Testosterone Therapy in Glucocorticoid-Treated Men

doi:10.1001/archinte.1996.00440100065008

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Vol. 156 No. 11, 10 JUNE 1996

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Testosterone Therapy in Glucocorticoid-Treated Men

Ian R. Reid, MD; Diana J. Wattie, RN; Margaret C. Evans; Joanne P. Stapleton, RGON

Arch Intern Med. 1996;156(11):1173-1177.

Abstract

Background
Treatment with glucocorticoid drugs is a valuable therapy, butthe use of these drugs is associated with major side effects,including osteoporosis, muscle wasting, and obesity. In menwho take glucocorticoids, circulating testosterone concentrationsare reduced, and this might contribute to the changes in boneand soft-tissue mass.

Objective
To assess the effect of testosterone replacement on these above-mentionedparameters in glucocorticoid-treated men.

Methods
Fifteen asthmatic men who were receiving long-term glucocorticoidtreatment were randomly allocated to receive therapy with testosteroneesters (30 mg of proprionate, 60 mg of phenylprionate, 60 mgof isocaproate, and 100 mg of decanoate [Sustanon]) (250-mg/mointramuscular depot injection) or to act as control subjectsduring 12 months. After a washout period for those men who werereceiving testosterone, the groups were then crossed over andstudied for a further 12 months. Bone density and body compositionwere assessed by dual-energy, x-ray absorptiometry. Paired orunpaired 2-tailed t tested were calculated. Unless otherwisestated, all values are given as mean±SEM.

Results
Bone density in the lumbar spine increased 5.0%±1.4%(mean±SEM) (P=.005) during testosterone supplementation,but it did not change during the control period (between-groupsdifference, P=.05). These changes were accompanied by a decreasein the indexes of bone turnover. There was a gain in body fatmass (2.1±0.06 kg, P=.01) and a loss of lean body mass(1.4±0.5 kg, P=.02) during the control period, with bothchanges being reversed by testosterone treatment (P<.03).

Conclusion
Testosterone treatment reverses the deleterious effects of glucocorticoiddrugs on skeletal and soft tissues in men.

(Arch Intern Med. 1996;156:1173-1177)

Author Affiliations

From the Department of Medicine, University of Auckland (New Zealand).

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