐year experience

Cited by 15 publications

References 43 publications

Wpływ testosteronowej terapii zastępczej na stężenia witaminy D i FGF-23 w hipogonadyzmie wrodzonym

Wpływ testosteronowej terapii zastępczej na stężenia witaminy D i FGF-23 w hipogonadyzmie wrodzonym

Endothelial dysfunction, insulin resistance and inflammation in congenital hypogonadism, and the effect of testosterone replacement

Effects of androgen replacement therapy on cornea and tear function in men with idiopathic hypogonadotropic hypogonadism

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