Long-Term Testosterone Replacement Improves Survival in Men with Type 2 Diabetes and Hypogonadism

Muraleedharan, Vakkat; Marsh, Hazel; Channer, Kevin Stephen; Jones, Hugh Thomas

doi:10.1210/endo-meetings.2011.part4.or7.or35-2

Cited by 2 publications

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“…A recent observational study evaluating the mortality rate in a series of 1,031 T-treated, compared with untreated hypogonadal (total T≤8.7 nmol/L) male veterans found that men receiving TRT have a 39% decrease in mortality, when compared to their untreated counterparts 75. Similar results have been previously reported in diabetic subjects 76. Interestingly, by meta-analyzing these studies, we found that the lack of TRT doubled the risk of mortality (Fig.…”

Section: Potential Positive Outcome Of Testosterone Replacement Therapysupporting

confidence: 84%

Risks and Benefits of Late Onset Hypogonadism Treatment: An Expert Opinion

Corona

Vignozzi

Sforza

et al. 2013

World J Mens Health

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Late-onset hypogonadism (LOH) is a syndromic condition that has a well-recognized association with sexual and reproductive failure. LOH is frequently associated with chronic conditions including cardiovascular diseases (CVD), obesity, osteoporosis, HIV infection, renal failure, and obstructive pulmonary diseases. Despite this evidence, in patients with these conditions, LOH is still only rarely investigated and testosterone replacement therapy (TRT) rarely considered. In this paper, we critically reviewed the available evidence on LOH treatment focusing on possible risks and benefits. Medical therapy of LOH should be individualized depending on the etiology of the disease and the patient's expectations. The fear of prostate cancer and the risk of erythrocytosis probably represent the main limitations of TRT in aging men. However, TRT in healthy older men in near physiological doses does not appear to incur serious adverse events, although regular monitoring of prostate-specific antigen and hematocrit levels is required. Available evidence also suggests that TRT might ameliorate central obesity and glycometabolic control in patients with metabolic syndrome and type 2 diabetes. In addition, TRT has been associated with an increase in bone mineral density in men with osteoporosis, with an improvement in lean body mass in subjects with human immunodeficiency virus infection or chronic obstructive pulmonary disease, as well as with peripheral oxygenation in patients with chronic kidney diseases. Despite this evidence, however, it should be recognized that the results of these trials were heterogeneous and limited by small sample sizes. Hence, further research is required regarding the long-term benefits and adverse effects of TRT in LOH.

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Section: Potential Positive Outcome Of Testosterone Replacement Therapysupporting

confidence: 84%

Risks and Benefits of Late Onset Hypogonadism Treatment: An Expert Opinion

Corona

Vignozzi

Sforza

et al. 2013

World J Mens Health

View full text Add to dashboard Cite

show abstract

“…Testosterone replacement therapy (TRT) in androgen-deficient men is now slowly being recognised for its therapeutic potential in the management of MetS and T2DM as well as its known benefit on quality of life and sexual health. Remarkably, physiologically replacing testosterone in men with T2DM and low testosterone levels has been demonstrated to significantly improve survival (Muraleedharan et al 2011, Shores et al 2012. However, with some confounding results, a lack of long-term placebo-controlled trials and an uncertainty regarding the underlying mechanisms of action, TRT remains controversial and its use as a protective metabolic hormone in CVD is at the centre of great debate.…”

Section: Introductionmentioning

confidence: 99%

Testosterone: a metabolic hormone in health and disease

Kelly

Jones

2013

Journal of Endocrinology

423

330

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Testosterone is a hormone that plays a key role in carbohydrate, fat and protein metabolism. It has been known for some time that testosterone has a major influence on body fat composition and muscle mass in the male. Testosterone deficiency is associated with an increased fat mass (in particular central adiposity), reduced insulin sensitivity, impaired glucose tolerance, elevated triglycerides and cholesterol and low HDL-cholesterol. All these factors are found in the metabolic syndrome (MetS) and type 2 diabetes, contributing to cardiovascular risk. Clinical trials demonstrate that testosterone replacement therapy improves the insulin resistance found in these conditions as well as glycaemic control and also reduces body fat mass, in particular truncal adiposity, cholesterol and triglycerides. The mechanisms by which testosterone acts on pathways to control metabolism are not fully clear. There is, however, an increasing body of evidence from animal, cell and clinical studies that testosterone at the molecular level controls the expression of important regulatory proteins involved in glycolysis, glycogen synthesis and lipid and cholesterol metabolism. The effects of testosterone differ in the major tissues involved in insulin action, which include liver, muscle and fat, suggesting a complex regulatory influence on metabolism. The cumulative effects of testosterone on these biochemical pathways would account for the overall benefit on insulin sensitivity observed in clinical trials. This review discusses the current knowledge of the metabolic actions of testosterone and how testosterone deficiency contributes to the clinical disease states of obesity, MetS and type 2 diabetes and the role of testosterone replacement.

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Long-Term Testosterone Replacement Improves Survival in Men with Type 2 Diabetes and Hypogonadism

Cited by 2 publications

References 0 publications

Risks and Benefits of Late Onset Hypogonadism Treatment: An Expert Opinion

Risks and Benefits of Late Onset Hypogonadism Treatment: An Expert Opinion

Testosterone: a metabolic hormone in health and disease

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