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Cited by 216Hormonal and reproductive studiesAdrenal Hormones and DisordersProstate Cancer Treatment and Research

The DOI matches its Crossref record; 57 of the 60 references it cites were found in a registry or an index.

Androgen Receptor Gene CAG Repeat Length and Body Mass Index Modulate the Safety of Long-Term Intramuscular Testosterone Undecanoate Therapy in Hypogonadal Men

Zitzmann, Michael, Nieschlag, Eberhard·2007·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2007-0620
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Abstract

CONTEXT: A reliable form of androgen substitution therapy regarding kinetics, tolerance, and restoration of androgenicity is paramount in hypogonadal men. Intramuscular injection of the long-acting ester testosterone undecanoate (TU) offers a new modality. OBJECTIVE: The objective of the study was to assess the safety of TU regarding metabolic and pharmacogenetic confounders. DESIGN: This was a longitudinal one-arm open observation trial. A minimum of five individual assessments was a prerequisite. Putative modulators of safety parameters entering regression models were nadir and/or delta total testosterone concentrations, body mass index, androgen receptor (AR) gene CAG repeat length, and age. SETTING: The study was conducted at an andrological outpatient clinic. PATIENTS: Patients included 66 hypogonadal men (mean age 38 +/- 9.9 yr). MAIN OUTCOME MEASURES: A total of 515 data time points each related to prostate, erythropoiesis, lipoproteins, and circulation during 118 treatment-years with 1000 mg TU at 10- to 14-wk intervals. RESULTS: Testosterone substitution resulted in significant decrements of serum levels of low-density lipoprotein-cholesterol, resting diastolic and systolic blood pressure, and heart rate. Erythropoiesis was stimulated and concentrations of high-density lipoproteincholesterol increased. Parameters remained stable after four injections. No adverse effects regarding the prostate were observed. Significantly increased hematocrit greater than 50% was predicted by enhanced androgen action (shorter AR CAG repeats per higher testosterone levels). However, insufficient androgen action (longer AR CAG repeats per lower testosterone levels) caused pathological safety parameters (high blood pressure, adverse lipid profiles). In addition, a body mass index 30 kg/m(2) or greater represents a clinically relevant factor for the occurrence of all pathological safety parameters. Risk calculations for obese patients and nonlinear pharmacogenetic models to tailor androgen substitution are presented. CONCLUSIONS: Testosterone substitution with im TU is generally well tolerated. Modifications of androgen action are due to both AR CAG repeats and testosterone levels. Adverse observations are mostly seen in obese patients.

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Crossref · 10.1210/jc.2007-0620

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Metadata

Authors
Zitzmann, M., & Nieschlag, E.
Affiliations
University Hospital Münster (DE)
Corresponding author
Nieschlag, Eberhard
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2007-10-01
Volume
92
Issue
10
Pages
3844-3853
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2007-0620
OpenAlex
W2127886125
Cited by
216
References
60
Citations by year
2026: 2 · 2025: 3 · 2024: 9 · 2023: 12 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 4 · 2017: 10 · 2016: 9 · 2015: 17 · 2014: 19 · 2013: 15 · 2012: 10
FWCI
16.08
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Prostate Cancer Treatment and Research
Keywords
testosterone undecanoate, androgen receptor gene, CAG repeat length, hypogonadism, testosterone replacement therapy, body mass index, obesity, pharmacogenetics, lipid profile, blood pressure, erythropoiesis, hematocrit, prostate
MeSH terms
Adult, Humans, Hypogonadism, Injections, Intramuscular, Male, Middle Aged, Obesity, Pharmacogenetics, Receptors, Androgen, Regression Analysis, Testosterone, Body Mass Index, Nonlinear Dynamics, Trinucleotide Repeats, Testosterone Congeners

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