Low-intermediate dose testosterone replacement therapy by different pharmaceutical preparations improves frailty score in elderly hypogonadal hyperglycaemic patients

• Published in: The aging male 2013-06, Vol.16 (2), p.33-37
• Main Authors: Strollo, Felice, Strollo, Giovanna, Morè, Massimo, Magni, Paolo, Macchi, Chiara, Masini, Maria Angela, Carucci, Iarba, Celotti, Fabio, Ruscica, Massimiliano, Gentile, Sandro
• Format: Article
• Language: English
• Subjects: Administration, Cutaneous; Administration, Oral; Aged; Aging - drug effects; Aging - physiology; Blood Glucose - analysis; Cohort Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Elderly; Frailty; Hormone replacement therapy; Hormone Replacement Therapy - methods; Humans; Hyperglycemia; Hyperglycemia - diagnosis; Hyperglycemia - drug therapy; Hypogonadism - diagnosis; Hypogonadism - drug therapy; Male; Motor Activity - drug effects; Motor Activity - physiology; Muscle Strength - drug effects; Muscle Strength - physiology; Obesity; Older people; overweight; Prospective Studies; Prostate-Specific Antigen - blood; Quality of Life; Risk Assessment; Testosterone; Testosterone - administration & dosage; testosterone treatment; Treatment Outcome
• ISSN: 1368-5538; 1473-0790
• DOI: 10.3109/13685538.2013.773305

Abstract An open-label follow-up study of low-to-intermediate dose testosterone replacement therapy (TRT) was conducted in 64 overweight patients (aged 65-75 years) with late onset hypogonadism (LOH) and increased fasting plasma glucose (FPG). Patients were subdivided into four treatment groups: oral testosterone (T) (T undecanoate, 80 mg/d), transmucosal T (60 mg/d), transdermal T (30 mg/d) or no treatment (control), and evaluated at 0 and 6 months. FPG, hemoglobin (Hb), prostate-specific antigen (PSA) and total T were measured and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated. Body mass index (BMI), waist circumference, fitness level (6-min walking test), Aging Males' Symptoms (AMS) scale, handgrip strength and energy expenditure with physical activity (Minnesota questionnaire for Leisure Time Physical Activity (LTPA)) were evaluated and a "frailty score" (based on: grip strength, gait speed and LTPA) was calculated. T levels increased in all treatment groups; the oral T group had values still in the hypogonadal range (5.9 ± 1.1 nmol/L). PSA and Hb concentrations did not change in any group. BMI, waist circumference, FPG and HOMA-IR improved in all T-treated groups after 6 months, with a greater effect seen with transmucosal and transdermal T compared with oral T. This study indicates that low-to-intermediate dose TRT may be safely utilized in LOH patients to ameliorate somatic and psychological frailty symptoms in association with improved anthropometric and glycometabolic parameters in aging, overweight men with LOH and impaired fasting glucose.