Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis

Background. Testosterone replacement therapy (TRT) is commonly used for the treatment of hypogonadism in men, which is often associated with type 2 diabetes mellitus (T2DM) and metabolic syndrome (Mets). Recent compiling evidence shows that TRT has beneficial metabolic effects on these patients. Obj...

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Main Authors: Shu-ying Li, Ya-ling Zhao, Yu-fan Yang, Xi Wang, Min Nie, Xue-yan Wu, Jiang-feng Mao
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2020/4732021
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author Shu-ying Li
Ya-ling Zhao
Yu-fan Yang
Xi Wang
Min Nie
Xue-yan Wu
Jiang-feng Mao
author_facet Shu-ying Li
Ya-ling Zhao
Yu-fan Yang
Xi Wang
Min Nie
Xue-yan Wu
Jiang-feng Mao
author_sort Shu-ying Li
collection DOAJ
description Background. Testosterone replacement therapy (TRT) is commonly used for the treatment of hypogonadism in men, which is often associated with type 2 diabetes mellitus (T2DM) and metabolic syndrome (Mets). Recent compiling evidence shows that TRT has beneficial metabolic effects on these patients. Objective. A meta-analysis has been conducted to evaluate the effects of TRT on cardiovascular metabolic factors. Methods. We conducted a systemic search on PubMed, Embase, Cochrane Library, Wanfang, and CNKI and selected randomized controlled trials (RCTs) to include. The efficacy of TRT on glycemia, insulin sensitivity, lipid profile, and body weight was meta-analyzed by Review Manager. Results. A total of 18 RCTs, containing 1415 patients (767 in TRT and 648 in control), were enrolled for the meta-analysis. The results showed that TRT could reduce HbA1c (MD = −0.67, 95% CI −1.35, −0.19, and P=0.006) and improve HOMA-IR (homeostatic model assessment of insulin resistance) (SMD = −1.94, 95% CI −2.65, −1.23, and P<0.0001). TRT could also decrease low-density lipoprotein (SMD = −0.50, 95% CI −0.82, −0.90, and P=0.002) and triglycerides (MD = −0.64, 95% CI −0.91, −0.36, and P<0.0001). In addition, TRT could reduce body weight by 3.91 kg (MD = −3.91, 95% CI −4.14, −3.69, and P<0.00001) and waist circumference by 2.8 cm (MD −2.80, 95% CI −4.38, −1.21 and P=0.0005). Erectile dysfunction (measured by IIEF-5) did not improve, while aging-related symptoms (measured by AMS scores) significantly improved. Conclusions. TRT improves glycemic control, insulin sensitivity, and lipid parameters in hypogonadism patients with T2DM and MetS, partially through reducing central obesity.
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spelling doaj-art-108d4f0b02ee4589b036573fb48576da2025-08-20T03:55:45ZengWileyInternational Journal of Endocrinology1687-83371687-83452020-01-01202010.1155/2020/47320214732021Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-AnalysisShu-ying Li0Ya-ling Zhao1Yu-fan Yang2Xi Wang3Min Nie4Xue-yan Wu5Jiang-feng Mao6Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaPeking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaPeking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaPeking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaPeking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaPeking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaPeking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Division of Endocrinology, Beijing 100730, ChinaBackground. Testosterone replacement therapy (TRT) is commonly used for the treatment of hypogonadism in men, which is often associated with type 2 diabetes mellitus (T2DM) and metabolic syndrome (Mets). Recent compiling evidence shows that TRT has beneficial metabolic effects on these patients. Objective. A meta-analysis has been conducted to evaluate the effects of TRT on cardiovascular metabolic factors. Methods. We conducted a systemic search on PubMed, Embase, Cochrane Library, Wanfang, and CNKI and selected randomized controlled trials (RCTs) to include. The efficacy of TRT on glycemia, insulin sensitivity, lipid profile, and body weight was meta-analyzed by Review Manager. Results. A total of 18 RCTs, containing 1415 patients (767 in TRT and 648 in control), were enrolled for the meta-analysis. The results showed that TRT could reduce HbA1c (MD = −0.67, 95% CI −1.35, −0.19, and P=0.006) and improve HOMA-IR (homeostatic model assessment of insulin resistance) (SMD = −1.94, 95% CI −2.65, −1.23, and P<0.0001). TRT could also decrease low-density lipoprotein (SMD = −0.50, 95% CI −0.82, −0.90, and P=0.002) and triglycerides (MD = −0.64, 95% CI −0.91, −0.36, and P<0.0001). In addition, TRT could reduce body weight by 3.91 kg (MD = −3.91, 95% CI −4.14, −3.69, and P<0.00001) and waist circumference by 2.8 cm (MD −2.80, 95% CI −4.38, −1.21 and P=0.0005). Erectile dysfunction (measured by IIEF-5) did not improve, while aging-related symptoms (measured by AMS scores) significantly improved. Conclusions. TRT improves glycemic control, insulin sensitivity, and lipid parameters in hypogonadism patients with T2DM and MetS, partially through reducing central obesity.http://dx.doi.org/10.1155/2020/4732021
spellingShingle Shu-ying Li
Ya-ling Zhao
Yu-fan Yang
Xi Wang
Min Nie
Xue-yan Wu
Jiang-feng Mao
Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis
International Journal of Endocrinology
title Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis
title_full Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis
title_fullStr Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis
title_full_unstemmed Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis
title_short Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis
title_sort metabolic effects of testosterone replacement therapy in patients with type 2 diabetes mellitus or metabolic syndrome a meta analysis
url http://dx.doi.org/10.1155/2020/4732021
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