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The effects of testosterone replacement therapy in men with age-dependent hypogonadism on body composition, and serum levels of leptin, adiponectin, and C-reactive protein
Abstract Introduction: Age-related hypogonadism in men leads to abnormal body composition development and overproduction of inflammatory cytokines, and thus has atherogenic and potentially cancer-promoting effects. The aim of the study was to assess the effect of age-dependent testosterone deficiency replacement in men on body composition, serum leptin, adiponectin, and C-reactive protein levels.
Material and methods: Men aged 50–65 years (56.0 ± 5.7, average ± SD), with total testosterone levels < 4 ng/mL, and clinical symptoms of hypogonadism were divided into two groups of 20 men and treated with testosterone (200 mg/two weeks intramuscularly) or placebo during 12 months.
Results: Twelve months of treatment with testosterone led to body mass index (BMI) and fat mass (FM) decrease from 26.6 ± 2.1 to 26.1 ± 1.8 kg/m2 , p < 0.05, and from 17.0 ± 4.4 to 15.6 ± 4.0 kg, p < 0.05, respectively. Body mass index and FM did not change in placebo-receiving subjects. Serum leptin and highly selective C-reactive protein (hsCRP) levels in testosterone group decreased from 6.2 ± 1.4 to 4.0 ± 1.2 μg/L, p < 0.05, and from 1.4 ± 1.2 to 1.0 ± 1.0 mg/L, p < 0.05 after 12 months, respectively. Adiponectin increased from 7.6 ± 2.5μg/mL to 9.4 ± 2.8 μg/mL, p < 0.05 in the same time. In the placebo group serum leptin, adiponectin, and hsCRP levels did not change significantly.
Conclusions: Testosterone replacement in men with age-related hypogonadism causes a decrease in body mass index, fat mass, serum leptin, and C-reactive protein levels and increases serum adiponectin levels.
Introduction
Age-related hypogonadism in men leads to changes in body composition: a decrease in fat-free mass and gain of fat mass, dysfunction of many organs, and poor quality of life [1]. Increased fat mass results in overproduction of leptin and inflammatory cytokines and a state of chronic inflammation. Elevated leptin interferes with endothelial dysfunction, increases platelet adhesion, and stimulates the migration and proliferation of smooth muscle cells, and thus has atherogenic effects [2]. Moreover, hyperleptinaemia potentially promotes cancer development [3]. On the other hand, adiponectin — a cytokine with beneficial metabolic properties — exhibits vasoprotective effects [4, 5]. C-reactive protein (CRP) is involved in atherosclerotic plaque formation and is considered as an independent risk marker for acute coronary incidents [6, 7].
Discussion
A decrease in testosterone secretion significantly contributes to changes in the body composition of the aging male [10]. Fat-free mass decreases and the enhancement of fat mass is observed. Adipose tissue starts to produce proinflammatory cytokines. Serum leptin and CRP are higher, and adiponectin levels decrease [11]. Lowering of the energy expenditure and insulin sensitivity associated with obesity lead to metabolic syndrome development and augmentation of cardiovascular risk. In our study, we demonstrate that 12-month testosterone supplementation reduces fat mass, significantly lowers leptin levels, and increases adiponectin levels.
Conclusions
Testosterone replacement in men with age-related hypogonadism causes a decrease in BMI, fat mass, serum leptin, and CRP levels and increases serum adiponectin levels.
Abstract Introduction: Age-related hypogonadism in men leads to abnormal body composition development and overproduction of inflammatory cytokines, and thus has atherogenic and potentially cancer-promoting effects. The aim of the study was to assess the effect of age-dependent testosterone deficiency replacement in men on body composition, serum leptin, adiponectin, and C-reactive protein levels.
Material and methods: Men aged 50–65 years (56.0 ± 5.7, average ± SD), with total testosterone levels < 4 ng/mL, and clinical symptoms of hypogonadism were divided into two groups of 20 men and treated with testosterone (200 mg/two weeks intramuscularly) or placebo during 12 months.
Results: Twelve months of treatment with testosterone led to body mass index (BMI) and fat mass (FM) decrease from 26.6 ± 2.1 to 26.1 ± 1.8 kg/m2 , p < 0.05, and from 17.0 ± 4.4 to 15.6 ± 4.0 kg, p < 0.05, respectively. Body mass index and FM did not change in placebo-receiving subjects. Serum leptin and highly selective C-reactive protein (hsCRP) levels in testosterone group decreased from 6.2 ± 1.4 to 4.0 ± 1.2 μg/L, p < 0.05, and from 1.4 ± 1.2 to 1.0 ± 1.0 mg/L, p < 0.05 after 12 months, respectively. Adiponectin increased from 7.6 ± 2.5μg/mL to 9.4 ± 2.8 μg/mL, p < 0.05 in the same time. In the placebo group serum leptin, adiponectin, and hsCRP levels did not change significantly.
Conclusions: Testosterone replacement in men with age-related hypogonadism causes a decrease in body mass index, fat mass, serum leptin, and C-reactive protein levels and increases serum adiponectin levels.
Introduction
Age-related hypogonadism in men leads to changes in body composition: a decrease in fat-free mass and gain of fat mass, dysfunction of many organs, and poor quality of life [1]. Increased fat mass results in overproduction of leptin and inflammatory cytokines and a state of chronic inflammation. Elevated leptin interferes with endothelial dysfunction, increases platelet adhesion, and stimulates the migration and proliferation of smooth muscle cells, and thus has atherogenic effects [2]. Moreover, hyperleptinaemia potentially promotes cancer development [3]. On the other hand, adiponectin — a cytokine with beneficial metabolic properties — exhibits vasoprotective effects [4, 5]. C-reactive protein (CRP) is involved in atherosclerotic plaque formation and is considered as an independent risk marker for acute coronary incidents [6, 7].
Discussion
A decrease in testosterone secretion significantly contributes to changes in the body composition of the aging male [10]. Fat-free mass decreases and the enhancement of fat mass is observed. Adipose tissue starts to produce proinflammatory cytokines. Serum leptin and CRP are higher, and adiponectin levels decrease [11]. Lowering of the energy expenditure and insulin sensitivity associated with obesity lead to metabolic syndrome development and augmentation of cardiovascular risk. In our study, we demonstrate that 12-month testosterone supplementation reduces fat mass, significantly lowers leptin levels, and increases adiponectin levels.
Conclusions
Testosterone replacement in men with age-related hypogonadism causes a decrease in BMI, fat mass, serum leptin, and CRP levels and increases serum adiponectin levels.
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