ECE2011 Poster Presentations Obesity (47 abstracts)
Testosterone and metabolic syndrome: a meta-analysis study
Giovanni Corona 1, , Matteo Monami 2 , Giulia Rastrelli 1 , Antonio Abersa 3 , Yuliya Tishova 4 , Farid Saad 5, , Andrea Lenzi 3 , Gianni Forti 8 & Mario Maggi 1
1Andrology and Sexual Medicine Unit, University of Florence, Florence, Italy; 2Diabetes Section Geriatric Unit, Department of Critical Care, University of Florence, Florence, Italy; 3Department of Medical Pathophysiology (DFM-Fisiopatologia Medica), Sapienza University, Rome, Italy; 4The Faculty of Medical Staff Refresher Training People’s Friendship University of Russia, Moscow, Russian Federation; 5Bayer Schering Pharma AG, Berlin, Germany; 6Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy; 7Gulf Medical University, Ajman, United Arab Emirates; 8Endocrinology Unit, University of Florence, Florence, Italy.
Introduction: Metabolic syndrome (MetS) is often associated with male hypogonadism. The role of testosterone replacement therapy (TRT) in MetS has not been completely clarified.
To systematically analyse the relationship between androgen levels and MetS we performed a review and meta-analyses of available prospective and cross-sectional studies. A specific meta-analysis on the metabolic effects of TRT in available randomised clinical trials (RCTs) was also performed.
Methods: An extensive Medline search was performed including the following words ‘testosterone’, ‘metabolic syndrome’ and ‘males’. Out of 323 retrieved articles, 302 articles were excluded for different reasons. Among the 20 published studies included, 13, 3, and 4 were cross-sectional, longitudinal, and RCTs, respectively. Another unpublished RCTs was retrieved on www.clinicaltrials.gov.
Results: MetS patients showed significantly lower T plasma levels, as compared to healthy individuals. Similar results were obtained when MetS subjects with and without erectile dysfunction were analyzed separately or when NCEP-ATPIII MetS criteria were compared to other definitions. Meta-regression analysis demonstrated that type 2 diabetes (T2DM) increased the MetS-associated T fall. In a multiple regression model, after adjusting for age and BMI, both T2DM and MetS independently predicted low testosterone (adj. r=−0.752; P<0.001 and −0.271; P<0.05 respectively). Analysis of longitudinal studies demonstrated that baseline testosterone was significantly lower among patients with incident MetS in comparison to controls (2.17(−2.41;−1.94) nmol/l; P<0.0001). Combining the results of RCTs, TRT was associated with a significant reduction of fasting plasma glucose, HOMA index, triglycerides and waist circumference. In addition, an increase of HDL-cholesterol was also observed.
Conclusions: The meta-analysis of the available cross-sectional data suggests that MetS can be considered an independent association of male hypogonadism. Although only few RCTs have been reported, TRT seems to improve metabolic control, as well as central obesity.
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Endocrine Abstracts
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