Effects of Intermission and Resumption of Long-term Testosterone Replacement Therapy on Body Weight and Metabolic Parameters in Hypogonadal in Middle-aged and Elderly Men

Aksam Yassin; Yousef Almehmadi; Farid Saad; Gheorghe Doros; Louis Gooren

Disclosures

Clin Endocrinol. 2016;84(1):107-114. 

In This Article

Results

Results are presented in Table 1 and Figs 1-5. Serum total and free T levels increased significantly in both Group C and Group I (Fig. 1). In Group C, the achieved serum T levels were maintained over the study period, while in Group I, these levels returned to baseline to reach pre-intermission levels after the resumption of T treatment. Sex hormone binding globulin (SHBG) declined modestly in the C Group and then remained stable in the further course of T administration, but in the last part of the observation period, a further modest but significant decrease was noted. In the I Group, SHBG levels declined significantly upon T administration, increased significantly during the intermission period and decreased significantly again during the resumption of T (Table 1, Fig. 1).

Figure 1.

Hormones

Figure 2.

Anthropometry

Figure 3.

Glycaemic control

Figure 4.

Blood pressure

Figure 5.

Lipids

In the C Group, body weight, BMI and waist circumference declined progressively and significantly over the study period (Table 1 and Fig. 2). In the I Group, a similar pattern was observed before the intermission. During the intermission, these variables increased significantly and declined significantly again when T treatment was reinstated but the lower values of the pre-intermission period were not attained (Table 1).

Fasting glucose levels declined significantly upon the initiation of T treatment in both groups (Table 1 and Fig. 3). In the C Group, these levels remained stable but upon longer-term treatment, there was a further decline. In the I Group, serum glucose increased significantly upon withdrawal of T treatment and returned again to pre-intermission values when T was reinstated. A similar pattern was observed for HbA1c (Table 1 and Fig. 3).

Serum cholesterol, LDL cholesterol and triglycerides declined progressively in the C Group over the study period and so did the ratio of total cholesterol: HDL as well as non-HDL cholesterol. In the I Group, there was a similar decline before the intermission and levels increased again during the intermission to return again to levels before the intermission when T treatment was resumed. HDL moved into opposite directions (Table 1 and Fig. 5).

The pattern observed for total cholesterol was also encountered with the serum transaminases (Table 1).

Systolic and diastolic blood pressure decreased and stabilized in the C Group. In the I Group, there was a significant increase in systolic blood pressure during the intermission, but not in diastolic blood pressure that remained stable. Pulse pressure decreased in both groups before the intermission period. In the I Group, pulse pressure increased during the intermission and returned to pre-intermission values after the resumption of T treatment (Table 1 and Fig. 4).

Serum C-reactive protein (CRP) showed an initial decline in the C Group. In the I Group, levels declined during T administration, moderately increased during the intermission and declined again when T administration was reinstated (Table 1).

The AMS questionnaire (assessing health-related quality of life and symptoms in ageing men) showed an improvement when men received T, which was lost during the intermission, but regained after the resumption of T treatment.

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