Endocrine Abstracts

Background: There is a close association between low testosterone and metabolic syndrome. Testosterone replacement therapy (TRT) has beneficial effects on cardiovascular (CV) risk factors in men with hypogonadism.

Aim: This is a retrospective audit of CV parameters in hypogonadal men treated with testosterone undecanoate (Nebido) in standard clinical practice.

Methods: Patients with hypogonadism on testosterone undecanoate injections from 2005 to 2009 were identified from hospital data base. Weight, blood pressure, non-fasting lipid profile and HbA1c (diabetic men n=42) were collected at 3, 6, and 12 months.

Results: Of the 120 patients 99 (82%) had previous TRT with other preparations. Mean age was 48±16 years. After excluding patients with changes in lipid lowering medications over the treatment period, the total cholesterol (TC) and calculated LDL cholesterol (cLDL) demonstrated significant improvement.

TC at 3 months was 3.8±1.4 (compared with 4.6 mmol/l±1.4 at baseline P=0.006, n=47), at 6 months 4.2±1.3 (P=0.03, n=36) and at 1 year 4.1±1.1 (P=0.005, n=41).

cLDL at 3 months was 1.9 mmol/l±1 (vs 2.3±1.1 at baseline; P=0.006, n=43) at 6 months 2.1±1 (P=0.13, n=38) and at 12 months 2.1±1 (P=0.046, n=33).

HDL-cholesterol (HDL) did not show any significant change at 6 months 1.05±0.3 (vs 1.08±0.3 at baseline P=0.33, n=44) or at 12 months 1.04±0.28 (P=0.08, n=35).

At 12 months no significant changes in weight (98 vs 99 kg; P=0.09, n=67) or blood pressure (SBP 135 vs 137 P=0.3 DBP 78 vs 80 P=0.2, n=69) were noted. HbA1c fell by 0.4% (P=0.07) at 6 months in diabetic patients.

Discussion: Testosterone undecanoate therapy in routine clinical practice had beneficial effects on total cholesterol and cLDL, but no significant effect on HDL. No effects were found on weight and blood pressure.