The Effects on Visceral Fat and Cardiovascular Risk Factors of Testosterone Replacement in Secondary Hypogonadal Men

Abstract

Background: Increased body fat, abdominal obesity and insulin resistance are important clinical features in hypogonadal men. Several studies have demonstrated that a low testosterone concentration in men is associated with coronary heart disease, visceral obesity and insulin resistance. In this study, the effects of testosterone replacement therapy on the abdominal visceral fat and cardiovascular risk factors in hypogonadal men were investigated.Methods: We selected 26 men with secondary hypogonadism (mean serum testosterone ± SD 0.39 ± 0.57 ng/mL), who were then treated with testosterone for 12 months. We measured the body composition, including the abdominal visceral fat area by abdominal CT at the L4 level, both before and 12 months after treatment, and the lipid profile, fasting plasma insulin, HOMA-IR and the serum homocysteine, CRP and IL-6 before and 6, 12 months after treatment.Results: With respect to the body composition, the lean body mass had significantly increased 12 months after treatment (P = 0.002), but there were no significant changes in the body fat mass and abdominal visceral fat area. There was a trend toward a decreased fasting plasma insulin and HOMA-IR, but this did not reach statistical significance. The total cholesterol had decreased significantly at 12 months (P = 0.04) and the HDL cholesterol decreased significantly over the course of study (P = 0.02). There were no significant changes in the serum homocysteine, CRP and IL-6 after treatment.Conclusions: After 12 months testosterone replacement therapy in the 26 men with hypogonadism, the lean body mass had increased significantly, but there was no significant change on the abdominal visceral fat during the treatment period. Testosterone replacement had deleterious effect on HDL cholesterol, but not significant effects on insulin resistance and the serum homocysteine, CRP and IL-6. These results suggest that testosterone replacement therapy may have a few adverse effects on cardiovascular diseases in hypogonadal men. However, it will be necessary to examine the long-term effects of testosterone replacement on the incidence of cardiovascular events as well as the cardiovascular risk factors in men with hypogonadism (J Kor Soc Endocrinol 20:252～260, 2005). ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Androgen Receptor Gene CAG Repeat Polymorphism and Effect of Testosterone Therapy in Hypogonadal Men in Korea

“…BMI, body mass index; DXA, dual energy X-ray absorptiometry; BMD, bone mineral density; NTx, type I collagen N-telopeptide; HDL, high-density lipoprotein cholesterol; LDL cholesterol, low-density lipoprotein cholesterol; PSA, prostate-specific antigen. The mean number of CAG repeats was 23 ± 3 (range, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”

“…Second, the number of CAG repeats was different (21 ± 4 [range, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] vs. 23 ± 3 [range, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]), which may be due to a racial difference. Another reason may be the difference in study methods.…”

Effects of Androgen on the Cardiovascular System in the Aging Male

“…Alterations in HDLcholesterole under testosterone therapy are usually described as a slight decline. [57][58][59] Wang et al investigated the effect of testosterone gel on 142 patients for 42 months, reporting no significant change in serum LDL and cholesterol, but a slight increase in serum HDL levels. Despite the modicum changes in lipid profile, patients showed significant improvements in body composition.…”