Men's Health Boston, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
J Sex Med. 2012 Feb;9(2):585-93. doi: 10.1111/j.1743-6109.2011.02557.x. Epub 2011 Dec 6.
The prognostic value of serum total testosterone (TT) prior to treatment has not been investigated.
This study was performed to determine how baseline TT influences changes in body composition in men undergoing testosterone therapy (TTh).
Response to TTh in a clinical population of men with symptomatic testosterone deficiency (TD).
Retrospective case series of 58 men with TD were treated with TTh. All were naïve to previous TTh. Men were stratified into two groups: group 1 (N = 38) consisted of men with baseline TT > 300 ng/dL (10.4 nmol/L) and group 2 (N = 20) consisted of men with total TT < 300 ng/dL. Men in group 1 were diagnosed with TD on the basis of low values of free testosterone (FT) < 1.5 ng/dL (19.3 pmol/L). Dual-energy X-ray absorptiometry was performed at baseline and follow-up (6.9 ± 4 months) to assess regional and whole body.
At baseline, both groups had similar lean mass (LM) and fat mass (FM), but percentage of trunk FM and percentage of total FM were significantly higher in group 2. Both groups demonstrated similar increases in LM for arms, legs, and total body. Percentage of total FM significantly decreased in both groups.
Baseline severity of symptomatic TD influences body composition. Similar changes in LM and FM were seen with TTh regardless of baseline severity in TD. Men with TT > 300 ng/dL demonstrated significant positive changes in body composition. The similarity in objective response to TTh in these two groups provides support for the value of FT in the assessment of men with symptoms suggestive of TD.
治疗前血清总睾酮(TT)的预后价值尚未得到研究。
本研究旨在确定基线 TT 如何影响接受睾酮治疗(TTh)的男性的身体成分变化。
有症状的睾酮缺乏(TD)男性的临床人群对 TTh 的反应。
对 58 例有 TD 的男性进行了回顾性病例系列研究,所有患者均为首次接受 TTh。男性分为两组:第 1 组(N = 38)包括基线 TT > 300ng/dL(10.4nmol/L)的男性,第 2 组(N = 20)包括基线 TT < 300ng/dL 的男性。第 1 组男性根据游离睾酮(FT)<1.5ng/dL(19.3pmol/L)的低值诊断为 TD。基线和随访(6.9 ± 4 个月)时进行双能 X 射线吸收法测量以评估区域和全身。
基线时,两组的瘦体重(LM)和脂肪量(FM)相似,但第 2 组的躯干 FM 百分比和总 FM 百分比明显较高。两组手臂、腿部和全身的 LM 均有相似的增加。两组的总 FM 百分比均显著降低。
有症状的 TD 的基线严重程度影响身体成分。无论 TD 的基线严重程度如何,TTh 都能使 LM 和 FM 发生相似的变化。TT > 300ng/dL 的男性身体成分有显著的积极变化。这两组对 TTh 的客观反应相似,为 FT 在评估有 TD 症状的男性中的价值提供了支持。