Long-Term Testosterone Treatment in Elderly Men with Hypogonadism and Erectile Dysfunction Reduces Obesity Parameters and Improves Metabolic Syndrome and Health-Related Quality of Life

被引:115
作者
Yassin, Dany-Jan [1 ]
Doros, Gheorghe [2 ]
Hammerer, Peter G. [1 ]
Yassin, Aksam A. [3 ,4 ]
机构
[1] Klinikum Braunschweig, Dept Urol & Oncourol, D-38126 Braunschweig, Germany
[2] Boston Univ, Sch Publ Hlth, Dept Epidemiol & Stat, Boston, MA USA
[3] Inst Urol & Androl, Norderstedt Hamburg, Germany
[4] Dresden Int Univ, Dresden, Germany
关键词
Late-Onset Hypogonadism; Erectile Dysfunction; Metabolic Syndrome; Obesity; Testosterone; Testosterone Replacement Therapy; Cholesterol; Glucose; Blood Pressure; Body Mass Index; Prostate Cancer; Lower Urinary Tract Symptoms; URINARY-TRACT SYMPTOMS; BONE-MINERAL DENSITY; PROSTATE-CANCER; REPLACEMENT THERAPY; SEXUAL FUNCTION; INSULIN-RESISTANCE; BODY-COMPOSITION; UNDECANOATE; DEFICIENCY; MORTALITY;
D O I
10.1111/jsm.12523
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction Late-onset hypogonadism (LOH) is diagnosed when declining testosterone concentrations in the aging male cause unwanted symptoms such as erectile dysfunction (ED), reduced bone density and muscle strength, and increased visceral obesity. Testosterone deficiency is also associated with insulin resistance and the metabolic syndrome (MetS). Restoring testosterone to physiological concentrations has beneficial effects on many of these symptoms; however, it is not known whether these effects can be sustained in the long term. Aims To investigate whether treatment with testosterone undecanoate (TU) has a long-term and sustained effect on parameters affected by the MetS in men with LOH and ED, to determine whether long-term testosterone treatment can improve the overall health-related quality of life in these men, and to establish the safety of long-term testosterone treatment. Methods Two hundred sixty-one patients (mean age 59.5 +/- 8.4 years) diagnosed with LOH and ED were treated with long-acting TU in a prospective, observational, and longitudinal registry study. Men received intramuscular injections of 1,000mg TU at day 1, at week 6, and every 3 months thereafter. Main Outcome Measures Parameters affected by the MetS, including obesity parameters (body weight, waist circumference, and body mass index [BMI]), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, glucose, HbA1c (glycated hemoglobin), and blood pressure, as well as total testosterone levels and health-related quality of life, were assessed. Results We found TU significantly improved obesity parameters (body weight, waist circumference, and BMI) and lowered total cholesterol, LDL cholesterol, triglycerides, fasting blood glucose, HbA1c, and blood pressure over the 5-year study. HDL cholesterol was increased. TU treatment resulted in a sustained improvement in erectile function and muscle and joint pain, which contributed to an improvement in long-term health-related quality of life. Furthermore, we found a relationship between health-related quality of life and waist circumference. Finally, we found no evidence that long-term treatment with TU increases the risk of prostate carcinoma. Conclusion Long-term TU in men with LOH and ED reduces obesity parameters and improves metabolic syndrome and health-related quality of life. Yassin DJ, Doros G, Hammerer PG, and Yassin AA. Long-term testosterone treatment in elderly men with hypogonadism and erectile dysfunction reduces obesity parameters and improves metabolic syndrome and health-related quality of life. J Sex Med 2014;11:1567-1576.
引用
收藏
页码:1567 / 1576
页数:10
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