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Weight Loss Ups Testosterone

Weight loss had a marked effect on reducing the prevalence of hypogonadism in obese men with impaired glucose intolerance.

By Charles Bankhead, MedPage Today

Medically Reviewed byZalman S Agus, MD

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HOUSTON — WEDNESDAY, June 27, 2012 (MedPage Today) —The prevalence of hypogonadism decreased by almost 50 percent in overweight men who lost weight by means of lifestyle changes, investigators reported here.

Men who increased physical activity and modified their diet had a hypogonadism prevalence of 11 percent after 1 year, as compared with 20 percent at baseline, Andrew A. Dwyer, MD, reported at ENDO 2012.

Treatment with metformin did not significantly affect testosterone levels in one group of men studied, all of whom had impaired glucose tolerance, said Dwyer, of Massachusetts General Hospital in Boston.

Changes in testosterone levels had significant associations with body weight, waist circumference, and the homeostatic model assessment (HOMA) of insulin deficiency and insulin resistance, he noted.

"Lifestyle modification really was important in reducing the percentage of men with low testosterone levels," Dwyer said. "Weight loss appears to play an important beneficial role in improving testosterone levels."

Testosterone levels increased without a compensatory increase in luteinizing hormone (LH), suggesting that enhanced Leydig-cell responsiveness drives the increase in testosterone, he added.

Testosterone has an inverse association with insulin resistance, which increases with body weight. Whether changes in body weight and insulin sensitivity affect serum testosterone levels has not been examined carefully.

The Diabetes Prevention Program (DPP) database afforded an opportunity to study relationships among testosterone, body weight, plasma glucose, and insulin sensitivity. Dwyer and colleagues evaluated a subset of 891 DPP participants, who had been randomized to lifestyle intervention, metformin, or placebo as part of the overall study protocol.

Mean values for baseline characteristics included age 53 to 54, body mass index (BMI) 32, waist circumference 107 cm, fasting insulin 26 µIU/L, fasting glucose 108 mg/dL, HOMA 7.1, and glycated hemoglobin (HbA1c) 6 percent.

Testosterone mean values ranged between 394 and 417 ng/dL across the three treatment groups. Dwyer reported that the prevalence of hypogonadism (testosterone

Lifestyle intervention included 150 minutes of physical activity weekly and adherence to a diet that had less fat and fewer calories than their regular diet.

After a year of follow-up, the mean testosterone level had not changed significantly from baseline in the overall study population. However, men randomized to lifestyle intervention had a statistically significant 15 percent increase in testosterone. Testosterone levels did not change significantly in the other two groups.

The proportion of men with low testosterone levels declined significantly in the intervention group but did not change in the other two groups.

The mean LH level remained at 3.1 IU/L from baseline to the end of the study in the overall study population and did not change significantly in any of the treatment groups.

The increase in testosterone in the lifestyle group occurred in association with weight loss that averaged 17 pounds, and the metformin group's average weight decreased by about 6 pounds. Mean weight did not change in the placebo group. The weight loss in the lifestyle group was significantly greater than in the metformin and placebo groups.

Testosterone's inverse associations with weight, waist circumference, and HOMA all achieved statistical significance. Hypogonadal men appeared to derive more benefit from lifestyle intervention than did men with baseline testosterone levels >300 ng/dL, said Dwyer.


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Date: 11.12.2018, 05:00 / Views: 52532