NEW ORLEANS — Men with obesity and hypogonadism who underwent testosterone therapy achieved greater 10-year weight loss and experienced protective effects against cardiovascular and mortality risks compared with similar men who did not receive testosterone, according to findings presented at the Endocrine Society Annual Meeting.
Karim Haider, MD, who is a member of a private urology practice in Bremerhaven, Germany, and colleagues conducted an observational registry study of 462 men with obesity and hypogonadism. Among the cohort, 273 men (mean age, 59.8 years) took injections of testosterone undecanoate 1,000 mg for 12 weeks while 189 men (mean age, 63.5 years) did not undergo testosterone therapy and were considered the control group. Median follow-up was 9 years for the testosterone group and 8 years for the control group.
Based on measurements that were taken between one and four times per year, the researchers found that over the course of 10 years, men who had testosterone therapy lost an average of 22.9 kg compared with a weight increase of 3.2 kg in the control group (P < .0001 for all comparisons). Ultimately, in comparison to baseline measures, there was a 24.3% difference in weight loss between the testosterone group (lost 20.3%) compared with the control group (gained 3.9%; P < .0001 for all comparisons) at 10 years.
The testosterone therapy group also experienced an average reduction of 12.5 cm in waist circumference from baseline compared with a 4.6-cm increase in the control group, for a difference of 17.1 cm at 10 years (P < .0001 for all comparisons). The average BMI measure for men in the testosterone group was 7.3 kg/m2 less than at baseline while BMI measures rose by an average of 0.9 kg/m2 for men in the control group, for a difference between groups of 8.2 kg/m2 (P < .0001 for all comparisons). In terms of adverse events, there were more deaths in the control group than in the testosterone therapy group (30.2% vs. 4.4%) at 10 years
“It is important to manage expectations. In our men, weight loss at the end of the first year of treatment is only 3%. We know from placebo-controlled studies that, during the first year of testosterone therapy, the increase in lean body mass and the decrease in fat mass are of the same magnitude, which is why the effect on weight is almost neutral,” Haider told Endocrine Today, adding that medication adherence was 100% because injections were administered during office visits four times per year. “However, from the second year on, weight loss becomes clinically meaningful, and patients do not regain weight. Therefore, the clinical implication is that men need patience, and long-term treatment is a prerequisite, but that applies to all chronic diseases.” – by Phil Neuffer