Background: Current guidelines recommend regular monitoring of total testosterone, haematocrit and prostate-specific antigen (PSA) when androgen-deficient males are commenced on testosterone replacement therapy (TRT). The aim is to restore serum total testosterone to the mid-normal range, whilst maintaining haematocrit and PSA at the recommended levels. Limited studies have assessed the impact of ethnicity on these biochemical parameters.
Aim: To measure the impact of ethnicity on total testosterone, haematocrit and PSA following Testosterone undecanoate replacement.
Method: A retrospective analysis of 50 male patients, treated with testosterone undecanoate between 2006 to 2017, in a large secondary care centre was performed. Changes in total testosterone, haematocrit and PSA over 10 years of treatment were analysed. Mann-Whitney U test was used to assess differences in these parameters of the two ethnic groups- Caucasians and Asians.
Results: Thirty-one Caucasians (age: median (IQR) 54.0 years (42.568.0); duration of treatment 1253.0 days (537.52066.8) and 19 Asians (age: median (IQR) 52.0 years (42.068.0); duration of treatment 1264.0 days (540.02077.0) were treated with TRT during the study period. There was no significant difference in total testosterone levels between the two ethnicities. There was a significant rise in haematocrit in Asians compared to Caucasians in the first (P=<.000) and sixth year (P=.029) of therapy. PSA was significantly higher in Caucasians compared to Asians in the second (P=.022), fourth (P=.014), fifth (P=.016), seventh (P=.032), eighth (P=.012) and ninth (P=.016) year of therapy.
Conclusion: Differences in haematocrit and PSA between the two ethnic groups varied from year to year. Caucasians have a tendency towards higher PSA rise compared to Asians with TRT. Particular focus on haematocrit may be needed in the first year of TRT in Asians.