Testosterone with dutasteride, but not anastrazole, improves insulin sensitivity in young obese men: a randomized controlled trial.
J Sex Med
; 11(2): 563-73, 2014 Feb.
Article
en En
| MEDLINE
| ID: mdl-24344872
ABSTRACT
INTRODUCTION:
Testosterone (T) administration to men increases T, estradiol (E2), dihydrotestosterone (DHT), and fat-free mass (FFM), and decreases fat mass (FM) but does not consistently improve insulin sensitivity (IS).AIM:
The aim of this study was to examine the effects of T administration in obese, nondiabetic men on body composition and IS, and to determine if inhibition (i) of metabolism of T to E2 with anastrazole or to DHT with dutasteride alters these effects.METHODS:
This was a 98-day randomized, double-blind, parallel group, placebo-controlled trial of 57 men, 24-51 year, free T in the lower 25% of normal range (<0.33 nmol/L), body mass index ≥ 30.0 kg/m(2). Subjects were randomized to one of four groups (i) placebo gel, pills, and injection; (ii) T/DHT/iE2 T gel, anastrazole, and acyline (gonadotropin releasing-hormone antagonist to suppress endogenous T); (iii) T/iDHT/E2 T gel, dutasteride, and acyline; (iv) T/DHT/E2 T gel, placebo pills, and acyline. MAIN OUTCOMEMEASURES:
Main outcome measures are insulin sensitivity as percent change (%Δ) in glucose disposal rates (GDR) from a two-step euglycemic clamp (GDR1 and 2), and %FM and %FFM by dual X-ray absorptiometry scan.RESULTS:
Insulin Sensitivity %Δ GDR1 differed across groups (P = 0.02, anova) and was significantly higher in the dutasteride (T/iDHT/E2) compared with the placebo and T gel (T/DHT/E2) groups. %ΔGDR2 was higher in the dutasteride (T/iDHT/E2) compared with the anastrazole (T/DHT/iE2) group. Body Composition T gel alone (T/DHT/E2) or with dutasteride (T/iDHT/E2) significantly increased %FFM (P < 0.05) and decreased %FM (P < 0.05). There was no change in %FFM or %FM after placebo or anastrazole (T/DHT/iE2).CONCLUSIONS:
The combination of T plus dutasteride improved body composition and IS while T alone improved body composition but not IS, suggesting that when T is administered to men, reduction to DHT attenuates the beneficial effects of aromatization to E2 on IS but not body composition.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Azaesteroides
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Testosterona
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Composición Corporal
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Resistencia a la Insulina
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Inhibidores de 5-alfa-Reductasa
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Obesidad
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
Límite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2014
Tipo del documento:
Article