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Lifestyle modification effectively reduced hypogonadism in men
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HOUSTON — Men with impaired glucose tolerance who participated in lifestyle modification were able to reverse hypogonadism, based on evidence from a retrospective study.
“Approximately one in four men with impaired glucose tolerance in this cohort of the [Diabetes Prevention Program] had low testosterone levels, and lifestyle modification was effective in increasing endogenous testosterone levels and was important in reducing the percentage of hypogonadism,” Andrew A. Dwyer, MD, of Massachusetts General Hospital, said during a presentation at the Endocrine Society’s 94th Annual Meeting and Expo.
Dwyer and colleagues studied 891 men with IGT from the Diabetes Prevention Program (DPP). None of the men were taking medications that could interfere with testosterone levels.
The large, multicenter study aimed to examine the effect of changes in body weight and insulin sensitivity on serum testosterone levels, Dwyer said. The mean age of the patients was 53.9 years, and they were randomly assigned to one of three groups: lifestyle modification (n=293), metformin 850 mg twice daily (n=305) or placebo (n=293).
BMI and waist circumference, physical activity completed per week, insulin sensitivity (homeostasis model assessment of insulin resistance [HOMA-IR]) and reproductive hormone levels were analyzed at baseline and 12 months.
“After 12 months of intervention, the metformin and placebo groups did not demonstrate changes in testosterone, whereas the lifestyle modification group had a significant improvement (15%) in total testosterone levels,” Dwyer said.
There was no change in luteinizing hormone levels (3.1 IU/L vs. 3.1 IU/L), and testosterone levels were unchanged in the other treatment groups.
Dwyer and colleagues found that the overall prevalence of hypogonadal testosterone levels (<300 ng/dL) at baseline was 23.7%. Yet, with lifestyle modification, this number decreased from 20.4% to 11.1% (P<.05). Moreover, hypogonadal testosterone levels did not differ with metformin (24.8% vs. 23.8%) or placebo (25.6% vs. 24.6%).
Data demonstrated a reduction in body weight that was greater with lifestyle modification than with metformin (–7.8 kg vs. –2.8 kg; P<.0001). There was also a decrease in HOMA-IR. Changes in testosterone levels related to changes in body weight (P<.0001), waist circumference (P=0.001) and HOMA-IR (P<.0001). However, the researchers found no link between change in testosterone and physical activity.
“The absence of compensatory increase in [luteinizing hormone] suggests that perhaps enhanced Leydig cell responsiveness may underlie this increase in testosterone, and the reduction in body weight appears to play an important, beneficial role in improving testosterone levels in this population,” Dwyer said. – by Samantha Costa
For more information:
Dwyer AA. Abstract #OR28-3. Presented at: the Endocrine Society’s 94th Annual Meeting & Expo; June 23-26, 2012; Houston.
Disclosure: The researchers report no relevant financial disclosures.