Five Years of Testosterone Ameliorates Metabolic Syndrome in Hypogonadal Men

Int J Clin Pract . Published online October 15, 2013   

A new observational study following men with hypogonadism taking testosterone for 5 years — the longest treatment duration to date — showed improvements in lipids, blood pressure, and blood glucose levels, thereby ameliorating a number of components of the metabolic syndrome."Men with hypogonadism, or testosterone deficiency, do get reasonable benefit from testosterone treatment, in a very subtle way," lead author Adulmaged M Traish, PhD, from Boston University School of Medicine, Massachusetts, told Medscape Medical News. "They lose a bit of weight, it reduces hyperglycemia and insulin resistance, and, although it was a surprise to me, testosterone certainly normalizes the lipid profile."

Testosterone Improves Cholesterol Over 5 Years

In their study, Dr. Traish and colleagues followed 255 men, aged 33 to 69 years of age, who had been diagnosed with subnormal plasma total testosterone levels (mean 9.93 nmol/L; range, 5.89–12.13 nmol/L) as well as at least mild symptoms of testosterone deficiency assessed by the Aging Males' Symptom scale. Testosterone therapy reduced waist circumference by an average of 8.5 cm over the course of the study, and body weight fell by a mean of 15.35 kg ( P < .0001 for both). These effects of testosterone on anthropometric parameters have been previously reported, say the researchers. Testosterone treatment resulted in a gradual and consistent decline in total-cholesterol levels, which was significant as early as 12 months of therapy and reached a plateau at 24 months. Similarly, there were marked and significant gradual and consistent decreases in LDL-cholesterol levels, and HDL-cholesterol levels slightly but significantly increased and remained elevated over the 5-year period of treatment.

Testosterone Improves BP, Blood Sugar, and HbA_1c

Testosterone treatment also produced a marked and sustained gradual decrease in systolic blood pressure and diastolic blood was significant and gradual over the first 2 years and remained low over the entire course of the 5 years of treatment.  And there was a significant gradual decrease in fasting blood glucose was significant after 12 months (P < .0001), further declined after 24 months. This was paralleled by a marked decrease in HbA_1c from 7.06% to 6.16%, which, in contrast to other parameters, was statistically significant after 12 months (P < .0001).

On a safety note, the incidence of prostate cancer was no different between Testosterone Replacement Therapy vs the general population.