Influence of methyltestosterone postmenopausal therapy on plasma lipids, inflammatory factors, glucose metabolism and visceral fat: a randomized study.
BACKGROUND
There has been a growing interest in treating postmenopausal women with androgens. However, hyperandrogenemia in females has been associated with increased risk of cardiovascular disease.


OBJECTIVE
We aimed to assess the effects of androgen replacement on cardiovascular risk factors.


METHODS
Thirty-seven postmenopausal women aged 42-62 years that had undergone hysterectomy were prospectively enrolled in a double-blind protocol to receive, for 12 months, percutaneous estradiol (E2) (1 mg/day) combined with either methyltestosterone (MT) (1.25 mg/day) or placebo.


METHODS
Along with treatment, we evaluated serum E2, testosterone, sex hormone-binding globulin (SHBG), free androgen index, lipids, fibrinogen, and C-reactive protein; glucose tolerance; insulin resistance; blood pressure; body-mass index; and visceral and subcutaneous abdominal fat mass as assessed by computed tomography.


RESULTS
A significant reduction in SHBG (P < 0.001) and increase in free testosterone index (P < 0.05; Repeated measures analysis of variance) were seen in the MT group. Total cholesterol, triglycerides, fibrinogen, and systolic and diastolic blood pressure were significantly lowered to a similar extent by both regimens, but high-density lipoprotein cholesterol decreased only in the androgen group. MT-treated women showed a modest rise in body weight and gained visceral fat mass relative to the other group (P < 0.05), but there were no significant detrimental effects on fasting insulin levels and insulin resistance.


CONCLUSIONS
This study suggests that the combination of low-dose oral MT and percutaneous E2, for 1 year, does not result in expressive increase of cardiovascular risk factors. This regimen can be recommended for symptomatic postmenopausal women, although it seems prudent to perform baseline and follow-up lipid profile and assessment of body composition, especially in those at high risk of cardiovascular disease.
Leão
Lenora M Camarate S M
LM
Service of Endocrinology, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil. lenora_leao@yahoo.com.br
Duarte
Mônica Peres C
MP
Silva
Dalva Margareth B
DM
Bahia
Paulo Roberto V
PR
Coeli
Cláudia Medina
CM
de Farias
Maria Lucia Fleiuss
ML
D050153:Abdominal Fat / Q000033:anatomy & histology / Q000187:drug effects*; D000209:Acute-Phase Proteins / Q000378:metabolism*; D000284:Administration, Oral; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D015914:Estrogen Replacement Therapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy; D008055:Lipids / Q000097:blood*; D008777:Methyltestosterone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010052:Ovariectomy; D017698:Postmenopause; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
D000209:Acute-Phase Proteins; D001786:Blood Glucose; D008055:Lipids; D012738:Sex Hormone-Binding Globulin; D005340:Fibrinogen; D002097:C-Reactive Protein; D008777:Methyltestosterone