Dimitriadis, Georgios K., Randeva, Harpal S., Saboor Aftab, S. A., Ali, Asad, Hattersley, John G., Pandey, S. B., Grammatopoulos, Dimitris, Valsamakis, Georgios, Jones, T. Hugh and Barber, T. M. (2018) Metabolic phenotype of male obesity-related secondary hypogonadism pre-replacementand post-replacement therapy with intra-muscular testosterone undecanoate therapy. Endocrine, 60 (1). pp. 175-184. doi:10.1007/s12020-017-1516-x

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Abstract

Aim:
To explore the metabolic phenotype of obesity-related Secondary Hypogonadism (SH) in men pre- 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 (9mmol/mol, P=0.03), with 52% improvement in HOMA%B. Improvement in glycaemic control was driven by the HG subgroup with T2D, with 18mmol/mol [P=0.02] improvement in HbA1C. Following TU IM therapy, there was a statistically significant reduction in fat mass (3.5Kg, P=0.03) and increase in lean body mass (2.9Kg, 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 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.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science > Engineering Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Hypogonadism, Overweight men, Testosterone -- Therapeutic use, Obesity, Diabetes
Journal or Publication Title:	Endocrine
Publisher:	Springer
ISSN:	1355-008X
Official Date:	April 2018
Dates:	Date Event April 2018 Published 2 February 2018 Available 29 December 2017 Accepted 4 November 2017 Submitted
Date of first compliant deposit:	13 March 2018
Volume:	60
Number:	1
Page Range:	pp. 175-184
DOI:	10.1007/s12020-017-1516-x
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED Bayer http://dx.doi.org/10.13039/100004326

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