Testosterone and depressive symptoms among men in the Diabetes Prevention Program

Kim, Catherine; Barrett‐Connor, Elizabeth; Aroda, Vanita R.; Mather, Kieren J.; Christophi, Christopher; Horton, Edward S.; Pi‐Sunyer, Xavier; Bray, George A.; Labrie, Fernand; Golden, Sherita Hill

doi:10.1016/j.psyneuen.2016.06.009

Cited by 21 publications

(16 citation statements)

References 46 publications

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“…The adverse impact of TD on mood and depressive symptoms has been reported in several studies [355565758596061]. Although the magnitude of improvements differed among the various studies, a link between TD, mood and depressive symptoms exists.…”

Section: Benefits Of T Therapy In Men With Tdmentioning

confidence: 99%

“…By 12-month PHQ-9 scores demonstrated clinically meaningful improvement. In another study in which men (n=886) participating in the Diabetes Prevention Program were treated with metformin, T levels were associated with improvements in mood [59]. In another study Westley et al [60] showed that depression and/or depressive symptoms were present in 56% of the subjects.…”

Section: Benefits Of T Therapy In Men With Tdmentioning

confidence: 99%

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Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

Traish

2016

Investig Clin Urol

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Although testosterone therapy in men with testosterone deficiency was introduced in the early 1940s, utilization of this effective treatment approach in hypogonadal men is met with considerable skepticism and resistance. Indeed, for decades, the fear that testosterone may cause prostate cancer has hampered clinical progress in this field. Nevertheless, even after considerable knowledge was acquired that this fear is unsubstantiated, many in the medical community remain hesitant to utilize this therapeutic approach to treat men with hypogonadism. As the fears concerning prostate cancer have subsided, a new controversy regarding use of testosterone therapy and increase in cardiovascular disease was introduced. Although the new controversy was based on one ill-fated clinical trial, one meta-analysis with studies that utilized unapproved formulation in men with liver cirrhosis, and two retrospective studies with suspect or nonvalidated statistical methodologies and database contaminations, the flames of such controversy were fanned by the lay press and academics alike. In this review we discuss the adverse effect of testosterone deficiency and highlight the numerous proven benefits of testosterone therapy on men's health and debunk the myth that testosterone therapy increases cardiovascular risk. Ultimately, we believe that there is considerable scientific and clinical evidence to suggest that testosterone therapy is safe and effective with restoration of physiological levels in men with testosterone deficiency, irrespective of its etiology.

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Section: Benefits Of T Therapy In Men With Tdmentioning

confidence: 99%

Section: Benefits Of T Therapy In Men With Tdmentioning

confidence: 99%

Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

Traish

2016

Investig Clin Urol

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“…In most men, at least 10% of weight loss is required to achieve an increase in circulating testosterone. The largest study examining the effects of weight changes on testosterone concentrations was a secondary analysis of 886 men participating in the diabetes prevention programme (DPP) trial . Obese (mean BMI 32 kg/m 2 ) middle‐aged (mean age 55 years) men who were randomized to an intensive lifestyle intervention (n = 293) lost 7.9 kg over 12 months.…”

Section: How Should Obesity‐associated Hypogonadism Be Treated? Does mentioning

confidence: 99%

Hypogonadism and male obesity: Focus on unresolved questions

Grossmann

2018

Clinical Endocrinology

107

116

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Obesity, increasing in prevalence globally, is the clinical condition most strongly associated with lowered testosterone concentrations in men and presents as one of the strongest predictors of receiving testosterone treatment. While low circulating total testosterone concentrations in modest obesity primarily reflect reduced concentrations of sex hormone binding globulin, more marked obesity can lead to genuine hypothalamic-pituitary-testicular axis (HPT) suppression. HPT axis suppression is likely mediated via pro-inflammatory cytokine and dysregulated leptin signalling and aggravated by associated comorbidities. Whether oestradiol-mediated negative hypothalamic-pituitary feedback plays a pathogenic role requires further study. Although the obesity-hypogonadism relationship is bidirectional, the effects of obesity on testosterone concentrations are more substantial than the effects of testosterone on adiposity. In markedly obese men submitted to bariatric surgery, substantial weight loss is very effective in reactivating the HPT axis. In contrast, lifestyle measures are less effective in reducing weight and generally only associated with modest increases in circulating testosterone. In randomized controlled clinical trials (RCTs), testosterone treatment does not reduce body weight, but modestly reduces fat mass and increases muscle mass. Short-term studies have shown that testosterone treatment in carefully selected obese men may have modest benefits on symptoms of androgen deficiency and body composition even additive to diet alone. However, longer term, larger RCTs designed for patient-important outcomes and potential risks are required. Until such trials are available, testosterone treatment cannot be routinely recommended for men with obesity-associated nonclassical hypogonadism. Lifestyle measures or where indicated bariatric surgery to achieve weight loss, and optimization of comorbidities remain first line.

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“…Accordingly to a meta‐analysis, lifestyle changes, such as diet and increased physical activity, have only moderate effects on body weight reduction and testosterone levels. Kim et al observed that intensive lifestyle intervention for 12 months in middle‐aged men with obesity only resulted in a slight increase in total testosterone levels but no significant changes on free testosterone. Besides, as weight regain after lifestyle interventions is very common, it limits the ability to sustain the metabolic and endocrine benefits of weight loss.…”

Section: Male Hypogonadism and Obesity: Breaking The Vicious Cyclementioning

confidence: 99%

Obesity and male hypogonadism: Tales of a vicious cycle

et al. 2019

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Summary Obesity prevalence, particularly in children and young adults, is perilously increasing worldwide foreseeing serious negative health impacts in the future to come. Obesity is linked to impaired male gonadal function and is currently a major cause of hypogonadism. Besides signs and symptoms directly derived from decreased circulating testosterone levels, males with obesity also present poor fertility outcomes, further evidencing the parallelism between obesity and male reproductive function. In addition, males with androgen deficiency also exhibit increased fat accumulation and reduced muscle and mineral bone mass. Thus, compelling evidence highlights a vicious cycle where male hypogonadism can lead to increased adiposity, while obesity can be a cause for male hypogonadism. On the opposite direction, sustained weight loss can attain amelioration of male gonadal function. In this scenario, a thorough evaluation of gonadal function in men with obesity is crucial to dissect the causes from the consequences in order to target clinical interventions towards maximized improvement of reproductive health. This review will address the causes and consequences of the bidirectional relationship between obesity and hypogonadism, highlighting the implicit male reproductive repercussions.

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Testosterone and depressive symptoms among men in the Diabetes Prevention Program

Cited by 21 publications

References 46 publications

Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

Hypogonadism and male obesity: Focus on unresolved questions

Obesity and male hypogonadism: Tales of a vicious cycle

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