Long Acting Testosterone Undecanoate is more Effective than Testosterone Gel in Improving Features of the Metabolic Syndrome in Hypogonadal Men
Saad, F(1, 2); Gooren, L(3); Haider, A(4); Yassin, A(2, 5)
(1)Bayer-Schering, Berlin, Germany (2)Gulf Medical College (3)VUmc, Amsterdam, Netherlands (4)Bremerhaven, Germany (5)Segeberger Kliniken, Norderstedt, Germany
Objective: To compare the effects of two different testosterone treatment modalities; long acting intra-muscular testosterone undecanoate (TU) and transdermal testosterone gel, upon clinical features of the metabolic syndrome in hypogonadal men. Methods: Elderly male patients with late onset hypogonadism were treated for 9 months with either long acting TU (1000mg i.m. at weeks 0 and 6, and thereafter every 12 weeks, n=28, mean age = 61) or testosterone gel (50mg/day, n=27, mean age = 60). Waist circumference, blood pressure (BP), and plasma levels of testosterone, sex hormone binding globulin (SHBG), total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglycerides were measured at baseline and months 3, 6 and 9. Results: Following treatment with testosterone gel, plasma testosterone rose from 2.24 ± 0.41 ng/ml at baseline to 2.95 ± 0.52 ng/ml at 3 months, 3.49 ± 0.89 ng/ml at 6 months and 3.80 ± 0.73 ng/ml at 9 months. Following treatment with TU significantly greater increases in plasma testosterone were observed; from 2.08 ± 0.56 ng/ml at baseline to 4.81 ± 0.83 ng/ml at 3 months, 5.29 ± 0.91 at 6 months, and 5.40 ± 0.77 at 9 months (all P<0.05 v gel). A significantly greater effect on SHBG was also observed with TU compared to testosterone gel; +2 v –9 nmol/L (P<0.05). In addition a significantly greater improvement in features of the metabolic syndrome was observed following treatment with TU compared to testosterone gel; waist circumference fell by 3.38 v 1.89 cm, systolic BP by 2 v 0 mmHg, diastolic BP by 1 v 0 mmHg, total cholesterol by 94 v 39 mg/dL, LDL-C by 32 v 19 mg/dL and triglycerides by –167 v –79 mg/dL (all P<0.05). HDL-C was elevated equally on both treatments +9 v +4 mg/dL. Conclusion: Testosterone administration had a beneficial effect on a number of clinical features of the metabolic syndrome, with a significantly greater effect observed following TU compared to testosterone gel.
