Somatic and psychological effects of low-dose aromatase inhibition in men with obesity-related hypogonadotropic hypotestosteronemia.
BACKGROUND
Reduced testosterone levels are frequently observed in obese men. Increased aromatase activity may be an etiological factor.


OBJECTIVE
In this study, we evaluate the clinical effects of aromatase inhibition in obesity-related hypogonadotropic hypotestosteronemia (OrHH).


METHODS
Double-blind, placebo-controlled, 6-month trial in 42 obese men with a BMI >35 kg/m(2), and a serum total testosterone <10 nmol/l. All patients started on one tablet of 2.5 mg/week, with subsequent dose escalation every month until a serum total testosterone of 20 nmol/l was reached.


METHODS
Psychological function, body composition, exercise capacity, and glucose, lipid, and bone metabolism.


RESULTS
Thirty-nine patients completed the study according to protocol. Letrozole decreased serum estradiol from 119.1±10.1 to 59.2±6.1 pmol/l (P<0.001), and increased serum LH from 3.3±0.3 to 8.8±0.9 U/l (P<0.0001) and serum total testosterone from 8.6±0.7 to 21.5±1.3 nmol/l (P<0.0001). Significant effects on the predefined endpoints were not observed.


CONCLUSIONS
Despite a marked rise in serum testosterone, low-dose aromatase inhibition had no somatic or psychological effects in men with OrHH.
Departments of Internal Medicine.
Sandra
S
Loves
Jos
J
de Jong
Adriaan
A
van Sorge
Darryl
D
Telting
Cees J
CJ
Tack
Ad
A
Hermus
Klaas
K
Westerterp
Hans
H
de Boer
D000328:Adult; D000728:Androgens / Q000097:blood; D047072:Aromatase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition / Q000187:drug effects; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects; D004311:Double-Blind Method; D002149:Energy Intake; D004958:Estradiol / Q000097:blood; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology; D006728:Hormones / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000097:blood* / Q000150:complications* / Q000523:psychology; D000077289:Letrozole; D050356:Lipid Metabolism / Q000187:drug effects; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009570:Nitriles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications* / Q000523:psychology; D011594:Psychometrics; D013739:Testosterone / Q000097:blood / Q000172:deficiency*; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000728:Androgens; D047072:Aromatase Inhibitors; D001786:Blood Glucose; D006728:Hormones; D009570:Nitriles; D014230:Triazoles; D013739:Testosterone; D004958:Estradiol; D000077289:Letrozole; D007986:Luteinizing Hormone