In a new study, researchers found that in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic functions.
The finding also suggests testosterone therapy (TTh) could be an effective alternative to bariatric (obesity) surgery.
The research was conducted by a team at Gulf Medical University and elsewhere.
The researchers collected data from a German registry of men in 2004 from a urological practice based in Bremerhaven.
The men all had functional hypogonadism (low testosterone without a known organic cause), and 471 of 773 men (61%) had obesity.
Of these men with obesity, 276 men received TTh with testosterone undecanoate (TU) (a 1000 mg injection in the clinic every 3 months) for up to 11 years (T-group).
The other 195 men opted against TTh and served as controls (CTRL).
Since injections were administered in the doctor’s office and documented, there was a 100% adherence to testosterone therapy. No patients dropped out of the study.
The follow-up period was about 8.8 years for the T-group and 8.4 years for controls, and the average age 60.6 years in the T-group and 63.5 years in the control group.
After 11 years of data collection in the registry, the weight (kg) decreased by about 23kg in the T group.
Conversely, there was a weight increased of 6kg in the control group. In percentage terms, the results were similar—with the T-group losing an average of 20% body weight, whereas controls increased by 6%.
In addition, waist circumference decreased by a mean 13cm in those receiving testosterone therapy and increased by 7cm in the control group.
Body mass index (BMI) fell by 7.6 points in the T-group, while it increased by 2 points in the controls.
Measurements of belly fat were also lower in the T-group.
There was also a big mortality difference between groups: 21 patients (7.6%) died in the T-group and 63 (32.3%) in the control group.
More than a quarter of men (28%) in the control group had a heart attack, and 53 (27.2%) a stroke.
There were no major cardiovascular events in the T-group. All the deaths in the T-group were related to traffic and sports accidents and post-surgical infections.
A total of 156 men (56.6%) in the T-group and 124 controls (63.6%) had type 2 diabetes.
A further 43 patients (22.1%) developed T2D during the study, meaning almost all (85%) of control patients had T2D after 11 years of follow-up.
No additional patients in the T-group developed type 2 diabetes.
The team says long-term testosterone therapy in hypogonadal men resulted in profound and sustained weight loss.
They believe testosterone therapy should be discussed with patients as an alternative to surgery and should be considered for male patients who cannot undergo surgery.
One author of the study is Dr. Farid Saad.
The study was presented at the European and International Congress on Obesity (ECOICO 2020).
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