The DOI matches its Crossref record; 81 of the 82 references it cites were found in a registry or an index.
Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial
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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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 the citing paper
“reduced liver fat”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]
In the citing paper
“improved insulin sensitivity”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]
In the citing paper
“18 weeks of testosterone therapy in men with OSA increased muscle mass”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]
In the citing paper
“heightened sexual desire compared with placebo therapy [87, 133].”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [87]
In the citing paper
“Only few studies to date reported that combination of TRT and LSM is superior to LSM alone in increasing insulin sensitivity, glycemic control, muscle mass and reducing liver fat (4, 5).”
From Effects of liraglutide on obesity-associated functional hypogonadism in men (2019) · cites this paper as [5]
In the citing paper
“A compelling number of clinical studies demonstrated that TRT led to improvement in glycemic control and insulin sensitivity (4, 5, 37, 42), whereas some failed to confirm these observations (43).”
From Effects of liraglutide on obesity-associated functional hypogonadism in men (2019) · cites this paper as [5]
Citations
Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C. (2009) · Circulation · doi:10.1161/circulationaha.109.192644 · Cited by 14,860
Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
Grundy, S. M., Becker, D. M., Clark, L. T., Cooper, R., Denke, M. A., Howard, J. L., Hunninghake, D. B., Illingworth, D. R., Luepker, R. V., McBride, P. E., et al. (2002) · Civil War Book Review · Cited by 12,198
Prevalence and Trends in Obesity Among US Adults, 1999-2008
Flegal, K. M. (2010) · JAMA · doi:10.1001/jama.2009.2014 · Cited by 7,580
Expert consensus document on arterial stiffness: methodological issues and clinical applications
Laurent, S., Cockcroft, J., Van Bortel, L., Boutouyrie, P., Giannattasio, C., Hayoz, D., Pannier, B., Vlachopoulos, C., Wilkinson, I., Struijker-Boudier, H., et al. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehl254 · Cited by 6,077
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678
A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.10.6079 · Cited by 3,824
The American Urological Association Symptom Index for Benign Prostatic Hyperplasia
Barry, M. J., Fowler, F. J., O’Leary, M. P., Bruskewitz, R. C., Holtgrewe, H. L., Mebust, W. K., & Cockett, A. T. �. (1992) · The Journal of Urology · doi:10.1016/s0022-5347(17)36966-5 · Cited by 3,455
Research works printed but not linked: 7
- 1995, INTERNATIONAL JOURNAL OF OBESITY AND RELATED METABOLIC DISORDERS, 19, 410
- 2008, 31, 1079
- 2008, 31, 1071
- 1992, INTERNATIONAL JOURNAL OF OBESITY AND RELATED METABOLIC DISORDERS, 16, 991
- 1995, INTERNATIONAL JOURNAL OF OBESITY AND RELATED METABOLIC DISORDERS, 19, 614
- 2007, 191, 235
- Jockenh vel, 1997, European journal of medical research, 2, 293
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Metadata
- 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
- 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
- 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 (medical) › 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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