The effect of testosterone replacement treatment on the inflammation and insulin resistance in patients with congenital hypogonadotrophic hypogonadism

Abstract

Cardio-metabolic risk is increased in hypogonadism. The effect of testosterone replacement treatment (TRT) on the cardiovascular and metabolic outcomes in hypogonadal patients is not clear. We investigated the effect of TRT on the insulin resistance and inflammation in patients with congenital hypogonadotrophic hypogonadism (CHH). A total of 80 patients with CHH (mean age 21,5±2,13 years) were enrolled. TRT was implemented in injectable and transdermal form. The demographic parameters, Pentraxin-3 (PTX3), high sensitive C reactive protein (hs-CRP) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured before and after TRT. After 6,0±2.41 months of TRT, body mass indexes (p < 0,001), waist circumferences (p=0,001), HOMA-IR (p=0,04) and PTX3 (p=0,02) levels were significantly increased and HDL cholesterol (p < 0,001) levels were significantly decreased. In the correlation analysis, there was no association between testosterone and PTX3, hsCRP, HOMA-IR levels, but there was only a significant and negative association between PTX3 and triglyceride levels (r=-0,28 p=0,03). The Results of the present study show that TRT has a negative effect on the insulin resistance and inflammation in patients with CHH. Whether this is an early implication of TRT related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardio-metabolic morbidity and mortality in this specific population. © Gülhane Tip Fakültesi 2016.