Metabolic phenotype of male obesity-related secondary hypogonadism pre-replacement and post-replacement therapy with intra-muscular testosterone undecanoate therapy
Metabolic phenotype of male obesity-related secondary hypogonadism pre-replacement and post-replacement therapy with intra-muscular testosterone undecanoate therapy
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DOI：
10.1007/s12020-017-1516-x
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发表时间：
2018-04-01
期刊：
影响因子：
3.7
通讯作者：
Barber, Thomas M.
中科院分区：
文献类型：
--
作者：
Dimitriadis, Georgios K.;Randeva, Harpal S.;Barber, Thomas M.
探讨长效肌内注射十一酸睾酮（TU）替代治疗前后男性肥胖相关继发性性腺功能减退（SH）的代谢表型。一项关于TU IM对男性肥胖相关SH（性腺功能低下[HG]组，n = 13）代谢影响的前瞻性观察性先导研究，包括与对照组（性腺功能正常[EG]组，n = 15）的基线比较。一半的受试者（每组7人）患有2型糖尿病（T2D）。人体代谢研究单位的基线代谢评估：空腹血液样本；BodPod（身体成分），以及；全身间接量热法。HG组接受TU IM治疗6-29个月（平均14.8个月[SD 8.7]），并在人类代谢研究单位重复评估。基线数据与随访数据（HG组）、基线数据（HG组与EG组）进行t检验比较。数据以均数（SD）报告。总体而言，TU IM治疗导致HbA1C改善具有统计学意义（9 mmol/mol, P = 0.03）， HOMA%B改善52%。血糖控制的改善是由伴有T2D的HG亚组驱动的，HbA1C改善了18 mmol/mol [P = 0.02]。经TU IM治疗后，脂肪质量降低（3.5 Kg, P = 0.03），瘦体重增加（2.9 Kg, P = 0.03），具有统计学意义。脂质谱和能量消耗在TU IM治疗后没有变化。除了睾酮、SHBG和基础代谢率（BMR）的差异外，HG组和EG组的基线数据比较是相同的。在患有肥胖相关SH的男性（包括T2D亚组）中，TU IM治疗改善了血糖控制、β细胞功能和身体成分。
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).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).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).In men with obesity-related SH (including a subgroup with T2D), TU IM therapy improved glycaemic control, beta cell function, and body composition.