Park Min Gu, Yeo Jeong Kyun, Park Sun Gu, Na Woong, Moon Du Geon
Department of Urology, Men's Health Clinic, Seoul Paik Hospital, Seoul 04551, Korea.
Department of Urology, Seoul Paik Hospital, Seoul 04551, Korea.
J Clin Med. 2019 Jan 29;8(2):151. doi: 10.3390/jcm8020151.
There is no conclusive evidence as to whether patients with testosterone deficiency (TD) who benefit from testosterone treatment (TRT) must continue the treatment for the rest of their lives. In some patients, the effect of TRT does not maintained after stopping TRT and, some patients show no significant TD symptoms, with normal testosterone levels after TRT cessation. Therefore, we investigated the predictive factors of response maintenance after TRT cessation. A total of 151 men with TD who responded to TRT were followed up for six months after TRT discontinuation. Ninety-two patients (Group I) failed to show response maintenance; 59 patients (Group II) had a maintained response. The groups did not differ in baseline characteristics or the type of TRT (oral, gel, short/long-acting injectables). However, TRT duration was significantly longer (10.7 vs. 5.2 months), and peak total testosterone (TT) level was significantly higher (713.7 vs. 546.1 ng/dL), in Group II than in Group I. More patients regularly exercised in Group II than in Group I (45.8% vs. 9.8%, < 0.001). A multivariate logistic regression analysis revealed that exercise (B = 2.325, odds ratio = 10.231, < 0.001) and TRT duration (B = 0.153, Exp(B) = 1.166, < 0.001) were independent predictive factors of response maintenance. In men with TD who respond to TRT, longer treatment periods can improve the response durability after TRT cessation, regardless of the type of TRT. Additionally, regular exercise can increase the probability of maintaining the response after TRT cessation.
对于睾酮缺乏(TD)且从睾酮治疗(TRT)中获益的患者是否必须终生持续接受治疗,尚无确凿证据。在一些患者中,停止TRT后,TRT的效果无法维持,并且一些患者在停止TRT后未表现出明显的TD症状,睾酮水平正常。因此,我们研究了停止TRT后反应维持的预测因素。共有151名对TRT有反应的TD男性患者在TRT停药后进行了6个月的随访。92名患者(第一组)未能维持反应;59名患者(第二组)维持了反应。两组在基线特征或TRT类型(口服、凝胶、短效/长效注射剂)方面无差异。然而,第二组的TRT持续时间明显更长(10.7个月对5.2个月),总睾酮(TT)峰值水平明显更高(713.7 ng/dL对546.1 ng/dL)。第二组中经常锻炼的患者比第一组更多(45.8%对9.8%,<0.001)。多因素逻辑回归分析显示,锻炼(B = 2.325,比值比 = 10.231,<0.001)和TRT持续时间(B = 0.153,Exp(B)=1.166,<0.001)是反应维持的独立预测因素。在对TRT有反应的TD男性中,无论TRT类型如何,较长的治疗期可提高TRT停药后的反应持久性。此外,经常锻炼可增加TRT停药后维持反应的可能性。