title: Hypogonadal obese men with and without diabetes mellitus type 2 lose weight and show improvement in cardiovascular risk factors when treated with testosterone: an observational study.
abstract: BACKGROUND
  Treatment of obesity with diet and exercise may have short-term success but longer-term maintenance of weight loss is less successful. Obesity is associated with a reduction of serum testosterone, and, vice versa, a reduction in serum testosterone is associated with obesity and features of the metabolic syndrome.
  
  
  OBJECTIVE
  To investigate whether restoring serum testosterone to normal in hypo-gonadal obese men is beneficial with regard to weight loss and improvement of the metabolic syndrome.
  
  
  METHODS
  A prospective registry accumulated to 181 men over five years (mean serum testosterone 10.06±1.3 nmol/L (N>12.1), body mass index (BMI) ≥30 kg/m2. Of these men, 72 had diabetes mellitus type 2. All received parenteral testosterone undecanoate 1000 mg/12 weeks for up to five years.
  
  
  RESULTS
  Waist circumference (cm) decreased from 111.2±7.54 to 100.46±7.1, weight (kg) from 114.71±11.59 to 93.2±8.49, BMI (kg/m2) from 36.72±3.72 to 30.2±2.59 (all variables statistically significant vs. baseline (p<0.0001) and each year compared to the previous year (p<0.0001)). In the 72 diabetic men, waist circumference (cm) decreased from 112.93±7.16 to 101.48±7.24, weight (kg) from 116.94±11.62 to 94.42±9.42, BMI (kg/m2) from 37.71±3.5 to 30.95±2.69 (all variables statistically significant vs. baseline (p<0.0001) and each year compared to the previous year (p<0.0001)). In all men serum glucose, HbA1c, lipid profiles and blood pressure improved significantly. Testosterone treatment as assessed by hemoglobin, hematocrit, serum prostate specific antigen (PSA) and occurrence of prostate cancer was acceptably safe.
  
  
  CONCLUSIONS
  Normalizing serum testosterone in obese hypogonadal men, also in those with diabetes type 2, improved their metabolic state.
authors.affiliation: Private Urology Practice, Bremerhaven, Germany.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Haider
authors.affiliation: Bayer Pharma, Global Medical Affairs Andrology, Berlin, Germany; Gulf Medical University School of Medicine, Ajman, United Arab Emirates. Electronic address: farid.saad@bayer.com.
authors.forename: Farid
authors.initials: F
authors.lastname: Saad
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Doros
authors.affiliation: Emeritus VU Medical Center, Amsterdam, The Netherlands; Androconsult, Chiang Mai, Thailand.
authors.forename: Louis
authors.initials: L
authors.lastname: Gooren
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000188:drug therapy*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D010288:Parenteral Nutrition; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000517:prevention & control; D012307:Risk Factors; D013739:Testosterone / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D055105:Waist Circumference; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D017430:Prostate-Specific Antigen; D013739:Testosterone; C010792:testosterone undecanoate
keywords: Diabetes mellitus type 2; Obesity; Testosterone; Waist circumference; Weight loss