Effects of Oxandrolone on Cardiometabolic Health in Boys With Klinefelter Syndrome: A Randomized Controlled Trial

Context: Klinefelter syndrome (KS) is a common condition in males, resulting in androgen deficiency and cardiometabolic diseases. These interrelated conditions may be present in prepubertal boys with KS. Objective: To determine whether supplemental low-dose androgen has a beneficial effect on body composition in prepubertal boys with KS. Design, Setting, and Participants: We conducted a secondary analysis of a randomized, double-blind, placebo-controlled clinical trial in 93 boys with KS aged 4 to 12 years. Interventions: Oral oxandrolone (Ox) 0.06 mg/kg/d or placebo for 2 years. Outcome Measures: The primary outcome was percent body fat standard deviation score (% BF SDS) at 2 years. Secondary outcomes included additional measures of cardiometabolic health and safety. Results: The % BF SDS at 2 years was significantly lower in the treatment (0.29 +/- 0.76 SDS) compared with placebo group (0.81 +/- 0.72 SDS) after adjusting for age and baseline % BF SDS (95% confidence interval for the difference between means 20.86 to 20.19 SDS, P = 0.009). Ox resulted in lower triglycerides (P = 0.043), but also lower high-density lipoprotein (HDL) cholesterol (P, 0.001) and a more rapid advancement in bone age (P = 0.011). Conclusions: Ox has positive effects on measures of cardiometabolic health in prepubertal boys with KS; however, it does lower HDL cholesterol and advance bone age.