title: Prostate volume and growth during testosterone replacement therapy is related to visceral obesity in Klinefelter syndrome.
abstract: OBJECTIVE
  Klinefelter syndrome (KS) is a chromosomal alteration characterized by increased risk of metabolic syndrome, mainly caused by visceral obesity. In the last years, obesity has been studied as a potential risk factor for prostate disease and recently a link has been demonstrated between visceral adiposity with prostate volume. The aim of this study was to analyze the relationship between obesity and prostate volume and growth during testosterone therapy in KS subjects.
  
  
  METHODS
  We evaluated reproductive hormones, metabolic parameters, anthropometric measures, PSA, and prostate volume in 121 naïve non-mosaic KS patients and 60 age-matched healthy male controls. Fifty-six KS hypogonadic subjects were treated with testosterone-gel 2% and reevaluated after 18 months of treatment.
  
  
  RESULTS
  Prostate volume in KS was positively related to waist circumference (WC). The KS group with WC ≥94 cm had significantly higher prostate volume, BMI, insulin plasma levels, homeostasis model assessment index, total cholesterol, triglycerides, and glycemia with respect to the KS group with WC <94 cm. After testosterone replacement therapy, only hypogonadic KS men with WC ≥94 cm had a statistically significant increase in prostate volume. Furthermore, in untreated KS subjects, prostate volume showed a statistically significant increase after 18 months of follow-up only in subjects with WC ≥94 cm.
  
  
  CONCLUSIONS
  This study showed that visceral obesity, insulin resistance, and lipid and glucose metabolism alterations are associated with prostate volume and growth during testosterone replacement therapy in KS, independently from androgen or estrogen levels. These latter findings might provide the basis for a better management and follow-up of KS subjects.
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Center for Human Reproduction Pathology, University of Padova, Via Gabelli 63, 35121 Padova, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Selice
authors.forename: N
authors.initials: N
authors.lastname: Caretta
authors.forename: A
authors.initials: A
authors.lastname: Di Mambro
authors.forename: M
authors.initials: M
authors.lastname: Torino
authors.forename: P
authors.initials: P
authors.lastname: Palego
authors.forename: A
authors.initials: A
authors.lastname: Ferlin
authors.forename: C
authors.initials: C
authors.lastname: Foresta
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D007621:Karyotyping; D007713:Klinefelter Syndrome / Q000150:complications* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000209:etiology / Q000473:pathology; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000209:etiology*; D013739:Testosterone / Q000097:blood* / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D013739:Testosterone; D017430:Prostate-Specific Antigen