Endocrine Abstracts

Objective: This study investigated effects of testosterone replacement therapy (TRT) on the metabolic syndrome in hypogonadal men over 5 years.

Methods: Cumulative, prospective registry study of 164 men with erectile dysfunction and testosterone below 12 nmol/l presenting to a urological institution. All patients received testosterone undecanoate injections 1000 mg every 12 weeks following an initial 6-week interval for a total of 5 years.

Results: After 5 years, mean weight decreased from 104.35±13.84 (minimum 74.0, maximum 141.00) to 92.49±11.15 (minimum 67.0; maximum 124.0). This decrease was statistically significant vs baseline (P<0.0001) and each year compared to the previous year. Mean change from baseline was −9.79±0.35%. After 5 years, 96% of men had lost any weight, 82% had lost ≥5%, 58% ≥10%, 34% ≥15%, and 18% ≥20%.

Waist circumference (cm) decreased from 108.61±10.13 (minimum 88.00; maximum 148.00) to 99.03±9.05 (minimum 85.00; maximum 137.00). 98% had any reduction in waist size, 84% ≥5, 48% ≥10, 15% ≥15 cm. BMI declined from 33.21±4.23 (minimum 24.96; maximum 43.10) to 29.42±3.37 (minimum 19.58; maximum 37.39) (P<0.0001 vs baseline for all values).

Fasting glucose decreased from 112.77±35.87 to 99.02±18.1 mg/dl, HbA1c from 6.73±1.27 to 5.63±0.64%. Total cholesterol declined from 264.24±49.16 to 212.2±40.88 mg/dl, LDL from 162.31±26.28 to 126.41±33.7 mg/dl, triglycerides from 261.07±89.16 to 199.04±52.34 mg/dl. HDL increased from 40.15±13.04 to 55.62±14.66 mg/dl. Systolic blood pressure decreased from 140.01±13.61 to 122.35±5.96 mmHg, diastolic from 81.67±9.55 to 77.68±4.07 mmHg (P<0.0001 for all).

Conclusions: TRT resulted in improvements of all components of the metabolic syndrome. Reductions of weight and waist circumference were progressive and statistically significant over the full 5 years of the study.