Mathis Grossmann1,2, Rudolf Hoermann1, Gary Wittert3, Bu B Yeap4,5. 1. Department of Medicine Austin Health, University of Melbourne, Heidelberg, Vic., Australia. 2. Endocrine Unit, Austin Health, Heidelberg, Vic., Australia. 3. Discipline of Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia. 4. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia. 5. Department of Endocrinology and Diabetes, Fremantle and Fiona Stanley Hospitals, Perth, WA, Australia.
Abstract
CONTEXT: The effects of testosterone treatment on glucose metabolism and other outcomes in men with type 2 diabetes (T2D) and/or the metabolic syndrome are controversial. OBJECTIVE: To perform a systematic review and meta-analysis of placebo-controlled double-blind randomized controlled clinical trials (RCT) of testosterone treatment in men with T2D and/or the metabolic syndrome. DATA SOURCES: A systematic search of RCTs was conducted using Medline, Embase and the Cochrane Register of controlled trials from inception to July 2014 followed by a manual review of the literature. STUDY SELECTION: Eligible studies were published placebo-controlled double-blind RCTs published in English. DATA EXTRACTION: Two reviewers independently selected studies, determined study quality and extracted outcome and descriptive data. DATA SYNTHESIS: Of the 112 identified studies, seven RCTs including 833 men were eligible for the meta-analysis. In studies using a simple linear equation to calculate the homeostatic model assessment of insulin resistance (HOMA1), testosterone treatment modestly improved insulin resistance, compared to placebo, pooled mean difference (MD) -1·58 [-2·25, -0·91], P < 0·001. The treatment effect was nonsignificant for RCTs using a more stringent computer-based equation (HOMA2), MD -0·19 [-0·86, 0·49], P = 0·58). Testosterone treatment did not improve glycaemic (HbA1c) control, MD -0·15 [-0·39, 0·10], P = 0·25, or constitutional symptoms, Aging Male Symptom score, MD -2·49 [-5·81, 0·83], P = 0·14). CONCLUSIONS: This meta-analysis does not support the routine use of testosterone treatment in men with T2D and/or the metabolic syndrome without classical hypogonadism. Additional studies are needed to determine whether hormonal interventions are warranted in selected men with T2D and/or the metabolic syndrome.
CONTEXT: The effects of testosterone treatment on glucose metabolism and other outcomes in men with type 2 diabetes (T2D) and/or the metabolic syndrome are controversial. OBJECTIVE: To perform a systematic review and meta-analysis of placebo-controlled double-blind randomized controlled clinical trials (RCT) of testosterone treatment in men with T2D and/or the metabolic syndrome. DATA SOURCES: A systematic search of RCTs was conducted using Medline, Embase and the Cochrane Register of controlled trials from inception to July 2014 followed by a manual review of the literature. STUDY SELECTION: Eligible studies were published placebo-controlled double-blind RCTs published in English. DATA EXTRACTION: Two reviewers independently selected studies, determined study quality and extracted outcome and descriptive data. DATA SYNTHESIS: Of the 112 identified studies, seven RCTs including 833 men were eligible for the meta-analysis. In studies using a simple linear equation to calculate the homeostatic model assessment of insulin resistance (HOMA1), testosterone treatment modestly improved insulin resistance, compared to placebo, pooled mean difference (MD) -1·58 [-2·25, -0·91], P < 0·001. The treatment effect was nonsignificant for RCTs using a more stringent computer-based equation (HOMA2), MD -0·19 [-0·86, 0·49], P = 0·58). Testosterone treatment did not improve glycaemic (HbA1c) control, MD -0·15 [-0·39, 0·10], P = 0·25, or constitutional symptoms, Aging Male Symptom score, MD -2·49 [-5·81, 0·83], P = 0·14). CONCLUSIONS: This meta-analysis does not support the routine use of testosterone treatment in men with T2D and/or the metabolic syndrome without classical hypogonadism. Additional studies are needed to determine whether hormonal interventions are warranted in selected men with T2D and/or the metabolic syndrome.
Authors: Jing Chao; Katya B Rubinow; Mario Kratz; John K Amory; Alvin M Matsumoto; Stephanie T Page Journal: J Clin Endocrinol Metab Date: 2016-08-02 Impact factor: 5.958
Authors: Katya B Rubinow; Jing H Chao; Derek Hagman; Mario Kratz; Brian Van Yserloo; Nilesh W Gaikwad; John K Amory; Stephanie T Page Journal: Am J Physiol Endocrinol Metab Date: 2017-07-11 Impact factor: 4.310