European Congress of Endocrinology

European Congress of Endocrinology

Source:

Cignarelli A, et al. Abstract #743. Presented at: European Congress of Endocrinology; May 22-26, 2021 (virtual meeting).

Disclosures: Cignarelli reports no relevant financial disclosures.
May 25, 2021
2 min read
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Low-calorie ketogenic diet boosts testosterone for men with obesity

Source:

Cignarelli A, et al. Abstract #743. Presented at: European Congress of Endocrinology; May 22-26, 2021 (virtual meeting).

Disclosures: Cignarelli reports no relevant financial disclosures.
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A very low-calorie ketogenic diet promotes a dramatic and early effect on insulin resistance and testosterone levels among men with overweight or obesity, according to a small study presented at the European Congress of Endocrinology.

The findings highlight the strong relationship between glucose regulation and hepatic and testicular function, Angelo Cignarelli, MD, PhD, assistant professor in the section of internal medicine, endocrinology, andrology and metabolic diseases at the University of Bari Aldo Moro, Italy, said during a virtual presentation.

Cignarelli is an assistant professor in the section of internal medicine, endocrinology, andrology and metabolic diseases at the University of Bari Aldo Moro, Italy.

“Functional hypogonadism is seen frequently in obese adults, and we know a low-calorie ketogenic diet may rapidly affect body weight,” Cignarelli told Healio. “We also know that weight loss is associated with a rise in testosterone level; however, whether this recovery may be due to weight loss itself or some other precocious mechanism is still a matter of debate.”

Cignarelli and colleagues analyzed data from 17 men with overweight or obesity but without diabetes (mean age, 41 years; mean BMI, 36.4 kg/m²) assigned to a very low-calorie ketogenic diet for 4 weeks. Participants underwent an oral glucose tolerance test, bioelectrical impedance analysis and blood tests to assess glycemic response and levels of insulin, total testosterone, sex hormone-binding globulin and luteinizing hormone at 1 and 4 weeks.

Within the cohort, mean baseline total testosterone was 2.5 ng/mL, and mean baseline SHBG was 24.2 nmol/L.

After following the very low-calorie ketogenic diet, mean weight loss for the cohort was –9.3 kg, mean fat mass loss was –6.5 kg and mean BMI reduction was –3.1 kg/m². At 1 and 4 weeks, mean total testosterone rose by 0.49 ng/mL and of 0.89 ng/mL, respectively. Researchers also observed mean increases of 3.47 ng/mL and 10.94 ng/mL in serum SHBG levels at 1 and 4 weeks, respectively.

Assessing high vs. low responders to the diet, researchers found the high responders differed only by the level of insulin sensitivity.

“Indeed, low responders, despite a comparable level of glycemia during OGTT, displayed a significantly higher level of insulinemia, indicating that they were more insulin-resistant vs. high responders,” the researchers wrote in an abstract.

“We found a significant increase in testosterone level at the end of the study, and almost half of this rise was observed after only 1 week of nutrition intervention in parallel with a dramatic reduction of insulin levels,” Cignarelli told Healio. “Therefore, low-calorie ketogenic diet could be safely used to improve hypoandrogenemia, and possibly to rescue obese patients from functional hypogonadism.”