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Endocrine
Published in: Endocrine 1/2018

Open Access 01-04-2018 | Original Paper

Metabolic phenotype of male obesity-related secondary hypogonadism pre-replacement and post-replacement therapy with intra-muscular testosterone undecanoate therapy

Authors: Georgios K. Dimitriadis, Harpal S. Randeva, Saboor Aftab, Asad Ali, John G. Hattersley, Sarojini Pandey, Dimitris K. Grammatopoulos, Georgios Valsamakis, Georgios Mastorakos, T. Hugh Jones, Thomas M. Barber

Published in: Endocrine | Issue 1/2018

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Abstract

Aim

To explore the metabolic phenotype of obesity-related secondary hypogonadism (SH) in men pre-replacement and post-replacement therapy with long-acting intramuscular (IM) testosterone undecanoate (TU).

Methods

A prospective observational pilot study on metabolic effects of TU IM in male obesity-related SH (hypogonadal [HG] group, n = 13), including baseline comparisons with controls (eugonadal [EG] group, n = 15). Half the subjects (n = 7 in each group) had type 2 diabetes mellitus (T2D). Baseline metabolic assessment on Human Metabolism Research Unit: fasting blood samples; BodPod (body composition), and; whole-body indirect calorimetry. The HG group was treated with TU IM therapy for 6–29 months (mean 14.8-months [SD 8.7]), and assessment at the Human Metabolism Research Unit repeated. T-test comparisons were performed between baseline and follow-up data (HG group), and between baseline data (HG and EG groups). Data reported as mean (SD).

Results

Overall, TU IM therapy resulted in a statistically significant improvement in HbA1C (9 mmol/mol, P = 0.03), with 52% improvement in HOMA%B. Improvement in glycaemic control was driven by the HG subgroup with T2D, with 18 mmol/mol [P = 0.02] improvement in HbA1C. Following TU IM therapy, there was a statistically significant reduction in fat mass (3.5 Kg, P = 0.03) and increase in lean body mass (2.9 kg, P = 0.03). Lipid profiles and energy expenditure were unchanged following TU IM therapy. Comparisons between baseline data for HG and EG groups were equivalent apart from differences in testosterone, SHBG and basal metabolic rate (BMR).

Conclusion

In men with obesity-related SH (including a subgroup with T2D), TU IM therapy improved glycaemic control, beta cell function, and body composition.
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Metadata
Title
Metabolic phenotype of male obesity-related secondary hypogonadism pre-replacement and post-replacement therapy with intra-muscular testosterone undecanoate therapy
Authors
Georgios K. Dimitriadis
Harpal S. Randeva
Saboor Aftab
Asad Ali
John G. Hattersley
Sarojini Pandey
Dimitris K. Grammatopoulos
Georgios Valsamakis
Georgios Mastorakos
T. Hugh Jones
Thomas M. Barber
Publication date
01-04-2018
Publisher
Springer US
Published in
Endocrine / Issue 1/2018
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-017-1516-x

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