Key result
Treatment for testosterone deficiency in men was associated with significant 12-month reductions in triglycerides, HbA1c, and HDL.
Why the study?
Does treatment for testosterone deficiency improve blood-based metabolic and cardiovascular risk profiles in men?
Cohort (n=4,307)
No
Does treatment for testosterone deficiency improve blood-based metabolic and cardiovascular risk profiles in men?
Answers are grounded in this paper and cite their sources.
Treatment for testosterone deficiency in men is associated with significant reductions in HbA1c and triglycerides, but also a reduction in HDL over 12 months.
BACKGROUND: Cross-sectional analyses demonstrate associations between lower endogenous testosterone, poorer metabolic health, and cardiovascular risk. However, the longitudinal associations between treating testosterone deficiency (TD) and key markers are unclear. AIM: To examine 12-month trends in total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), haemoglobin A1c (HbA1c), triglycerides, and triglyceride:HDL ratios during treatment for TD. METHODS: This retrospective cohort study used mixed effects models to assess marker trajectories. OUTCOMES: Absolute and percentage changes calculated from average marker values at 0 and 12 months (overall and sub-groups). RESULTS: The cohort comprised 4307 men (median age 41 years; baseline BMI 28.4 kg/m2). No significant changes were observed in LDL. The average HDL level at baseline was 1.26 mmol/L (95% CI: 1.25 to 1.26), decreasing to 1.15 (95% CI: 1.10 to 1.20) at 12 months, a relative change of -8.73% (P < 0.001). There was a 1.55 mmol/mol (95% CI: -2.74 to -0.36) average reduction in HbA1c over 12 months (relative change -4.46%, P = 0.011). The average triglyceride level was 2.25 mmol/L at baseline (95% CI: 2.20 to 2.28) and 1.79 mmol/L (95% CI: 1.55 to 2.04) at 12 months, a relative change of -20.09% (P < 0.001). Men with elevated baseline triglycerides had marked reductions, from 3.13 mmol/L at baseline to (95% CI: 3.67 to 3.79) to 2.29 mmol/L at 12 months (95% CI: 1.90 to 2.68), relative change -26.84% (P < 0.001). There was a positive relationship between baseline triglyceride:HDL elevation and relative reductions; in men with a baseline ratio > 6, values went from 8.99 at baseline (95% CI: 8.80 to 9.18) to 1.90 (95% CI: 0.19 to 3.61) at month 12, a relative change of -78.86% (P < 0.001). CLINICAL IMPLICATIONS: In this non-randomized study, significant reductions in HDL, HbA1c, triglycerides, and the triglyceride:HDL ratio were observed during the course of treatment for TD. STRENGTHS & LIMITATIONS: The study used a large cohort of men and explored clinically relevant sub-groups, albeit from a single healthcare provider. CONCLUSIONS: Interventions for TD could have potential to improve longer-term cardiometabolic health in hypogonadic men. Large, prospective, controlled studies are needed to identify the causal contributions from TD treatment strategies and lifestyle changes on biochemical marker improvements.
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Clift et al. (2025) conducted a cohort in Testosterone deficiency (n=4,307). Treatment for testosterone deficiency vs. Baseline (pre-treatment) was evaluated on 12-month trends in total cholesterol, HDL, LDL, HbA1c, triglycerides, and triglyceride:HDL ratios. Treatment for testosterone deficiency in men was associated with significant 12-month reductions in triglycerides, HbA1c, and HDL.
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