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Cited by 240Hormonal and reproductive studiesLipoproteins and Cardiovascular HealthAdrenal Hormones and Disorders

Intramuscular testosterone esters and plasma lipids in hypogonadal men: a meta-analysis

Whitsel, Eric A, Boyko, Edward J, Matsumoto, Alvin M, Anawalt, Bradley D, Siscovick, David S·2001·The American Journal of Medicine
DOI 10.1016/s0002-9343(01)00833-6
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Abstract

Purpose It is unclear whether intramuscular administration of testosterone esters to hypogonadal men is associated with changes in plasma lipids. We therefore analyzed 19 studies published between 1987 and 1999 that focused on male subjects with nonexperimental hypogonadism, treated subjects with an intramuscular testosterone ester and reported pretreatment and post-treatment concentrations of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, or total triglyceride.Methods We calculated study-specific, post-treatment minus pretreatment differences in each plasma lipid concentration (mean [95% confidence interval]). After testing of between-study homogeneity, we combined the study-specific differences. We then determined whether heterogeneity of differences could be explained in models of the differences on study and patient characteristics (mean +/- SE) before and after excluding extreme values using a multiple outlier procedure.Results The studies represented 272 hypogonadal men (age 44 +/- 4 years; 20% with hypergonadotropic hypogonadism; total testosterone 0.5 +/- 0.2 ng/mL) who received, on average, 179 +/- 13 mg intramuscular testosterone ester every 16 +/- 1 days for 6 +/- 1 months. Fixed-effects estimates of post-treatment minus pretreatment differences were -14 [-17 to -11] mg/dL (total cholesterol), -5 [-8 to -1] mg/dL (LDL cholesterol), -4 [-5 to -2] mg/dL (HDL cholesterol), and -1 [-6 to + 4] mg/dL (triglyceride). Decreases in HDL cholesterol were larger at lower dosages of testosterone ester (r = -0.54, P = 0.055), but were not explained by attrition, regression to the mean, dosing frequency or duration, concomitant elevation of plasma total testosterone, aromatization of testosterone to estradiol, or other study and patient characteristics.Conclusion Intramuscular administration of testosterone esters to hypogonadal men is associated with a small, dosage-dependent decrease in HDL cholesterol and concomitant declines in total cholesterol and LDL cholesterol. The aggregate effect of these changes on cardiovascular risk remains unknown but deserves further study.

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Authors
Whitsel, E. A., Boyko, E. J., Matsumoto, A. M., Anawalt, B. D., & Siscovick, D. S.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • University of Washington (US)
ORCID
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2001-09
Volume
111
Issue
4
Pages
261-269
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/s0002-9343(01)00833-6
OpenAlex
W1969632703
Cited by
240
References
72
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 10 · 2021: 4 · 2020: 6 · 2019: 1 · 2018: 8 · 2017: 6 · 2016: 8 · 2015: 14 · 2014: 10 · 2013: 9 · 2012: 16
FWCI
1.97
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Washington
  • National Heart, Lung, and Blood Institute (T32HL007055, 5T32-HL07055)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
testosterone esters, hypogonadism, male hypogonadism, plasma lipids, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides, testosterone replacement therapy, dosage dependence, cardiovascular risk
MeSH terms
Dose-Response Relationship, Drug, Humans, Hypogonadism, Injections, Intramuscular, Lipids, Cholesterol, HDL, Male, Testosterone

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