title: The effect of testosterone on insulin sensitivity in men with heart failure.
abstract: Resistance to insulin occurs in chronic heart failure (CHF) and is related to prognosis. Studies of testosterone in non-(CHF) males suggest that physiological testosterone therapy improves insulin sensitivity. This was a single-blind placebo controlled crossover trial to determine the effect of testosterone replacement on insulin sensitivity in 13 men with moderate to severe CHF (ejection fraction 30.5+/-1.3). The primary outcome was the homeostatic model index (HOMA-IR) of fasting insulin sensitivity and secondary outcomes were body composition as measured by bioelectrical impedance and glucose tolerance to a standard 75 g oral glucose load. Analysis was performed on the delta values with the treatment effect of placebo compared with that of testosterone. At baseline HOMA-IR correlated with measures of body fat [% fat mass (rP=0.84, p=0.0001) and body mass index (rP=0.79, p=0.01)] but not with CHF severity. Testosterone reduced HOMA-IR (-1.9+/-0.8, p=0.03) indicating improved fasting insulin sensitivity. Testosterone also increased total mass (+1.5+/-0.5 kg, p=0.008) and decreased body fat (-0.8+/-0.3%, p=0.02). Testosterone improves fasting insulin sensitivity in men with CHF and may also increase lean body mass, these data suggest a favourable effect of testosterone on an important metabolic component of CHF.
authors.affiliation: Department of Cardiology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, S10 2JF, United Kingdom.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Malkin
authors.forename: T Hugh
authors.initials: TH
authors.lastname: Jones
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Channer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D005215:Fasting; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D016037:Single-Blind Method; D013739:Testosterone / Q000494:pharmacology*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D010919:Placebos; D013739:Testosterone; D003404:Creatinine