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Cited by 145Hormonal and reproductive studiesObstructive Sleep Apnea ResearchMenopause: Health Impacts and Treatments

Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial

Hoyos, Camilla M, Yee, Brendon J, Phillips, Craig L, Machan, Elizabeth A, Grunstein, Ronald R, Liu, Peter Y·2012·European Journal of Endocrinology
DOI 10.1530/eje-12-0525
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Abstract

BACKGROUND: The combination of male gender, obstructive sleep apnoea (OSA) and obesity magnifies cardiometabolic risk. There has been no systematic study evaluating whether testosterone therapy can improve cardiometabolic health in obese men with OSA by improving body composition, visceral abdominal fat and insulin sensitivity. OBJECTIVE: To assess body compositional and cardiometabolic effects of testosterone treatment in obese men with severe OSA. DESIGN: An 18-week randomised, double-blind, placebo-controlled and parallel group trial in 67 men. METHODS: Participants (age=49 ± 12 years, apnoea hypopnoea index=39.9 ± 17.7 events/h, BMI=31.3 ± 5.2 kg/m(2)) were placed on a hypocaloric diet and received i.m. injections of either 1000 mg testosterone undecanoate (n=33) or placebo (n=34) for 18 weeks. Outcomes were the changes in body composition (total muscle mass, total and abdominal fat, total body dual-energy X-ray absorptiometry and computerised tomography (CT)), weight, insulin sensitivity (homeostasis model assessment), abdominal liver fat (CT), arterial stiffness (pulse wave analysis), resting metabolic rate and respiratory quotient (indirect calorimetry) and blood lipids and metabolic syndrome from baseline to week 18. RESULTS: After 18 weeks, testosterone treatment increased insulin sensitivity (-1.14 units, 95% confidence interval (95% CI) -2.27 to -0.01, P<0.05), reduced liver fat (0.09 Hounsfield attenuation ratio, 95% CI 0.009 to 0.17, P=0.03) and increased muscle mass (1.6 kg, 95% CI 0.69 to 2.5, P=0.0009) to a greater extent than placebo. Other measures of body composition and regional adiposity as well as the number of participants with metabolic syndrome did not change. Testosterone also decreased arterial stiffness (augmentation index) by 3.2% (95% CI -6.01 to -0.46%, P=0.02) and decreased the respiratory quotient (95% CI -0.04, -0.08 to -0.001, P=0.04) after 18 weeks compared with placebo. CONCLUSION: Eighteen weeks of testosterone therapy in obese men with OSA improved several important cardiometabolic parameters but did not differentially reduce overall weight or the metabolic syndrome. Longer term studies are required.

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Crossref · 10.1530/eje-12-0525

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  • In an 18-week placebo-controlled RCT in obese patients with obstructive sleep apnea, the combination of TRT and lifestyle modifications improved insulin sensitivity, reduced liver fat, and increased muscle mass compared with placebo and lifestyle modifications alone.

    “Similarly, an 18-week, placebocontrolled RCT in obese patients with obstructive sleep apnea demonstrated that the combination of TRT and lifestyle modifications improved insulin sensitivity, reduced liver fat, and increased muscle mass in comparison with placebo and lifestyle modifications alone (69).”

    From Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis (2013) · cites this paper as [69]

  • Substantial evidence implicates testosterone and cortisol in the development of insulin resistance.

    “substantial evidence implicate testosterone and cortisol in the development of insulin resistance.”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]

  • Testosterone treatment improves insulin sensitivity in men at risk for type 2 diabetes mellitus.

    “Randomized controlled trials show that testosterone treatment improves insulin sensitivity in men at risk for type 2 diabetes mellitus (T2DM) [86, 87]”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]

  • In men with OSA, 18 weeks of testosterone therapy reduced liver fat compared with placebo.

    “reduced liver fat”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]

  • In men with OSA, 18 weeks of testosterone therapy improved insulin sensitivity compared with placebo.

    “improved insulin sensitivity”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]

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Authors
Hoyos, C. M., Yee, B. J., Phillips, C. L., Machan, E. A., Grunstein, R. R., & Liu, P. Y.
Affiliations
The University of Sydney (AU)
Corresponding author
Liu, Peter Y
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2012-10
Volume
167
Issue
4
Pages
531-541
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-12-0525
OpenAlex
W2143044197
Cited by
145
References
82
Citations by year
2026: 3 · 2025: 5 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 11 · 2019: 7 · 2018: 20 · 2017: 19 · 2016: 9 · 2015: 21 · 2014: 13 · 2013: 14
FWCI
12.30
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Centre National de la Recherche Scientifique
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
testosterone replacement therapy, testosterone undecanoate, obstructive sleep apnea, obesity, body composition, insulin sensitivity, visceral fat, liver fat, muscle mass, arterial stiffness, metabolic syndrome, cardiometabolic risk, hypocaloric diet, respiratory quotient, resting metabolic rate, serum lipids, menopause, hormone replacement therapy
MeSH terms
Body Composition, Double-Blind Method, Heart, Hormones, Humans, Male, Metabolism, Middle Aged, Obesity, Placebos, Prostate, Severity of Illness Index, Testosterone, Treatment Outcome, Sleep Apnea, Obstructive

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