Effects of testosterone gel treatment in hypogonadal men with liver cirrhosis.

Abstract

INTRODUCTION:

Hypogonadism characterized by low serum testosterone level, loss of libido, small testes, impotence and gynecomastia is a common clinical situation in male patients with advanced chronic liver disease. The aim of the study was to assess the efficacy and safety of testosterone replacement on muscle strength, bone mineral density (BMD), body composition and gynecomastia in hypogonadal men with liver cirrhosis.

METHODS:

Sixteen hypogonadal male cirrhotic patients were included and twelve completed the study. Abdominal USG and/or MRI were performed to exclude hepatocellular cancer. Testogel 50mg/day was administered for 6 months. Liver enzymes, hormone profiles and muscle strength were evaluated monthly. Body composition parameters, BMD and gynecomastia were evaluated before and after 6 months.

RESULTS:

Serum free testosterone level was higher (20.13 ± 10.06 pmol/L; 57.26 ± 39.56 pmol/L, P=0.002) after treatment. Testosterone replacement resulted in an increase in muscle strength (34.03 ± 7.24 kg; 39.18 ± 5.99 kg, P<0.001), the subscapular site subcutaneous fat tissue (P=0.012) and the sum of the four regions (P=0.04). Subareolar breast tissue was lower (28.83 ± 17.18 mm; 15.00 ± 6.74 mm, P=0.007) after treatment. No significant adverse effects were detected.

DISCUSSION:

Testosterone gel 50mg/day raises free testosterone to values below supraphysiological levels in cirrhotic men. Transdermal testosterone replacement improves muscle strength, ameliorates gynecomastia, alters body fat distribution and causes upper body adiposity in hypogonadal men with cirrhosis. Application of testosterone gel, which undergoes no hepatic first-pass metabolism, seems as a safe and well-tolerated agent in liver cirrhosis as compared to other anabolic steroids, which may be associated with various adverse events.

• Authors: Alper Yurci, Mehmet Yucesoy, Kursad Unluhizarci, Edip Torun, Sebnem Gursoy, Mevlut Baskol, Kadri Guven, Omer Ozbakir
• Journal: Clinics and research in hepatology and gastroenterology (Clin Res Hepatol Gastroenterol) Vol. 35 Issue 12 Pg. 845-54 (Dec 2011) ISSN: 2210-741X [Electronic] France
• PMID: 22074639 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2011. Published by Elsevier Masson SAS.

Chemical References

• Gels
• Testosterone

Topics

• Administration, Topical
• Gels
• Humans
• Hypogonadism (complications, etiology)
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Prospective Studies
• Testosterone (administration & dosage, therapeutic use)