The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism

Objective. To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). Methods. A retrospective clinical study at a tertiary...

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Main Authors: Guadalupe Vargas-Ortega, Gabriel Pérez-Villarreal, Andrés Ramírez de Santiago, Lourdes Balcázar-Hernández, Victoria Mendoza-Zubieta, Oscar Landa-Gutierrez, Carlos Estrada-Robles, Baldomero González-Virla
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2019/2356580
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author Guadalupe Vargas-Ortega
Gabriel Pérez-Villarreal
Andrés Ramírez de Santiago
Lourdes Balcázar-Hernández
Victoria Mendoza-Zubieta
Oscar Landa-Gutierrez
Carlos Estrada-Robles
Baldomero González-Virla
author_facet Guadalupe Vargas-Ortega
Gabriel Pérez-Villarreal
Andrés Ramírez de Santiago
Lourdes Balcázar-Hernández
Victoria Mendoza-Zubieta
Oscar Landa-Gutierrez
Carlos Estrada-Robles
Baldomero González-Virla
author_sort Guadalupe Vargas-Ortega
collection DOAJ
description Objective. To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). Methods. A retrospective clinical study at a tertiary care center was performed in 101 men with NFPMA, HH, and TTh; metabolic profile, cardiovascular risk, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function 5 (IIEF-5) scores were evaluated before initiation of TTh and at the last checkup with TTh. Results. Age was 49.3 ± 8.8 years; T before TTh was 195 ng/mL (101–259) vs. 574 (423–774) at the last checkup. The time of TTh administration was 34 months (12–72). An increase in triglyceride levels (200 (153–294) vs. 174 (134–233) mg/dL; p=0.03), dyslipidemia (40% vs. 52%; p=0.03), and MetS (25% vs. 34%; p=0.05) was corroborated. A statistical difference in the Globorisk score and cardiovascular (CV) risk stratification was not found. IIEF-5 score was 15.5 ± 6.5 vs. 17.8 ± 5.3 (p=0.11). An improvement in penetration quality (2.0 ± 1.5 vs. 2.6 ± 1.3; p=0.05), erection after penetration (1.8 ± 1.2 vs. 2.5 ± 1.6; p=0.02), completion of intercourse (1.8 ± 1.2 vs. 2.4 ± 1.3; p=0.03), and satisfaction of sexual intercourse (1.8 ± 1.3 vs. 2.5 ± 1.5; p=0.01) was evidenced. IPSS score was 6 (IQR 2–10) vs. 7 (IQR 4–12); p=0.30. A lower rate of intermittency (14% vs. 3%; p=0.02), urgency (39% vs. 16%; p=0.01), and episodes of nocturia (18% vs. 4%; p=0.02) was found. An increase of hematocrit (44.1 ± 4.4 vs. 47.3 ± 4.4%; p=0.001), hemoglobin (14.9 ± 1.4 vs. 15.9 ± 1.4 g/dL; p=0.001), and prostatic specific antigen (0.59 (0.43–1.19) vs. 0.82 (0.45–1.4) ng/mL; p=0.02) was evidenced during TTh. Conclusion. TTh in young men with NFPMA improves LUTS, sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context.
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spelling doaj-art-e0625abaa487421cbbf1f1a736b07a002025-08-20T03:26:05ZengWileyInternational Journal of Endocrinology1687-83371687-83452019-01-01201910.1155/2019/23565802356580The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic HypogonadismGuadalupe Vargas-Ortega0Gabriel Pérez-Villarreal1Andrés Ramírez de Santiago2Lourdes Balcázar-Hernández3Victoria Mendoza-Zubieta4Oscar Landa-Gutierrez5Carlos Estrada-Robles6Baldomero González-Virla7From the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoFrom the Endocrinology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoObjective. To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). Methods. A retrospective clinical study at a tertiary care center was performed in 101 men with NFPMA, HH, and TTh; metabolic profile, cardiovascular risk, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function 5 (IIEF-5) scores were evaluated before initiation of TTh and at the last checkup with TTh. Results. Age was 49.3 ± 8.8 years; T before TTh was 195 ng/mL (101–259) vs. 574 (423–774) at the last checkup. The time of TTh administration was 34 months (12–72). An increase in triglyceride levels (200 (153–294) vs. 174 (134–233) mg/dL; p=0.03), dyslipidemia (40% vs. 52%; p=0.03), and MetS (25% vs. 34%; p=0.05) was corroborated. A statistical difference in the Globorisk score and cardiovascular (CV) risk stratification was not found. IIEF-5 score was 15.5 ± 6.5 vs. 17.8 ± 5.3 (p=0.11). An improvement in penetration quality (2.0 ± 1.5 vs. 2.6 ± 1.3; p=0.05), erection after penetration (1.8 ± 1.2 vs. 2.5 ± 1.6; p=0.02), completion of intercourse (1.8 ± 1.2 vs. 2.4 ± 1.3; p=0.03), and satisfaction of sexual intercourse (1.8 ± 1.3 vs. 2.5 ± 1.5; p=0.01) was evidenced. IPSS score was 6 (IQR 2–10) vs. 7 (IQR 4–12); p=0.30. A lower rate of intermittency (14% vs. 3%; p=0.02), urgency (39% vs. 16%; p=0.01), and episodes of nocturia (18% vs. 4%; p=0.02) was found. An increase of hematocrit (44.1 ± 4.4 vs. 47.3 ± 4.4%; p=0.001), hemoglobin (14.9 ± 1.4 vs. 15.9 ± 1.4 g/dL; p=0.001), and prostatic specific antigen (0.59 (0.43–1.19) vs. 0.82 (0.45–1.4) ng/mL; p=0.02) was evidenced during TTh. Conclusion. TTh in young men with NFPMA improves LUTS, sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context.http://dx.doi.org/10.1155/2019/2356580
spellingShingle Guadalupe Vargas-Ortega
Gabriel Pérez-Villarreal
Andrés Ramírez de Santiago
Lourdes Balcázar-Hernández
Victoria Mendoza-Zubieta
Oscar Landa-Gutierrez
Carlos Estrada-Robles
Baldomero González-Virla
The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism
International Journal of Endocrinology
title The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism
title_full The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism
title_fullStr The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism
title_full_unstemmed The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism
title_short The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism
title_sort testosterone effect on metabolic and urologic outcomes in patients with nonfunctioning pituitary macroadenomas and hypogonadotropic hypogonadism
url http://dx.doi.org/10.1155/2019/2356580
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