Body Composition, Metabolic Syndrome and Testosterone in Aging Men

C A Allan; B J G Strauss; R I McLachlan

Disclosures

Int J Impot Res. 2007;19(5):448-457. 

In This Article

Conclusion: The Role of Testosterone Therapy in Ageing Men?

Evidence from randomized controlled trials of testosterone therapy in ageing men suggests that with respect to body composition and specifically FM, those men most likely to benefit from therapy are those with low baseline testosterone levels[32,50] who receive therapy for in excess of 12 months.[31,32] While there are little data examining the effect of therapy as a function of baseline FM, it is plausible to hypothesize that those men with the greatest amount of body fat may receive the greatest benefit from testosterone therapy in this regard. Indeed it may be that ageing males with a high proportion of body fat and those with age-related hypoandrogenism represent overlapping cohorts. In the Massachusetts Male Aging Study, obese men (with no other comorbidities) had TT levels 25% lower than their non-obese peers[1] and increasing BMI was as important as age in influencing the decline in serum testosterone experienced by older men.[5] In a cohort of ageing Australian men with symptoms suggestive of hypoandrogenism, 12.1% of obese men but only 0.8% of non-obese men had TT level <8 nM.[91] As the worldwide prevalence of obesity increases, in the United States, 36% of men aged 60--74 years are obese[92] (an increase of 12% between 1988 to 1994 and 1999 to 2000), it is likely that the number of men considered to have age-related hypoandrogenism will increase in parallel. Given the strong association of obesity with metabolic syndrome[61] and excess cardiovascular morbidity and mortality,[93,94] the question as to whether testosterone therapy in older men with low testosterone levels (and likely accompanying obesity) will modify metabolic and cardiovascular risk is a timely and pertinent one.


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