Cited by 101Hormonal and reproductive studiesHypothalamic control of reproductive hormonesGrowth Hormone and Insulin-like Growth Factors

The DOI matches its Crossref record; 45 of the 46 references it cites were found in a registry or an index; none of the 51 sources its claims cite is checked for support yet.

Effects of liraglutide on obesity-associated functional hypogonadism in men

Open access
Jensterle, M, Podbregar, A, Goricar, K, Gregoric, N, Janez, A·2019·Endocrine Connections

Abstract

Lifestyle measures (LSMs) should be the first-line approach offered for obesity-related functional hypogonadism (FH). When LSMs fail, the role of testosterone replacement treatment (TRT) is unclear. GLP1 receptor agonist liraglutide is linked to progressive and sustained weight loss. A potential direct impact of GLP1 on hypothalamus-pituitary-testicular (HPT) axis was reported in animal models. We aimed to compare the effects of liraglutide and TRT on FH in obese men that had been poor responders to LSM, by means of reversal of FH and weight reduction. We designed a 16-week prospective randomized open-label study with 30 men (aged 46.5 ± 10.9 years, BMI 41.2 ± 8.4 kg/m 2 , mean ± s.d. ) that were randomized to liraglutide 3.0 mg QD (LIRA) or 50 mg of 1% transdermal gel QD (TRT). Sexual function and anthropometric measures were assessed. Fasting blood was drawn for determination of endocrine and metabolic parameters followed by OGTT. Model-derived parameters including HOMA IR and calculated free testosterone (cFT) were calculated. Total testosterone significantly increased in both arms (+5.9 ± 7.2 in TRT vs +2.6 ± 3.5 nmol/L in LIRA) and led to improved sexual function. LIRA resulted in a significant increase of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) ( P < 0.001 for between-treatment effect). Subjects treated with LIRA lost on average 7.9 ± 3.8 kg compared with a 0.9 ± 4.5 kg loss in TRT ( P < 0.001). Metabolic syndrome was resolved in two patients in LIRA and in no subjects in TRT. Liraglutide was superior to TRT in improving an overall health benefit in men with obesity-associated FH after LSM failed.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a 16-week randomized open-label pilot of 30 obese men with functional hypogonadism who had failed lifestyle measures, liraglutide 3.0 mg/day and transdermal testosterone both raised total testosterone and improved sexual function, but liraglutide produced greater weight loss and increased LH/FSH whereas testosterone suppressed gonadotropins. Liraglutide was concluded to be superior to testosterone replacement for overall health benefit in this population.

Key findings

  • Total testosterone increased in both arms: +5.9 ± 7.2 nmol/L with testosterone replacement (TRT) vs +2.6 ± 3.5 nmol/L with liraglutide (LIRA), with no significant between-group difference (P = 0.239). Sexual function improved in both arms, with no significant between-treatment differences for libido (P = 0.762), morning erections (P = 0.550), or ejaculations (P = 0.204).
  • Gonadotropins diverged significantly: LIRA increased LH (+0.7 ± 1.2 IU/L) and FSH (+0.9 ± 1.8 mIU/L), while TRT suppressed LH (−2 ± 1.3 IU/L) and FSH (−3.2 ± 1.7 mIU/L); between-treatment P < 0.001 for both.
  • LIRA produced greater weight loss than TRT: abstract reports 7.9 ± 3.8 kg vs 0.9 ± 4.5 kg (P < 0.001); Table 2 reports −8 ± 4 kg vs −1 ± 5 kg (P < 0.001). BMI change was −2.6 ± 1.3 vs −0.3 ± 1.4 kg/m² (P < 0.001), and waist circumference change was −5 ± 5 vs −2 ± 4 cm (P = 0.035).
  • Metabolic syndrome resolved in 2 patients in LIRA and 0 in TRT. HbA1c decreased significantly in LIRA, with a significant between-treatment difference favoring LIRA (P = 0.004); HOMAIR decreased significantly in TRT (P = 0.033) but not in LIRA (P = 0.754).

Methods

  • 16-week prospective randomized open-label pilot study of 30 middle-aged obese men with functional hypogonadism who had been poor responders to lifestyle measures; participants were randomized to liraglutide 3.0 mg QD s.c. (LIRA, N = 15) or 50 mg of 1% transdermal testosterone gel QD (TRT, N = 15), with lifestyle measures actively promoted in both groups.
  • Assessments at baseline and study end included sexual function self-reports (morning erections, ejaculations, libido scored 1–3), the Aging Male Syndrome (AMS) scale, endocrine parameters (total testosterone, SHBG, LH, FSH, calculated free and bioavailable testosterone), anthropometric measures, and metabolic parameters including OGTT, HOMAIR, HbA1c, and lipids.
  • Statistical analysis used Wilcoxon signed-rank tests for related samples and Mann–Whitney tests for independent groups, with P < 0.05 considered significant.

Limitations

  • The authors state that conclusions are limited by a small sample size and short-term observation, and that libido and sexual function were not measured with validated tools.
  • The authors note that 11 of 30 subjects had type 2 diabetes, which could independently affect the HPT axis, although diabetes presence was balanced between groups and well controlled.
  • Evident from the text: the study was open-label and did not include a placebo arm, so expectancy effects cannot be excluded; it was also a pilot study, limiting generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1530/ec-18-0514

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

39 Own result · 33 Not checked yet · 11 Own method · 8 Own interpretation · 2 No basis given

Verify all 51 references — free account
  • It may state two separate claims as one. 24
  • Probably not a substantial claim. 25
43 of 43
  • The paper relies on this without support.

    In clinical practice, lifestyle measures often fail.

    “yet in clinical practice LSM often fails.”
  • The paper relies on this without support.

    Testosterone replacement therapy appears to improve body composition and glycometabolic profile without clearly affecting weight loss.

    “On the other hand, testosterone replacement therapy (TRT) appears to improve body composition and glycometabolic profile without clearly affecting weight lost as well as its role after a trail of unsuccessful LSM is unclear.”
  • The paper relies on this without support.

    The role of testosterone replacement therapy after unsuccessful lifestyle measures is unclear.

    “On the other hand, testosterone replacement therapy (TRT) appears to improve body composition and glycometabolic profile without clearly affecting weight lost as well as its role after a trail of unsuccessful LSM is unclear.”
  • The paper relies on this without support.

    The impact of liraglutide on obesity-related functional hypogonadism has not yet been addressed in a prospective clinical study.

    “Despite the fact that the prevalence of FH in obese male population is increased by 13-fold (8), the impact of liraglutide on obesity-related FH has not yet been addressed in a prospective clinical study.”
  • The authors state this as an assumption.

    A complex bidirectional relationship between dysglycemia and the HPT axis was controlled in one direction.

    “We assumed that a complex bidirectional relationship between dysglycemia and HPT was controlled in one direction.”
5 of 5

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3 of 3

Citations

Cites

Show all 46 references

Research works printed but not linked: 42

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Metadata

Authors
Jensterle, M., Podbregar, A., Goricar, K., Gregoric, N., & Janez, A.
Affiliations
  • Ljubljana University Medical Centre (SI)
  • Univerzitetni Rehabilitacijski Inštitut (SI)
  • 3University of Ljubljana, Faculty of Medicine, Institute of Biochemistry, Pharmacogenetics Laboratory, Ljubljana, Slovenia
  • 1Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
Venue
Endocrine Connections
Published
2019-03
Volume
8
Issue
3
Pages
195-202
ISSN
2049-3614 (ISSN-L)
OpenAlex
W2911630547
Cited by
101
References
46
Citations by year
2026: 17 · 2025: 22 · 2024: 17 · 2023: 13 · 2022: 13 · 2021: 6 · 2020: 7 · 2019: 6
FWCI
6.49
Type
journal article
Language
en
Open access
Locations
  • Endocrine Connections (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Keywords
liraglutide, testosterone replacement therapy, GLP-1 receptor agonists, hypothalamic-pituitary-testicular axis, luteinizing hormone, follicle-stimulating hormone, weight loss, sexual function, metabolic syndrome

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