June 12, 2009
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Testosterone replacement therapy improved liver function, metabolic syndrome in men with low testosterone

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The Endocrine Society's 91st Annual Meeting

Significant improvements were found in the risk for cardiovascular disease, diabetes and liver steatosis in middle-aged and older men with hypogonaidism assigned to long-term testosterone replacement therapy.

“When we talk about the metabolic syndrome we discuss several risk factors that predispose patients to type 2 diabetes and cardiovascular diseases. These risk factors are not often taken seriously and the parameters of insulin resistance, dyslipidemia and hypertension may go unnoticed for years,” said Farid Saad, PhD, head of Scientific Affairs of Men’s Healthcare at Bayer Schering Pharma in Berlin.

“It has been described in many studies that metabolic syndrome is associated with low levels of testosterone in men,” he said during a press conference. “Liver steatosis is also an important factor in the pathogenesis and is linearly correlated with all components of the metabolic syndrome.”

Saad and colleagues assessed the effects of testosterone administration on variables of metabolic syndrome and liver functions and C-reactive protein in 122 hypogonadal men aged 36 to 69. Men were assigned to parenteral testosterone undecanoate (Bayer Schering Pharma) for 24 months to 30 months. At baseline, men had testosterone levels ranging from 5.9 nmol/L to 12.1 nmol/L.

A progressive, significant decrease was found in values of BMI, waist circumference and LDL following six months of testosterone administration. In addition, HDL levels significantly increased over the study period. Serum cholesterol and triglyceride levels also significantly decreased during year one and then later stabilized. The researchers also reported continuous declines in C-reactive protein levels.

Thirty-six of 47 men who met the criteria for metabolic syndrome at baseline no longer had metabolic syndrome after two years of treatment.

“We found improvements in liver enzymes, which came as surprises because there are some warnings on testosterone labels indicating that testosterone may adversely affect liver function,” said Saad. “However, with a decrease in fat mass we found improvements in liver functions.”

“Restoring plasma testosterone levels to normal in elderly hypogonadal men leads to significant improvements in features of the metabolic syndrome and of liver steatosis. These improvements were progressive over time,” he said. – by Jennifer Southall

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