Testosterone therapy reduces metabolic syndrome components in deficient men

Friday, November 1, 2013. On October 15, 2013, the International Journal of Clinical Practice reported the finding of Abdulmaged M. Traish, MBA, PhD of Boston University School of Medicine and his associates of a beneficial effect for testosterone therapy in lowering metabolic syndrome and related cardiovascular disease risk in hypogonadal men.

The study included 255 men aged 33 to 69 years who had sought treatment for symptoms related to low testosterone and had low plasma total testosterone levels upon assessment. All men were treated with testosterone at the beginning of the study period, at six weeks, and every twelve weeks thereafter for up to five years. Weight, height and waist circumference were measured at these time points, and blood samples were assessed for lipids, fasting glucose, hemoglobin A1c, C-reactive protein (CRP, a marker of inflammation) and liver enzymes. All but eleven of the men included in the study had three or more metabolic syndrome components, which include increased waist circumference, hypertension, disordered lipids and insulin resistance.

Treatment with testosterone nearly doubled levels of the hormone within the first year, after which concentrations remained consistent for the remainder of the observation period. Total cholesterol, which averaged 282 milligrams per deciliter (mg/dL) before treatment, was reduced to an average of 188 mg/dL after two years and remained stable. Low-density lipoprotein (LDL) cholesterol and triglycerides showed a similar pattern of decline, while high-density lipoprotein (HDL) increased.

In addition to the benefits in lipid levels observed, the men experienced a decrease in systolic and diastolic blood pressure, fasting glucose, hemoglobin A1c, CRP, and liver enzymes (which, when elevated, are associated with liver dysfunction, as well as an increased risk of metabolic syndrome).

"These findings suggest that long-term treatment of men with testosterone deficiency restoring physiological levels of testosterone produces important clinical benefits," the authors write. "This study differs from previous studies in that it followed men with testosterone deficiency for a period of five years, which is the longest reported duration of treatment to date."

"These data are congruent with our previous work in which we reported that long-term testosterone resulted in a gradual decline in weight and waist circumference and strongly suggests that testosterone therapy in hypogonadal men may prove useful in reducing the risk of cardiometabolic diseases," Dr Traish concluded.