Effect of Testosterone Replacement on Whole Body Glucose Utilisation and Other Cardiovascular Risk Factors in Males with Idiopathic Hypogonadotrophic Hypogonadism

Tripathy, D.; Shah, Pankaj; Reddy, K. S.

doi:10.1055/s-2007-978950

Cited by 63 publications

(38 citation statements)

References 7 publications

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“…Our study also shows that testosterone replacement therapy decreases total cholesterol in hypogonadal men, with no significant changes in HDL cholesterol. This is in agreement with two other studies which reported a similar effect of androgen supplementation on total and HDL cholesterol (38,39). Testosterone treatment has also been shown to reduce total cholesterol in hypogonadal men with coronary artery disease, even in patients already on statins (23).…”

Section: Discussionsupporting

confidence: 91%

Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

Kapoor

Goodwin²,

Channer³

et al. 2006

eur j endocrinol

699

625

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Objective: Low levels of testosterone in men have been shown to be associated with type 2 diabetes, visceral adiposity, dyslipidaemia and metabolic syndrome. We investigated the effect of testosterone treatment on insulin resistance and glycaemic control in hypogonadal men with type 2 diabetes. Design: This was a double-blind placebo-controlled crossover study in 24 hypogonadal men (10 treated with insulin) over the age of 30 years with type 2 diabetes. Methods: Patients were treated with i.m. testosterone 200 mg every 2 weeks or placebo for 3 months in random order, followed by a washout period of 1 month before the alternate treatment phase. The primary outcomes were changes in fasting insulin sensitivity (as measured by homeostatic model index (HOMA) in those not on insulin), fasting blood glucose and glycated haemoglobin. The secondary outcomes were changes in body composition, fasting lipids and blood pressure. Statistical analysis was performed on the delta values, with the treatment effect of placebo compared against the treatment effect of testosterone.

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Section: Discussionsupporting

confidence: 91%

Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

Kapoor

Goodwin²,

Channer³

et al. 2006

eur j endocrinol

699

625

View full text Add to dashboard Cite

show abstract

“…However, the data could not employ as the group of participants were not all naïve subjects (133) The effects of gonadotropin and T therapies on lipids and lipoprotein(a) were studied in 31 hypogonadal males. The data were not considered for our study since the patients were pre-pubertal men (134) This study aims to look at the T role in developing insulin resistance and other cardiovascular risks factors in men. The data were not included in the meta analysis as were obtained from a group of subjects affected by puberty delayed (135) RCT on the effects of placebo or TE (25, 50, 125, 300 or 600 mg).…”

Section: Referencesmentioning

confidence: 99%

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

Corona

Giagulli²,

Maseroli

et al. 2016

European Journal of Endocrinology

186

121

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Objective: The role of testosterone (T) in regulating body composition is conflicting. Thus, our goal is to meta-analyse the effects of T supplementation (TS) on body composition and metabolic outcomes. Methods: All randomized controlled trials (RCTs) comparing the effect of TS on different endpoints were considered. Results: Overall, 59 trials were included in the study enrolling 3029 and 2049 patients in TS and control groups respectively. TS was associated with any significant modification in body weight, waist circumference and BMI. Conversely, TS was associated with a significant reduction in fat and with an increase in lean mass as well as with a reduction of fasting glycaemia and insulin resistance. The effect on fasting glycaemia was even higher in younger individuals and in those with metabolic diseases. When only RCTs enrolling hypogonadal (total T !12 mol/l) subjects were considered, a reduction of total cholesterol as well as triglyceride (TGs) levels were also detected. Conversely, an improvement in HDL cholesterol levels as well as in both systolic and diastolic blood pressure was not observed. Conclusion: Our data suggest that TS is able to improve body composition and glycometabolic profile particularly in younger subjects and in those with metabolic disturbances. Specifically designed studies are urgently needed to confirm this point.

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“…However, androgen-induced declines in circulating HDL cholesterol should not automatically be assumed to be proatherogenic, because these declines may instead reflect accelerated reverse cholesterol transport. 63 Short-term application of supraphysiological doses of exogenous T stimulates vasorelaxation and can reduce the severity and frequency of angina pectoris and improve the electrocardiographic signs of myocardial ischemia; long-term effects have not been investigated. Nonetheless, interpretations of the effects of pharmacologic doses of androgens on arterial compliance, and flow-mediated dilatation in particular, must be treated with circumspection also because at physiological concentrations, beneficial, neutral, and detrimental effects on vascular reactivity can be observed, respectively.…”

Section: Aversa Et Almentioning

confidence: 99%

A Rationale for the Use of Testosterone “Salvage” in Treatment of Men With Erectile Dysfunction Failing Phosphodiesterase Inhibitors

Aversa¹,

Bruzziches²,

Spera³

2005

The Endocrinologist

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An age-related decline of serum testosterone (T) is reported in approximately 20% to 30% of men. However, the evaluation of total T levels may be misleading because of an increase in sex hormone-binding globulin (SHBG). Free and bioavailable T levels seem to be a better biochemical marker. Observational studies show that T concentrations are consistently lower among men with cardiovascular disease but not with erectile dysfunction (ED), suggesting a possible preventive role that requires critical evaluation with prospective studies. Hormonal replacement therapy can induce both beneficial and deleterious effects on cardiovascular risk factors by decreasing serum levels of high-density lipoprotein (HDL) cholesterol, plasminogen activator inhibitor type-1, lipoprotein (a), fibrinogen, and visceral fat mass in hypogonadal men. By contrast, the possible beneficial effects of T in cardiovascular disease include antiatherogenic and coronary vasodilator effects. Shortterm interventional studies show that T produces a modest but consistent improvement in cardiac ischemia over placebo. ED is most frequently caused by pelvic arterial insufficiency resulting from atherosclerosis, and T administration in men with arteriogenic ED produces robust vasodilator effects on the cavernous arteries. The role of T supplementation on erectile function in the era of phosphodiesterase type 5-inhibitors is discussed. (The Endocrinologist 2005;15: 99 -105) Learning Objectives • Explain the systemic vascular effects of testosterone (T) and the mechanisms by which it counters the vasorelaxant and/or vasoconstrictive changes underlying erectile dysfunction. • Describe how circulating T levels may relate to risk factors for cardiovascular disease. • Compare the possible effects of administering T with other treatments for erectile dysfunction secondary to hypogonadism.N ormal aging is associated with a decrease in total testosterone (T) levels of the order of 0.5% to 2% per year. This age-related T decline may affect either arterial reactivity or sexual function. 1 Hypogonadism in aging men, as defined by a low free testosterone index, is the result of declining testosterone production and increased sex hormone-binding globulin levels. Approximately 20% of men in their 60s and 30% of men aged 70 -79 years may have low testosterone levels. 2 Diagnosis of hypogonadism is based on clinical symptoms (eg, decreased muscle mass, fat mass ratio, bone fractures, loss of libido, and erectile dysfunction ͓ED͔) and laboratory determinations of serum testosterone, usually total T levels. Measuring bioavailable T, or free T, is expensive and time-consuming, but may more accurately detect hypogonadism. The normal range for serum total T levels in early morning hours in healthy, young men, 20 to 40 years of age, is approximatively 300 to 1000 ng/dL (10.5-35 nmol/L). Levels falling below 200 ng/dL (7 nmol/L) clearly indicate hypogonadism and the need for hormone replacement therapy (HRT). Total T levels between 200 and 400 ng/dL (7-14 nmol/L) should be repeate...

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Effect of Testosterone Replacement on Whole Body Glucose Utilisation and Other Cardiovascular Risk Factors in Males with Idiopathic Hypogonadotrophic Hypogonadism

Abstract: Insulin sensitivity does not decrease on testosterone replacement therapy of male subjects with idiopathic hypogonadotrophic hypogonadism. Testosterone replacement was associated with decrease in other cardiovascular risk factors.

Cited by 63 publications

References 7 publications

Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

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

A Rationale for the Use of Testosterone “Salvage” in Treatment of Men With Erectile Dysfunction Failing Phosphodiesterase Inhibitors

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