J Korean Soc Endocrinol.  2005 Jun;20(3):252-260. 10.3803/jkes.2005.20.3.252.

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

• Hong ES
• Kim SY
• Choi YJ
• Kim SW
• Shin CS
• Park KS
• Jang HC
• Kim SY
• Cho BY
• Lee HK

• KMID: 2200565
• DOI: http://doi.org/10.3803/jkes.2005.20.3.252

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+/- 0.57ng/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

MeSH Terms

Adipose Tissue
Body Composition
Cardiovascular Diseases
Cholesterol
Cholesterol, HDL
Coronary Disease
Fasting
Homocysteine
Humans
Hypogonadism
Incidence
Insulin
Insulin Resistance
Interleukin-6
Intra-Abdominal Fat*
Male
Multiple Endocrine Neoplasia Type 1
Obesity, Abdominal
Plasma
Risk Factors*
Testosterone*
Tomography, X-Ray Computed
Cholesterol
Cholesterol, HDL
Homocysteine
Insulin
Interleukin-6
Testosterone

Figure

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  Fig. 1 Fasting insulin and HOMA-IR in 26 men with hypogonadism who were replaced with testosterone for 12months

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  Fig. 2 Lipid parameters in 26 men with hypogonadism who were replaced with testosterone for 12months

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  Fig. 3 Non-traditional cardiovascular risk factors in 26 men with hypogonadism who were replaced with testosterone for 12months

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