Effects of intermission and resumption of long-term testosterone replacement therapy on body weight and metabolic parameters in hypogonadal in middle-aged and elderly men.
OBJECTIVE
In addition to primary and secondary ('classical') hypogonadism, hypogonadism occurring in middle-aged and elderly men has been recognized. There is evidence that restoring T levels to normal improves body weight, serum lipids and glucose levels.


METHODS
Observational registry study.


METHODS
Two hundred and sixty-two hypogonadal, middle-aged and elderly, men received testosterone replacement treatment (TRT). After having been on TRT for a mean duration of 65·5 months, TRT was temporarily intermitted in 147 patients for a mean of 16·9 months (Group I) due to cost reimbursement issues and in seven men due to prostate cancer. All these men resumed TRT for a mean period of 14·5 months. Of the cohort, 115 men were treated continuously (designated as Group C). To compare on-treatment to off-treatment periods, three periods of equal duration were defined: pre-intermission (on TRT), during intermission (off TRT) and post-intermission (on TRT after resumption of TRT). For proper comparison, the same periods were analysed for those patients who continued TRT throughout (Group C).


METHODS
Variables of body weight, glucose metabolism, lipids, blood pressure and C-reactive protein (CRP).


RESULTS
In Group C there was a continuous improvement of body weight, serum lipids, glucose, HbA1c , blood pressure and CRP. In Group I there was a similar initial improvement which was reversed upon intermission of T administration but which appeared again when T treatment was reinstated.


CONCLUSIONS
Our observation indicates that T administration improves body weight and metabolic factors in men with hypogonadism but withdrawal of T reverses these beneficial effects to appear again when TRT is resumed.
Institute of Urology and Andrology, Segeberger Kliniken, Norderstedt, Germany.|Gulf Medical University, Ajman, UAE.|Dresden International University, Dresden, Germany.
Aksam
A
Yassin
Institute of Urology and Andrology, Segeberger Kliniken, Norderstedt, Germany.|Gulf Medical University, Ajman, UAE.|Dresden International University, Dresden, Germany.
Yousef
Y
Almehmadi
Gulf Medical University, Ajman, UAE.|Global Medical Affairs Men's Healthcare, Bayer Pharma AG, Berlin, Germany.
Farid
F
Saad
Department of Epidemiology and Statistics, Boston University School of Public Health, Boston, MA, USA.
Gheorghe
G
Doros
Department of Internal Medicine, Endocrine Section, VU medical Center, Amsterdam, The Netherlands.
Louis
L
Gooren
D000328:Adult; D000368:Aged; D000728:Androgens / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight / Q000187:drug effects*; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D013739:Testosterone / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
D000728:Androgens; D001786:Blood Glucose; D008055:Lipids; D013739:Testosterone; D002097:C-Reactive Protein