Oral Presentation The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2017

Effect of testosterone treatment on adipokines and gut hormones in obese men on a hypocaloric diet (#58)

Mark Ng Tang Fui 1 2 , Rudolf Hoermann 1 , Mathis Grossmann 1 2
  1. Medicine, University of Melbourne, Heidelberg, Victoria, Australia
  2. Austin Health, Heidelberg, Victoria, Australia

Context: In obese men with lowered testosterone levels, testosterone treatment augments the diet-associated loss of body fat.

Objective:We hypothesized that testosterone treatment modulates the circulating concentrations of hormonal mediators of fat mass and energy homeostasis in obese men subjected to a rigorous weight loss program.

Design: Pre-specified secondary analysis of a randomized double-blind, placebo-controlled trial.

Setting: Tertiary referral centre.

Participants: Obese men (body mass index >30kg/m2) with a repeated total testosterone level <12nmol/L.

Intervention: One hundred participants aged 53 years (IQR 47-60) receiving 10 weeks of a very low energy diet followed by 46 weeks of weight maintenance were randomly assigned at baseline to 56 weeks of intramuscular testosterone undecanoate (n= 49, cases) or matching placebo (n= 51, controls). Eighty-two men completed the study.

Main outcome measures:Between-group differences during follow-up in leptin, adiponectin, ghrelin, glucagon-like peptide-1, gastric inhibitory polypeptide, peptide YY, pancreatic polypeptide, and amylin. 

Results: At study end, compared to controls, cases had greater reductions in leptin (MAD -3.6ng/ml[-5.3,-1.9], p<0.001). The change in leptin levels between testosterone and placebo treated men was dependent on baseline fat mass, as the between-group difference progressively increased with increasing fat mass (MAD -0.26ng/ml [-0.31,-0.26], p=0.001 per 1 kg of baseline fat mass). Weight loss-associated changes in other hormones persisted during the weight maintenance phase but were not modified by testosterone treatment.

Conclusions: Testosterone treatment leads to reductions in leptin over and above those achieved by diet-associated weight loss. Testosterone treatment may reduce leptin resistance in obese men.