Journal Article

Long-Term Testosterone Administration on Insulin Sensitivity in Older Men With Low or Low-Normal Testosterone Levels

Grace Huang, Karol M Pencina, Zhuoying Li, Shehzad Basaria, Shalender Bhasin, Thomas G Travison, Thomas W Storer, S Mitchell Harman and Panayiotis Tsitouras

in The Journal of Clinical Endocrinology & Metabolism

Volume 103, issue 4, pages 1678-1685
ISSN: 0021-972X
Published online January 2018 | e-ISSN: 1945-7197 | DOI: https://dx.doi.org/10.1210/jc.2017-02545
Long-Term Testosterone Administration on Insulin Sensitivity in Older Men With Low or Low-Normal Testosterone Levels

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  • Medicine and Health
  • Clinical Medicine
  • Endocrinology and Diabetes
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Abstract

Background

Serum testosterone levels and insulin sensitivity both decrease with age. Severe testosterone deficiency is associated with the development of insulin resistance. However, the effects of long-term testosterone administration on insulin sensitivity in older men with low or low-normal testosterone levels remain unknown.

Methods

The Testosterone Effects on Atherosclerosis in Aging Men Trial was a placebo-controlled, randomized, double-blind trial. The participants were 308 community-dwelling men, ≥60 years old, with total testosterone 100 to 400 ng/dL or free testosterone <50 pg/mL. A subset of 134 nondiabetic men (mean age, 66.7 ± 5.1 years) underwent an octreotide insulin suppression test at baseline and at 3 and 36 months after randomization to measure insulin sensitivity. Insulin sensitivity was estimated as the steady-state plasma glucose (SSPG) concentration at equilibrium during octreotide and insulin administration. Secondary outcomes included total lean mass (TLM) and total fat mass (TFM) by dual energy x-ray absorptiometry.

Results

There was a significant (P = 0.003) increase in SSPG in the placebo group, whereas no change was seen in testosterone-treated subjects from baseline to 36 months; however, the between-group differences in change in SSPG over 3 years were not statistically significant (+15.3 ± 6.9 mg/dL in the placebo group vs +6.2 ± 6.4 mg/dL in the testosterone group; mixed-model effect, P = 0.17). Changes in SSPG with testosterone treatment were not associated with changes in serum total or free testosterone concentrations. Changes in TFM but not TLM were associated with increases in SSPG. Stratification by age or baseline total testosterone level did not show significant intervention effects.

Conclusion

Testosterone administration for 36 months in older men with low or low-normal testosterone levels did not improve insulin sensitivity.

Journal Article.  5270 words.  Illustrated.

Subjects: Medicine and Health ; Clinical Medicine ; Endocrinology and Diabetes ; Medical Oncology ; Reproductive Medicine

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