Metabolic Effects of Testosterone Added to Intensive Lifestyle Intervention in Older Men With Obesity and Hypogonadism.

HbA1c decreased similarly in both treatment groups, with no additional benefit from adding TRT to lifestyle therapy.

• HbA1c change was -0.5 ± 0.1% in the LT + TRT group versus -0.6 ± 0.1% in the LT + Pbo group (P = 0.35).
• This was the primary outcome of the study.
• Study included 83 older men (age ≥ 65 years) with obesity (BMI ≥ 30 kg/m²) and persistently low morning testosterone (< 10.4 nmol/L) associated with frailty.
• The intervention lasted 6 months in a randomized, double-blind, placebo-controlled trial at a Veterans Affairs Medical Center.

TRT eliminated the augmentative effect of lifestyle therapy on HDL cholesterol concentration.

• HDL cholesterol increased by 5.4 ± 1.0 mg/dL in the LT + Pbo group compared to only 0.2 ± 1.1 mg/dL in the LT + TRT group (P = .01).
• This represented a blunting of the beneficial lipid effect otherwise observed with lifestyle therapy alone.
• This was among the secondary outcomes assessed.

TRT eliminated the augmentative effect of lifestyle therapy on adiponectin levels.

• Adiponectin levels changed by -408 ± 489 ng/mL in the LT + TRT group versus +1832 ± 468 ng/mL in the LT + Pbo group (P = .02).
• The LT + TRT group showed a decrease in adiponectin while the LT + Pbo group showed an increase.
• Adiponectin was among the secondary outcomes including inflammatory markers and adipokines.

TRT showed no synergistic effect with lifestyle therapy on any of the secondary metabolic outcomes measured.

• Secondary outcomes included changes in other glucometabolic and lipid profile components, liver enzymes, inflammatory markers, and adipokines.
• Additional secondary outcomes included subcutaneous, visceral, intramuscular, and hepatic fat; blood pressure; and metabolic syndrome score.
• No statistically significant additional benefit of TRT over placebo was found for any of these secondary outcomes.

The study population consisted of older men with obesity, hypogonadism, and frailty enrolled in a randomized controlled trial.

• Participants were age ≥ 65 years with BMI ≥ 30 kg/m² and persistently low morning testosterone < 10.4 nmol/L associated with frailty.
• A total of 83 men were randomized to LT plus testosterone (LT + TRT) or LT plus placebo (LT + Pbo).
• The trial was a randomized, double-blind, placebo-controlled design conducted at a Veterans Affairs Medical Center.
• This report was described as a secondary analysis of the randomized controlled trial.