Prostate volume and growth during testosterone replacement therapy is related to visceral obesity in Klinefelter syndrome

Selice, Riccardo; Caretta, Nicola; Mambro, Antonella Di; Torino, Mario; Palego, Pierfrancesco; Ferlin, Alberto

doi:10.1530/eje-13-0488

Cited by 18 publications

(14 citation statements)

References 37 publications

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“…A single study found triglycerides to decrease after testosterone treatment, but this might be caused by selection bias as the population as a whole at baseline had a mean triglycerides level at 117.6 ± 169.9 mg/dL, while the subset of patients followed before and after treatment at baseline had a mean triglyceride level of 311.5 ± 500.5. It is thus significantly higher than the population as a whole and the normal reference range <150 mg/dL provided by the authors (114).…”

Section: Lipidsmentioning

confidence: 57%

“…In another study, both mean serum insulin and HOMA were numerically higher in treated versus untreated KS (no statistics applied) (98), and in yet another study, KS on testosterone treatment had lower HOMA-IR than the untreated group (87), indicating some effect of treatment. Similarly, HOMA-IR, but not serum insulin, was reduced in a group of 56 men with KS after 18 months of testosterone treatment (114). Thus, the data on the effect of testosterone treatment on features of carbohydrate metabolism in KS are somewhat conflicting.…”

Section: Glucose and Insulinmentioning

confidence: 99%

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Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology

et al. 2018

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Although first identified over 70 years ago, Klinefelter syndrome (KS) continues to pose substantial diagnostic challenges, as many patients are still misdiagnosed, or remain undiagnosed. In fact, as few as 25% of patients with KS are accurately diagnosed and most of these diagnoses are not made until adulthood. Classic characteristics of KS include small testes, infertility, hypergonadothropic hypogonadism, and cognitive impairment. However, the pathophysiology behind KS is not well understood, although genetic effects are also thought to play a role. For example, recent developments in genetics and genomics point to a fundamental change in our understanding of KS, with global epigenetic and RNA expression changes playing a central role for the phenotype. KS is also associated with more general health markers, including higher morbidity and mortality rates and lower socioeconomic status (which likely affect both morbidity and mortality). In addition, hypogonadism is associated with greater risk of metabolic syndrome, type 2 diabetes, cardiovascular disease, breast cancer, and extragonadal germ cell tumors. Medical treatment typically focuses on testosterone replacement therapy (TRT), although the effects of this therapy have not been studied rigorously, and future studies need to evaluate the effects of TRT on metabolic risk and neurocognitive outcomes. This review presents a comprehensive interdisciplinary examination of recent developments in genetic, endocrine, and neurocognitive science, including the study of animal models. It provides a number of recommendations for improving the effectiveness of research and clinical practice, including neonatal KS screening programs, and a multidisciplinary approach to KS treatment from childhood until senescence.

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Section: Lipidsmentioning

confidence: 57%

Section: Glucose and Insulinmentioning

confidence: 99%

Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology

et al. 2018

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“…Furthermore, in men with Klinefelter's syndrome (primary hypogonadism) treated with testosterone to eugonadal levels, only men with a waist circumference > 94 cm had a significant increase in prostate size; 41 the implication being that visceral obesity (one of the most significant components of metabolic syndrome) is associated with prostate volume and influences prostate growth during TRT.…”

Section: Metabolic Syndrome Lower Urinary Tract Symptoms and Testostmentioning

confidence: 99%

Testosterone and benign prostatic hyperplasia

2015

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The use of testosterone to treat the symptoms of late-onset hypogonadal men has increased recently due to patient and physician awareness. However, concerns regarding the effect of testosterone on the prostate, in particular any possible effect on the risk of prostate cancer have prompted further research in this regard. Surprisingly, numerous retrospective or small, randomized trials have pointed to a possible improvement in male lower urinary tract symptoms (LUTS) in patients treated with testosterone. The exact mechanism of this improvement is still debated but may have a close relationship to metabolic syndrome. For the clinician, the results of these studies are promising but do not constitute high levels of evidence. A thorough clinical examination (including history, examination and laboratory testing of testosterone) should be undertaken before considering the diagnosis of late-onset hypogonadism or instigating treatment for it. Warnings still remain on the testosterone supplement product labels regarding the risk of urinary retention and worsening LUTS, and these should be explained to patients.

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“…[23,37] наблюдали лишь некоторое улучшение композиционного состава тела после гормональной терапии у пациентов с СК. Имеются сообщения и об отсутствии значительных изменений после терапии [40,41].…”

Section: ожирениеunclassified

Klinefelter syndrome in children and adolescents

Bespalyuk

Алексеевна²,

Чугунов

et al. 2018

Probl Endokrinol (Mosk)

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Klinefelter syndrome is a chromosomal pathology, which is the most common anomaly of sex chromosomes and the most common form of primary male hypogonadism. The presence of an extra X-chromosome in the karyotype causes infertility, azoospermia, small size of testicles, high level of gonadotropins and low level of testosterone, tallness and disproportionate physique, learning difficulties, and developmental speech disorders. Despite the high incidence of the syndrome in the population, only 25% of patients are aware of their disease during their lifetime. Late diagnosis and delayed treatment are often due to pronounced clinical polymorphism of the disease, different symptom onset time, as well as high incidence of associated conditions, so that these patients are followed by various specialists, but they are not aware of the main diagnosis. This review presents data on the history, etiology of the syndrome, clinical and laboratory features characteristic of children, adolescents, and adults. The most common associated diseases are listed and current data on their prevalence and the effect of testosterone replacement therapy on these conditions are provided.

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Prostate volume and growth during testosterone replacement therapy is related to visceral obesity in Klinefelter syndrome

Cited by 18 publications

References 37 publications

Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology

Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology

Testosterone and benign prostatic hyperplasia

Klinefelter syndrome in children and adolescents

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