Endocrine Abstracts (2018) 59 P183 | DOI: 10.1530/endoabs.59.P183

Impact of ethnicity on the change in total testosterone, haematocrit and prostate-specific antigen with Testosterone undecanoate treatment

Punith Kempegowda1,2, Lauren Quinn3, Anupama Rayachaudhari1, Lisa Shepherd1, Samina Kauser1, Joht Singh Chandan4, Tom Thomas4, Asad Rahim1 & Andrew Bates1


1University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 2Institute of Metabolism and Systems Research, Birmingham, UK; 3University of Birmingham Medical School, Birmingham, UK; 4Health Education West Midlands, Birmingham, UK.


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 (42.5–68.0); duration of treatment 1253.0 days (537.5–2066.8) and 19 Asians (age: median (IQR) 52.0 years (42.0–68.0); duration of treatment 1264.0 days (540.0–2077.0) 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.