Departments of Internal Medicine.
Eur J Endocrinol. 2013 Oct 8;169(5):705-14. doi: 10.1530/EJE-13-0190. Print 2013 Nov.
Reduced testosterone levels are frequently observed in obese men. Increased aromatase activity may be an etiological factor.
In this study, we evaluate the clinical effects of aromatase inhibition in obesity-related hypogonadotropic hypotestosteronemia (OrHH).
Double-blind, placebo-controlled, 6-month trial in 42 obese men with a BMI >35 kg/m(2), and a serum total testosterone <10 nmol/l. All patients started on one tablet of 2.5 mg/week, with subsequent dose escalation every month until a serum total testosterone of 20 nmol/l was reached.
Psychological function, body composition, exercise capacity, and glucose, lipid, and bone metabolism.
Thirty-nine patients completed the study according to protocol. Letrozole decreased serum estradiol from 119.1±10.1 to 59.2±6.1 pmol/l (P<0.001), and increased serum LH from 3.3±0.3 to 8.8±0.9 U/l (P<0.0001) and serum total testosterone from 8.6±0.7 to 21.5±1.3 nmol/l (P<0.0001). Significant effects on the predefined endpoints were not observed.
Despite a marked rise in serum testosterone, low-dose aromatase inhibition had no somatic or psychological effects in men with OrHH.
肥胖男性常伴有睾酮水平降低。芳香化酶活性增加可能是其发病因素之一。
本研究旨在评估芳香化酶抑制剂对肥胖相关性低促性腺激素型低睾酮血症（OrHH）的临床疗效。
对 42 名 BMI＞35 kg/m²且血清总睾酮＜10 nmol/l 的肥胖男性进行为期 6 个月的双盲、安慰剂对照试验。所有患者均起始服用每周 1 片 2.5 mg，随后每月递增剂量，直至血清总睾酮达到 20 nmol/l。
心理功能、身体成分、运动能力以及血糖、血脂和骨代谢。
39 名患者按方案完成了研究。来曲唑可使血清雌二醇从 119.1±10.1 pmol/l 降至 59.2±6.1 pmol/l（P＜0.001），LH 从 3.3±0.3 U/l 升至 8.8±0.9 U/l（P＜0.0001），总睾酮从 8.6±0.7 nmol/l 升至 21.5±1.3 nmol/l（P＜0.0001）。但未观察到对预设终点有显著影响。
尽管血清睾酮水平明显升高，但低剂量芳香化酶抑制剂对 OrHH 男性无躯体或心理作用。
