Background: The concept of testosterone (T) supplementation (TS) as a new anti-obesity medication in men with testosterone deficiency syndrome (TDS) is emerging.
Aim: To systematically review and meta-analyze available observational and register studies reporting data on body composition in studies on TS in TDS.
Methods: An extensive Medline Embase and Cochrane search was performed including the following words: testosterone, body composition.
Main outcome measures: All observational studies comparing the effect of TS on body weight and other body composition and metabolic endpoints were considered.
Results: Out of 824 retrieved articles, 32 were included in the study enrolling 4513 patients. TS was associated with a time-dependent reduction of body weight and waist circumference (WC). The estimated weight loss and WC reduction at 24 months were −3.50 (−5.21; −1.80) kg and −6.23 (−7.94; −4.76) cm, respectively. TS was also associated with a significant reduction of fat (−0.62 (−1.06; −0.18); P<0.01) and with an increase of lean mass (0.62 (0.18; 1.05); P<0.01) as well as with a reduction of fasting glycemia and insulin resistance. In addition, an improvement of lipid profile (reduction of total cholesterol as well as of triglyceride levels and an improvement in HDL cholesterol levels) and in both systolic and diastolic blood pressure were observed.
Conclusions: Present data support the view of a positive effect of TS on body composition and on glucose and lipid metabolism. In addition, a significant effect on body weight loss was observed, which should be confirmed by a specifically designed RCT.