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Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip

International Journal of Impotence Research volume 20, pages 378–387 (2008)Cite this article

Abstract

Our intention was to examine if subnormal testosterone levels in older men were associated with a reduction in quality of life and physical and mental health, and secondly to examine if testosterone treatment could improve these conditions. We performed a nested case–control study and a 1-year testosterone intervention study. Men with subnormal testosterone had significantly higher weight, fat mass and abdominal adipose tissue. They also had significantly higher glucose and insulin levels, and they had higher triglyceride levels. Testosterone treatment had a large impact on body composition with reduced fat mass and abdominal adipose tissue and increased fat-free mass, but it did not affect weight and glucose and lipid metabolism. Bone mineral density in the hip was significantly higher after the testosterone treatment. Older men with subnormal testosterone levels had an unfavorable metabolic profile. Testosterone treatment improved body composition, but it did not reverse the unfavorable metabolic profile.

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References

  1. Gray A, Feldman A, McKinley JB, Longcope C . Age, disease, and changing sex hormone levels in middle-aged men: result of the Massachusetts Male Aging Study. J Clin Endocrinol Metab 1991; 73: 1016–1025.

    CAS  PubMed  Google Scholar 

  2. Svartberg J, Midtby M, Bønaa KH, Sundsfjord J, Joakimsen RM, Jorde R . The associations of age, lifestyle factors and chronic disease with testosterone in men. The Tromsø Study. Eur J Endocrinol 2003; 149: 145–152.

    Article  CAS  PubMed  Google Scholar 

  3. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR . Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab 2001; 86: 724–731.

    Article  CAS  PubMed  Google Scholar 

  4. Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. J Clin Endocrinol Metab 2002; 87: 589–598.

    Article  CAS  PubMed  Google Scholar 

  5. Barrett-Connor E, Bhasin S . Time for (more research on) testosterone. J Clin Endocrinol Metab 2004; 89: 501–502.

    Article  CAS  PubMed  Google Scholar 

  6. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2006; 91: 1995–2010.

    Article  CAS  PubMed  Google Scholar 

  7. Bønaa KH, Arnesen E . Association between heart rate and atherogenic blood lipid fractions in a population. The Tromsø Study. Circulation 1992; 86: 394–405.

    Article  PubMed  Google Scholar 

  8. Matthews DP, Hosker JP, Rudenski AS, Naylor BA, Treacker DF, Turner RC . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985; 28: 412–419.

    Article  CAS  PubMed  Google Scholar 

  9. Ly LP, Jimenez M, Zhuang TN, Celermajer DS, Conway AJ, Handelsman DJ . A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscular strength, mobility, and quality of life in older men with partial androgen deficiency. J Clin Endocrinol Metab 2001; 86: 4078–4088.

    Article  CAS  PubMed  Google Scholar 

  10. The International Activity Questionnaire 2006. Available at http://www.ipaq.ki.se.

  11. Jorde R, Waterloo K, Saleh F, Haug E, Svartberg J . Neuropsychological function in relation to serum parathyroid hormone and serum 25-hydroxyvitamin D levels. The Tromsø study. J Neurol 2006; 253: 464–470.

    Article  CAS  PubMed  Google Scholar 

  12. Heinemann LA . Aging Males’ Symptoms scale: a standardized instrument for the practice. J Endocrinol Invest 2005; 28 (Suppl): 34–38.

    CAS  PubMed  Google Scholar 

  13. Power M, Quinn K, Schmidt S, WHOQOL-OLD Group. Development of the WHOQOL-old module. Qual Life Res 2005; 14: 2197–2214.

    Article  PubMed  Google Scholar 

  14. Vermeulen A, Verdonck L, Kaufman JM . A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 1999; 84: 3666–3672.

    Article  CAS  PubMed  Google Scholar 

  15. Kenny AM, Prestwood KM, Gruman CA, Marcello KM, Raisz LG . Effects of transdermal testosterone on bone and muscle in older men with low bioavailable testosterone levels. J Gerontol A Biol Sci Med Sci 2001; 56: M266–M272.

    Article  CAS  PubMed  Google Scholar 

  16. Snyder PJ, Peachey H, Hannoush P, Berlin JA, Loh L, Lenrow DA et al. Effects of testosterone treatment on body composition and muscle strength in men over 65 years of age. J Clin Endocrinol Metab 1999; 84: 2647–2653.

    CAS  PubMed  Google Scholar 

  17. Witters GA, Chapman IM, Haren MT, Mackintosh S, Coates P, Morley JE . Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status. J Gerontol A Biol Sci Med Sci 2003; 58: 618–625.

    Article  Google Scholar 

  18. Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP et al. The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: a prospective cohort study. J Clin Endocrinol Metab 2005; 90: 712–719.

    Article  CAS  PubMed  Google Scholar 

  19. Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP et al. Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care 2004; 27: 1036–1041.

    Article  CAS  PubMed  Google Scholar 

  20. Malik S, Wong ND, Franklin SS, Kamath TV, L’Italien GJ, Pio JR et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004; 110: 1245–1250.

    Article  PubMed  Google Scholar 

  21. Purnell JQ, Kahn SE, Albers JJ, Nevin DN, Brunzell JD, Schwartz RS . Effect of weight loss with reduction of intra-abdominal fat on lipid metabolism in older men. J Clin Endocrinol Metab 2000; 85: 977–982.

    CAS  PubMed  Google Scholar 

  22. Sih R, Morley JE, Kaiser FE, Perry III HM, Patrick P, Ross C . Testosterone replacement in older hypogonadal men: a 12-month randomized controlled trial. J Clin Endocrinol Metab 1997; 82: 1661–1667.

    Article  CAS  PubMed  Google Scholar 

  23. Page ST, Amory JK, Bowman FD, Anawalt BD, Matsumoto AM, Bremner WJ et al. Exogenous testosterone (T) alone or with finasteride increases physical performance, grip strength, and lean body mass in older men with low serum T. J Clin Endocrinol Metab 2005; 90: 1502–1510.

    Article  CAS  PubMed  Google Scholar 

  24. Snyder PJ, Peachey H, Hannoush P, Berlin JA, Loh L, Holmes JH et al. Effect of testosterone treatment on bone mineral density in men over 65 years of age. J Clin Endocrinol Metab 1999; 84: 1966–1972.

    CAS  PubMed  Google Scholar 

  25. Amory JK, Watts NB, Easley KA, Sutton PR, Anawalt BD, Matsumoto AM et al. Exogenous testosterone or testosterone and finasteride increases bone mineral density in older men with low serum testosterone. J Clin Endocrinol Metab 2004; 89: 503–510.

    Article  CAS  PubMed  Google Scholar 

  26. Carani C, Qin K, Simoni M, Faustini-Fustini M, Serpente S, Boyd J et al. Effect of testosterone and estradiol in a man with aromatase deficiency. N Engl J Med 1997; 337: 91–95.

    Article  CAS  PubMed  Google Scholar 

  27. English KM, Steeds RP, Jones TH, Diver MJ, Channer KS . Low-dose transdermal testosterone therapy improves angina threshold in men with chronic stable angina: a randomized, double-blind, placebo-controlled study. Circulation 2000; 102: 1906–1911.

    Article  CAS  PubMed  Google Scholar 

  28. Reddy P, White CM, Dunn AB, Moyna NM, Thompson PD . The effect of testosterone on health-related quality of life in elderly males – a pilot study. J Clin Pharm Ther 2000; 25: 421–426.

    Article  CAS  PubMed  Google Scholar 

  29. Barrett-Connor E, von Mühlen DG, Kritz-Silverstein D . Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo study. J Clin Endocrinol Metab 1999; 84: 573–577.

    Article  CAS  PubMed  Google Scholar 

  30. Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G . Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology 2004; 63: 641–646.

    Article  CAS  PubMed  Google Scholar 

  31. Kenny AM, Fabregas G, Song C, Biskup B, Bellantonio S . Effects of testosterone on behaviour, depression, and cognitive function in older men with mild cognitive loss. J Gerontol A Biol Sci Med Sci 2004; 59: 75–78.

    Article  PubMed  Google Scholar 

  32. Kenny AM, Bellantonio S, Gruman CA, Acosta RD, Prestwood KM . Effects of transdermal testosterone on cognitive function and health perception in older men with low bioavailable testosterone levels. J Gerontol A Biol Sci Med Sci 2002; 57: M321–M325.

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank the patients for their participation and patience throughout the study and the staff at the Clinical Research Unit for their excellent work. The study was supported by a grant from Center for Research in the Elderly in Tromsø. Bayer Schering Pharma AG is recognized for providing the study medication free of charge and an independent grant.

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Authors and Affiliations

  1. Department of Medicine, University Hospital of North Norway, Tromsø, Norway

    J Svartberg, I Agledahl & R Jorde

  2. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway

    J Svartberg & R Jorde

  3. Department of Medical Biochemistry, University Hospital of North Norway, Tromsø, Norway

    Y Figenschau

  4. Department of Medical Biochemistry, University of Tromsø, Tromsø, Norway

    Y Figenschau

  5. Department of Radiology, University Hospital of North Norway, Tromsø, Norway

    T Sildnes

  6. Department of Neurology, University Hospital of North Norway, Tromsø, Norway

    K Waterloo

  7. Department of Psychology, University of Tromsø, Tromsø, Norway

    K Waterloo

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  1. J Svartberg
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  2. I Agledahl
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  3. Y Figenschau
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  4. T Sildnes
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  5. K Waterloo
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  6. R Jorde
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Correspondence to J Svartberg.

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Svartberg, J., Agledahl, I., Figenschau, Y. et al. Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip. Int J Impot Res 20, 378–387 (2008). https://doi.org/10.1038/ijir.2008.19

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  • DOI: https://doi.org/10.1038/ijir.2008.19

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