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Total serum testosterone levels in hypogonadal men over the course of 60 months of testosterone treatment.
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Hypogonadism is associated with increased fat mass and reduced muscle mass, which contributes to obesity and health risks, such as cardiovascular disease.Testosterone treatment of hypogonadal men improves muscle mass and reduces fat mass; however, many of these studies are of short duration.Thus, the long-...
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... Следует помнить, что гипогонадизм, особенно длительно текущий, зачастую приводит к метаболическим нарушениям, которые наблюдались в вышеописанном клиническом случае. По данным ряда исследований, снижение уровня тестостерона проявляется не только снижением либидо и эректильной дисфункцией, но и способствует уменьшению количества мышечной массы, | 73 Вестник репродуктивного здоровья / Bulletin of Reproductive Health развитию ожирения, остеопении, остеопороза, сахарного диабета, увеличению рисков сердечно-сосудистых заболеваний [11][12][13][14]. При обсуждении данного клинического наблюдения важно упомянуть о частом осложнении в послеоперационном периоде после транссфеноидального хирургического вмешательствагипонатриемии, своевременная диагностика и коррекция которого позволяет избежать серьезных и даже жизнеугрожающих последствий. ...
The prevalence of pituitary adenomas in the population among tumors of the central nervous system is about 17%. Pituitary adenomas are divided into non-functional (about 36–54%), characterized by the absence of secretory activity, and functional (about 46–64%), secreting hormones or their subunits. The most common are prolactinomas (32–51%), somatotropinomas (9– 11%), corticotropinomas (3–6%), the frequency of gonadotropins and thyrotropins is low and amounts to less than 1% of cases. This article presents a clinical observation of a patient with gonadotropinoma, which has been occurring for a long time under the guise of hyperprolactinemia.
... Conflicting results are available on the effect of testosterone on lipids, which mostly appear already after 4 weeks (33). Table 2 shows an overview of studies investigating metabolic and anthropometric parameters (32,39,41,43,45,53,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80). ...
Testosterone therapy is the cornerstone in the care of men with hypogonadism and transgender males. Gel and intramuscular injections are most frequently used, and are registered and included in the international guidelines. The specific preparation should be selected according to the patient’s preference, cost, availability, and formulation-specific properties. As the majority of men with hypogonadism and transgender males require lifelong treatment with testosterone, it is important to utilize a regimen that is effective, safe, inexpensive and convenient to use with optimal mimicking of the physiological situation. This systematic review reviews current literature on differences between the three most used testosterone preparations in adult men with hypogonadism and transgender males. Although it appeared hardly any comparative studies have been carried out, there are indications of differences between the preparations, e.g. on stability of testosterone levels, hematocrit, bone mineral density, and patient satisfaction. However, there are no studies on the effects of testosterone replacement on endpoints such as cardiovascular disease in relation to hematocrit, or osteoporotic fractures in relation to bone mineral density. The effect of testosterone therapy on health-related quality of life is strongly underexposed in the reviewed studies, while this is a highly relevant outcome measure from a patient perspective. In conclusion, current recommendations on testosterone treatment appear to be based on data primarily from non-randomized clinical studies and observational studies. The availability of reliable comparative data between the different preparations will assist in the process of individual decision making to choose the most suitable formula.
... A recent meta-analysis examining the prevalence of endocrine disorders in obese men reported the prevalence of hypogonadism to be 42.8% when determined by measuring total T (589). Numerous studies have also reported that TRT was associated with significant weight loss among men with hypogonadism and obesity (203,204,244,314,506,507,583,644,584). However, most of such reports were based on observational data gathered via one or two registries at various intervals of time. ...
Cardiovascular disease (CVD) continues to be the leading cause of death in adults, highlighting the need to develop novel strategies to mitigate cardiovascular risk. The advancing obesity epidemic is now threatening the gains in CVD risk reduction brought about by contemporary pharmaceutical and surgical interventions. There are sex differences in the development and outcomes of CVD; premenopausal women have significantly lower CVD risk than men of the same age, but women lose this advantage as they transition to menopause, an observation suggesting potential role of sex hormones in determining CVD risk. Clear differences in obesity and regional fat distribution among men and women also exist. While men have relatively high fat in the abdominal area, women tend to distribute a larger proportion of their fat in the lower body. Considering that regional body fat distribution is an important CVD risk factor, differences in how men and women store their body fat may partly contribute to sex-based alterations in CVD risk as well. This article presents findings related to the role of obesity and sex hormones in determining CVD risk. Evidence for the role of sex hormones in determining body composition in men and women is also presented. Lastly, the clinical potential for using sex hormones to alter body composition and reduce CVD risk is outlined. © 2022 American Physiological Society. Compr Physiol 12:1-45, 2022.
... In this observational study, 5 years of testosterone treatment led to marked and significant decrease in body weight, waist circumference and body mass index. 31 Even when focusing solely on elderly men with hypogonadism and erectile dysfunction, testosterone undecanoate similarly led to significant improvements in the same obesity parameters. 32 The reduction in metabolic risk is likely multifactorial. ...
Background:
While previous studies have demonstrated testosterone's beneficial effects on glycemic control in men with hypogonadism and Type 2 Diabetes, the extent to which these improvements are observed based on the degree of treatment adherence has been unclear.
Objectives:
To evaluate the effects of long-term testosterone therapy in A1C levels in men with Type 2 Diabetes Mellitus and hypogonadism, controlling for BMI, pre-treatment A1C, and age among different testosterone therapy adherence groups.
Materials and methods:
We performed a retrospective analysis of 1737 men with diabetes and hypogonadism on testosterone therapy for 5 years of data from 2008-2018, isolating A1C, lipid panels, and BMI results for analysis. Subjects were categorized into adherence groups based on quartiles of the proportion of days covered (> 75% of days, 51-75% of days, 26-50% of days and 0-25% of days), with >75% of days covered considered adherent to therapy.
Results:
Pre-treatment median A1C was 6.8%. Post-treatment median A1C was 7.1%. The adherent group, >75%, was the only group notable for a decrease in A1C, with a median decrease of -0.2 (p=0.0022). BMI improvement was associated with improved post-treatment A1C (p= 0.007). When controlling for BMI, age, and pre-treatment A1C, the > 75% adherence group was associated with improved post-treatment A1C (p < 0.001).
Discussion:
When controlling for all studied variables, testosterone adherence was associated with improved post-treatment A1C. The higher the initial A1C at the initiation of therapy, the higher the potential for lowering the patient's A1C with >75% adherence. Further, all groups showed some reduction in BMI, which may indicate that testosterone therapy may affect A1C independent of weight loss.
Conclusion:
Even when controlling for improved BMI, pre-treatment A1C, and age, testosterone positively impacted glycemic control in diabetes patients with hypogonadism, with the most benefit noted in those most adherent to therapy (>75%).
... Studies suggest that obese men can increase their testosterone levels upon weight loss, either by supervised diet, exercise, or, in more extreme cases, bariatric surgery [19][20][21]. Other treatments make use of hormone replacement therapy or testosterone gel supplementation [22][23][24][25], in which testosterone treatment reduced visceral adiposity and waist circumference [26][27][28]. In sum, a number of studies have shown that the increase in testosterone levels can lead to weight loss and vice versa [14]. ...
Testosterone is the most important male sex hormone, and its deficiency brings many physical and mental harms. Efficiently identifying individuals with low testosterone is crucial prior to starting proper treatment. However, routine monitoring of testosterone levels can be costly in many regions, resulting in an underreporting of cases, especially in developing countries. Moreover, there are few studies that employ machine learning (ML) in prognosticating testosterone deficiency. This research, therefore, aims to offer a coherent comparative analysis of machine learning methods that can predict testosterone deficiency without having patients undergo costly medical tests. In doing so, we seek to provide to the urological community a publicly available dataset (https://github.com/osmarluiz/Testosterone-Deficiency-Dataset) to increase research in this yet untapped field. For this analysis, we used ten base classifiers (optimized with grid search stratified K-fold Cross Validation); three ensemble methods; and eight sampling strategies to analyze a total of 3,397 patients. The analysis was based on six features (age; abdominal circumference; triglycerides; high-density lipoprotein; diabetes; and hypertension), all of which obtained by low-cost out-of-pocket exams. We compared the sampling strategies and the classifiers' performance on an independent test set using ranking (PR-AUC), probabilistic (Brier score), and threshold metrics. We found that: (1) within the ranking metrics, sampling strategies did not enhance results in this slightly imbalanced (4:1 ratio) dataset; (2) the ensemble classifier using weighted average presented the best performance; (3) the best base classifier was XGBoost; (4) calibration showed significant improvement for the sampling strategies and slight improvements for the no sampling strategy; (5) the McNemar's test presented statistically similar results among all classifiers; and (6) abdominal circumference (AC) had by far the highest feature importance, followed by triglycerides (TG). Age, on the other hand, showed very little significance in predicting testosterone deficiency.
... Data mainly derived from observational studied showed that TTh is potentially effective treatment in aging obese men with TD [27]. There is also some evidence that long-term T may result in substantial and sustained reductions in body weight, waist circumference and BMI in obese hypogonadal men [114][115][116]. The successful achievement of weight loss, as well as the consistent increase in lean mass, lead to beneficial effects on diabetes mellitus type 2 [117]. ...
The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age globally. One in four persons living in Europe and Northern America will be aged 65 or over. One of the goals of ISSAM is to raise awareness of the special health needs of older men. Since a significant number of aging men will eventually become testosterone deficient, the Hypogonadism panel of ISSAM updates its guidelines.
... Prospective studies of men with FH who were receiving TU showed 5% decrease in body weight in the first year of TTh and greater than 13% decrease after 5 years [51]. These effects are most notable in patients with high BMI [52]. Testosterone increases lean body mass, an effect that is superior to other drugs (anti-obesity or antidiabetic medications) either alone or in combination with behavioral and lifestyle modifications [53]. ...
Objective
We evaluated long-term effects of testosterone undecanoate on glycemic control, metabolic syndrome, vascular function and morphology in obese men with functional hypogonadism (FH) and type 2 diabetes (T2D) in a 2-year prospective clinical trial.
Methods
A total of 55 participants were enrolled in this study; group P (n = 27) received placebo during first and testosterone therapy (TTh) during second year, group T (n = 28) received TTh both years. We pooled results after 1 year of TTh to obtain more statistical power. Results for group T after 2 years of TTh are also presented. We evaluated wide assortment of biochemical (fasting plasma glucose—FPG, glycated hemoglobin—HbA1c and lipid profile), hormonal, vascular (flow-mediated dilatation—FMD and intima-media thickness—IMT), anthropometrical and derived parameters (BMI, HOMA-IR, non-HDL cholesterol, bioavailable and calculated free testosterone). Quality of life was assessed using Aging Males’ Symptoms (AMS) questionnaire.
Results
FPG, HbA1c, HOMA-IR and IMT decreased, FMD increased, lipid profile and AMS sexual sub-score improved, and testosterone levels fully normalized after 2 years of TTh.
Conclusions
Two-year of TTh resulted in normalized serum testosterone levels, improved glycemia, endothelial function, lipids and insulin sensitivity, and quelled the symptoms of hypogonadism, potentially reducing cardiovascular risk in obese men with FH and T2D.
... The beneficial effects of testosterone on the body composition and on the cardio-metabolic estimates are well-established [14]. Testosterone replacement in deficient individuals ameliorates metabolic parameters [15], improves vascular function [16], and reduces body weight [17]. Finally, it has been shown that longterm testosterone therapy improves urinary sexual function and QoL in men with hypogonadism [18]. ...
... All subjects were required to have a stable body weight throughout the sports season (no weight changes >3%). Significant changes in fat mass and fat-free mass (FFM) are associated with circulating T concentrations due to their role in energy metabolism and adipogenesis [26]. The participants did not take regular medication, anti-inflammatory medications or nutritional supplementation during the two weeks prior to the measurements. ...
The aim of this study was to determine the possible changes in plasma of several hormones such as Luteinizing Hormone, Testosterone, Cortisol and Insulin in endurance runners during the sports season. Twenty-one high-level male endurance runners (22 ± 3.2 years, 1.77 ± 0.05 m) participated in the study. Basal plasma hormones were measured at four moments during the season (initial, 3, 6 and 9 months), and were analyzed using ELISA (enzyme-linked immunosorbent assay). Testosterone and Luteinizing Hormone (LH) suffered very significant decreases (p < 0.01) at 3 months compared with the beginning and an increase (p < 0.05) at 6 and 9 months compared with 3 months. Insulin level was significantly lower (p < 0.05) at 3, 6 and 9 months compared with the initial test. Insulin and cortisol were associated inversely (r = 0.363; β = −0.577; p = 0.017) and positively (r = 0.202; β = 0.310; p = 0.043), respectively, with the amount of km per week performed by the runners. There was a significant association between km covered at a higher intensity than the anaerobic threshold and I (r = 0.580; β = −0.442; p = 0.000). Our findings indicate that testosterone, LH and insulin were more sensitive to changes in training volume and intensity than cortisol in high-level endurance runners. Basal testosterone and LH concentrations decrease in athletes who perform a high volume of aerobic km in situations of low energy availability.
... It is reported by many studies that the overweight and obese individuals are at high risk of developing caradiovascular diseases [8][9][10]. Phramceuticals and their effects on body weight is considered as strong obesity affecting factor such as the endocrine disrupting chemicals and the endocrine therapy [10,11]. There is strong association between aging, low blood concentration of testosterone and obesity. ...
Objective: This article investigated the effect of age and body mass index of male humans on the carotid arteries intima media thickness (IMT) and the blood concentration of glucose, triglycerides, total cholesterol and HDL cholesterol.
Methods: Thirty seven normal male human subjects participated in this study. The participants were classified to three groups depending on their age; 20–29 (11), 30–39 (14) and 40–49 (12). Also, the study subjects were divided to three groups according to their body mass index; normal (13), overweight (13) and obese (11). The Anova test was used for the statistical analysis of the obtained results.
Results: The body mass index significantly affected the blood glucose concentration while its effect on all the other parameters was insignificant. The age significantly affected all the studied parameters except the blood glucose, triglycerides and HDL cholesterol. The total cholesterol/HDL ratio was significantly affected by the age and insignificantly by the body mass index.
Conclusions: The age was more effective on the studied parameters than the body mass index. Worsening of the lipid profile was seen in the overweight participants rather than the obese ones.
