Hypogonadal obese men with and without diabetes mellitus type 2 lose weight and show improvement in cardiovascular risk factors when treated with testosterone: an observational study.
BACKGROUND
Treatment of obesity with diet and exercise may have short-term success but longer-term maintenance of weight loss is less successful. Obesity is associated with a reduction of serum testosterone, and, vice versa, a reduction in serum testosterone is associated with obesity and features of the metabolic syndrome.


OBJECTIVE
To investigate whether restoring serum testosterone to normal in hypo-gonadal obese men is beneficial with regard to weight loss and improvement of the metabolic syndrome.


METHODS
A prospective registry accumulated to 181 men over five years (mean serum testosterone 10.06±1.3 nmol/L (N>12.1), body mass index (BMI) ≥30 kg/m2. Of these men, 72 had diabetes mellitus type 2. All received parenteral testosterone undecanoate 1000 mg/12 weeks for up to five years.


RESULTS
Waist circumference (cm) decreased from 111.2±7.54 to 100.46±7.1, weight (kg) from 114.71±11.59 to 93.2±8.49, BMI (kg/m2) from 36.72±3.72 to 30.2±2.59 (all variables statistically significant vs. baseline (p<0.0001) and each year compared to the previous year (p<0.0001)). In the 72 diabetic men, waist circumference (cm) decreased from 112.93±7.16 to 101.48±7.24, weight (kg) from 116.94±11.62 to 94.42±9.42, BMI (kg/m2) from 37.71±3.5 to 30.95±2.69 (all variables statistically significant vs. baseline (p<0.0001) and each year compared to the previous year (p<0.0001)). In all men serum glucose, HbA1c, lipid profiles and blood pressure improved significantly. Testosterone treatment as assessed by hemoglobin, hematocrit, serum prostate specific antigen (PSA) and occurrence of prostate cancer was acceptably safe.


CONCLUSIONS
Normalizing serum testosterone in obese hypogonadal men, also in those with diabetes type 2, improved their metabolic state.
['Haider|Ahmad|A|', 'Saad|Farid|F|', 'Doros|Gheorghe|G|', 'Gooren|Louis|L|']
D000328:Adult D000368:Aged D001786:Blood Glucose D001794:Blood Pressure D015992:Body Mass Index D002318:Cardiovascular Diseases D003924:Diabetes Mellitus, Type 2 D005500:Follow-Up Studies D006442:Glycated Hemoglobin A D006400:Hematocrit D006454:Hemoglobins D006801:Humans D007006:Hypogonadism D008297:Male D024821:Metabolic Syndrome D008875:Middle Aged D009765:Obesity D010288:Parenteral Nutrition D011446:Prospective Studies D017430:Prostate-Specific Antigen D011471:Prostatic Neoplasms D012307:Risk Factors D013739:Testosterone D055105:Waist Circumference D015431:Weight Loss
Obesity Diabetes mellitus type 2 Testosterone Weight loss Waist circumference