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比较健康男性中孕激素雄激素二甲双胍十一酸酯和 11β-MNTDC 的代谢作用。

Comparison of metabolic effects of the progestational androgens dimethandrolone undecanoate and 11β-MNTDC in healthy men.

机构信息

Department of Medicine, Division of Endocrinology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.

Department of Medicine, University of Washington, Seattle, WA, USA.

出版信息

Andrology. 2021 Sep;9(5):1526-1539. doi: 10.1111/andr.13025. Epub 2021 May 22.

Abstract

BACKGROUND

Dimethandrolone (DMA) and 11β-methyl-19-nortestosterone (11β-MNT) are two novel compounds with both androgenic and progestational activity that are under investigation as potential male hormonal contraceptives. Their metabolic effects have never been compared in men.

OBJECTIVE

Assess for changes in insulin sensitivity and adiponectin and compare the metabolic effects of these two novel androgens.

MATERIALS/METHODS: In two clinical trials of DMA undecanoate (DMAU) and 11β-MNT dodecylcarbonate (11β-MNTDC), oral prodrugs of DMA and 11β-MNT, healthy men received drug, or placebo for 28 days. Insulin and adiponectin assays were performed on stored samples. Mixed model analyses were performed to compare the effects of the two drugs. Student's t test, or the non-parametric Kruskal-Wallis test as appropriate, was used to evaluate for an effect of active drug versus placebo.

RESULTS

Class effects were seen, with decrease in HDL-C and SHBG, and increase in weight and hematocrit, with no statistically significant differences between the two compounds. No changes in fasting glucose, fasting insulin, or HOMA-IR were seen with either compound. There was a slight decrease in adiponectin with DMAU that was not seen with 11β-MNTDC. An increase in LDL-C was seen with 11β-MNTDC but not with DMAU.

DISCUSSION

There were no significant changes in insulin resistance after 28 days of oral administration of these novel androgens despite a mild increase in weight. There may be subtle differences in their metabolic impacts that should be explored in future studies.

CONCLUSION

Changes in metabolic parameters should be carefully monitored when investigating androgenic compounds.

摘要

背景

二甲雄烷酮(DMA)和 11β-甲基-19-去甲睾酮(11β-MNT)是两种具有雄激素和孕激素活性的新型化合物,它们作为潜在的男性激素避孕药正在研究中。它们在男性中的代谢作用从未被比较过。

目的

评估胰岛素敏感性的变化,并比较这两种新型雄激素的代谢作用。

材料/方法:在两个二甲雄烷酮月桂酸酯(DMAU)和 11β-MNT 癸酸酯(11β-MNTDC)的临床试验中,这两种 DMA 和 11β-MNT 的口服前药,健康男性接受药物或安慰剂治疗 28 天。对储存的样本进行胰岛素和脂联素检测。采用混合模型分析比较两种药物的效果。采用学生 t 检验或适当的非参数 Kruskal-Wallis 检验评估活性药物与安慰剂的效果差异。

结果

观察到类效应,高密度脂蛋白胆固醇(HDL-C)和性激素结合球蛋白(SHBG)降低,体重和红细胞压积增加,但两种化合物之间无统计学差异。两种化合物均未观察到空腹血糖、空腹胰岛素或 HOMA-IR 的变化。DMAU 可使脂联素略有下降,而 11β-MNTDC 则没有。11β-MNTDC 可使 LDL-C 增加,但 DMAU 则没有。

讨论

尽管体重略有增加,但在口服这些新型雄激素 28 天后,胰岛素抵抗没有明显变化。它们的代谢影响可能存在细微差异,应在未来的研究中进一步探讨。

结论

在研究雄激素化合物时,应仔细监测代谢参数的变化。

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