Testosterone Undecanoate Significantly Reduces Low Density Lipoprotein Cholesterol and Triglycerides in Men With Adult‐Onset Testosterone Deficiency
Anirudh Bhat, Arjun Ajith Kumar, Michael Zitzmann, Farid Saad, Carola S. König, Karim Sultan Haider, Ahmad Haider, Geoffrey Hackett, Pieter Desnerck, John Marriott, Amar Mann, Richard C. Strange, Sudarshan RamachandranABSTRACT
Background
Adult‐onset testosterone deficiency, a condition characterised by low serum testosterone and hypogonadal symptoms is associated with a higher incidence of cardiovascular disease (CVD) and mortality.
Objective
To evaluate associations between change (Δ) in total cholesterol (TC), triglycerides (TG) and low‐density lipoprotein (LDL)‐cholesterol and testosterone undecanoate (TU) treatment.
Materials & Methods
We analysed a registry of men with adult‐onset TD (409 TU‐treated and 415 TU‐untreated men, median follow‐up 153 months), restricting the analysis to men whose statin treatment was not changed during follow‐up, thus avoiding statin related effects. The study cohort comprised the following groups: TU‐untreated/not on statins ( n = 95), TU‐untreated/on statins ( n = 245), TU‐treated/not on statins ( n = 194), and TU‐treated/on statins ( n = 207). Intra‐group non‐parametric statistics were performed as baseline characteristics varied between the study groups. We used multivariate and logistic regression models to determine predictors of ∆ lipids (LDL‐cholesterol and TG) and mortality.
Results
Whilst there was a significant decrease in LDL‐cholesterol and TG (mostly in the initial 24 months) in the TU‐treated men, the reverse was evident in the untreated men, irrespective of concurrent statin therapy. Baseline LDL‐cholesterol and TG inversely predicted ∆ values in the TU‐treated men, regardless of statin therapy. LDL‐cholesterol at final assessment appeared independently associated with mortality.
Conclusions
In this long‐term, real‐world registry, TC, TG, and LDL‐cholesterol decreased in the TU‐treated men with baseline values predicting the change, whilst a gradual increase was observed in the TU‐untreated men. Using published data, the relative risk reduction in CVD due to LDL‐cholesterol reduction is estimated to be around 40%.