The Effect of Testosterone on Metabolic Syndrome and Type 2 Diabetes

Background: Metabolic syndrome (MetS) and diabetes type 2 (DM2) are increasing in incidence in the United States. A recent study found that roughly 34% of the adult population meets the criteria for metabolic syndrome. Patients with metabolic syndrome were found to have a 3 fold higher incidence of MI, stroke and CHD compared to patients without MetS. They were also more likely to develop DM2. Men with metabolic syndrome or DM2 also have a higher incidence of hypogonadism. It is estimated that 37.8% of men >45 years are hypogonadal. Multiple studies have established a link between hypogonadism and metabolic syndrome and the next step is to evaluate if raising a man’s testosterone levels back to physiologic norms has any benefit in the treatment of metabolic syndrome or DM2. Methods: A comprehensive review of the literature was performed using the data bases: CINAHL, ovid Medline, EBMR Multifile, Web of Science, PubMed and Google scholar. This produced a number of studies and the following exclusion criteria were applied to limit the search. Exclusion criteria: studies in another language, studies not using testosterone as a therapy, studies on patients who did not have MetS or DM2, studies on women, studies using non-hypogonadal men, studies with a sample size less than 15. Results: This resulted in three studies which were evaluated for this review. In all three studies evaluated, there was a greater improvement in patients treated with testosterone therapy than placebo. In the 52 week study of diet and exercise compared to diet and exercise plus testosterone, 62.5% of testosterone patients no longer met the criteria for MetS and 87.5% of them reached a HgbA1c goal of <6.5%. The two other studies, which only had a treatment phase of 3 months, also had promising results. Both studies demonstrated a drop in fasting glucose and insulin levels which corresponded to a decrease in HgbA1C. Patients in all three studies had improvements in BMI and waist to hip ratio. There were no adverse outcomes reported in any of the studies. Conclusion: Testosterone replacement therapy appears to be beneficial in more places than the bedroom. We have yet to discover all effects testosterone replacement has on the body, but initial studies are promising. Preliminary studies demonstrate that testosterone replacement in hypogonadal men has a greater benefit than risk. It is currently recommended to test men with symptoms of hypogonadism, especially if they have concurrent MetS or DM2. Returning a man’s T level back to physiologic norms can improve MetS and potentially slow its progression to DM2. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/224 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/224 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed.