睾酮对肥胖男性身体成分的影响在停止睾酮治疗后无法持续。
The effects of testosterone on body composition in obese men are not sustained after cessation of testosterone treatment.
机构信息
Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Vic., Australia.
Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia.
出版信息
Clin Endocrinol (Oxf). 2017 Oct;87(4):336-343. doi: 10.1111/cen.13385. Epub 2017 Jun 27.
BACKGROUND
Testosterone treatment in obese dieting men augments the diet-associated loss of fat mass, but protects against loss of lean mass. We assessed whether body composition changes are maintained following withdrawal of testosterone treatment.
METHODS
We conducted a prespecified double-blind randomized placebo-controlled observational follow-up study of a randomized controlled trial (RCT). Participants were men with baseline obesity (body mass index >30 kg/m ) and a repeated total testosterone level <12 nmol/L, previously enrolled in a 56-week testosterone treatment trial combined with a weight loss programme. Main outcome measures were mean adjusted differences (MAD) (95% confidence interval), in body composition between testosterone- and placebo-treated men at the end of the observation period.
RESULTS
Of the 100 randomized men, 82 completed the RCT and 64 the subsequent observational study. Median [IQR] observation time after completion of the RCT was 82 weeks [74; 90] in men previously receiving testosterone (cases) and 81 weeks [67;91] in men previously receiving placebo (controls), P=.51. At the end of the RCT, while losing similar amounts of weight, cases had, compared to controls, lost more fat mass, MAD -2.9 kg (-5.7, -0.2), P=.04, but had lost less lean mass MAD 3.4 kg (1.3, 5.5), P=.002. At the end of the observation period, the former between-group differences in fat mass, MAD -0.8 kg (-3.6, 2.0), P=1.0, in lean mass, MAD -1.3 kg (-3.0, 0.5), P=.39, and in appendicular lean mass, MAD -0.1 kg/m (-0.3, 0.1), P=.45, were no longer apparent. During observation, cases lost more lean mass, MAD -3.7 kg (-5.5, -1.9), P=.0005, and appendicular lean mass, MAD -0.5 kg/m (-0.8, -0.3), P<.0001 compared to controls.
CONCLUSIONS
The favourable effects of testosterone on body composition in men subjected to a concomitant weight loss programme were not maintained at 82 weeks after testosterone treatment cessation.
背景
在肥胖节食男性中进行睾酮治疗会增强与饮食相关的脂肪量损失，但可防止瘦体重损失。我们评估了在停用睾酮治疗后，身体成分的变化是否得以维持。
方法
我们对一项随机对照试验（RCT）进行了预设的双盲随机安慰剂对照观察性随访研究。参与者为基线肥胖（体重指数>30kg/m ）且反复总睾酮水平<12nmol/L 的男性，他们先前参加了一项为期 56 周的睾酮治疗试验，并结合了减肥计划。主要结局指标为观察期末接受睾酮和安慰剂治疗的男性之间的平均调整差异（MAD）（95%置信区间）。
结果
在 100 名随机男性中，82 名完成了 RCT，64 名完成了随后的观察性研究。在完成 RCT 后，中位数[IQR]观察时间为先前接受睾酮治疗的男性（病例）为 82 周[74；90]，先前接受安慰剂治疗的男性（对照）为 81 周[67；91]，P=0.51。在 RCT 结束时，尽管体重减轻量相似，但与对照组相比，病例组丢失了更多的脂肪量，MAD-2.9kg（-5.7，-0.2），P=0.04，而丢失的瘦体重更少，MAD3.4kg（1.3，5.5），P=0.002。在观察期末，脂肪量的组间差异不再明显，MAD-0.8kg（-3.6，2.0），P=1.0，瘦体重的差异，MAD-1.3kg（-3.0，0.5），P=0.39，四肢瘦体重的差异，MAD-0.1kg/m（-0.3，0.1），P=0.45。在观察期间，与对照组相比，病例组丢失了更多的瘦体重，MAD-3.7kg（-5.5，-1.9），P=0.0005，四肢瘦体重，MAD-0.5kg/m（-0.8，-0.3），P<.0001。
结论
在接受减肥计划的同时进行睾酮治疗对男性身体成分的有利影响，在停用睾酮治疗后 82 周时并未维持。
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