Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial

Background: Men with obesity tend to be insulin resistant and often have low-normal testosterone concentrations. We conducted a clinical trial aimed to evaluate potential therapeutic strategies for low testosterone in men with obesity. Methods: We did a 1-year, parallel, randomized, double-blind, pl...

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Authors: Fernández-García, J.C. (José Carlos)|||/items/88c911df-a83d-4be9-aca5-d298ee41f6cb, Barrios-Rodríguez, R. (Rocío)|||/items/a1817321-37c7-402b-b7bc-70d1464f3add, Asenjo-Plaza, M. (Maite)|||/items/70f1d7d2-fb4e-441d-aff2-2b490ee6ee25, Ramos-Molina, B. (Bruno)|||/items/728f7858-ad11-4f2a-b259-7dd369f72220, Molina-Vega, M. (María)|||/items/00d2b443-7ffa-4abb-a997-a8fc772af24a, Peinado-Guzmán, J. A. (José Antonio)|||/items/74ec3b93-c3d5-47d6-b8f0-95d9b528f48f, Moreno-León, L. (Luis)|||/items/af529412-6d1b-47b7-956f-cd6fd200753a, Yubero-Serrano, E.M. (Elena M.)|||/items/133e700d-159b-4eb8-ac7e-f3de8668645c, Rius-Díaz, F. (Francisca)|||/items/b9312d2e-c945-417f-9d12-7a92b856b47b, Valdes, S. (Sergio)|||/items/018ae2cf-0a02-4601-bc06-8b62452b3319, Martínez-González, M.A. (Miguel Ángel)|||/items/8b591471-4165-4697-8534-cfa0ad5eb1b7, Jiménez-Moleón, J.J. (José Juan)|||/items/cb714f5d-4da0-4452-8033-a194006facec, Tinahones, F.J. (Francisco J.)|||/items/3c469348-deec-4066-bd93-383e05813c10
Format: article
Publication Date:2022
Country:España
Institution:Universidad de Navarra
Repository:Dadun. Depósito Académico Digital de la Universidad de Navarra
Language:English
OAI Identifier:oai:dnet:dadun_______::4fa5168c6586b6805853f54c10f85645
Online Access:https://hdl.handle.net/10171/124546
Access Level:Open access
Keyword:Erectile dysfunction
Insulin resistance
Metformin
Obesity
Testosterone
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spelling Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trialFernández-García, J.C. (José Carlos)|||/items/88c911df-a83d-4be9-aca5-d298ee41f6cbBarrios-Rodríguez, R. (Rocío)|||/items/a1817321-37c7-402b-b7bc-70d1464f3addAsenjo-Plaza, M. (Maite)|||/items/70f1d7d2-fb4e-441d-aff2-2b490ee6ee25Ramos-Molina, B. (Bruno)|||/items/728f7858-ad11-4f2a-b259-7dd369f72220Molina-Vega, M. (María)|||/items/00d2b443-7ffa-4abb-a997-a8fc772af24aPeinado-Guzmán, J. A. (José Antonio)|||/items/74ec3b93-c3d5-47d6-b8f0-95d9b528f48fMoreno-León, L. (Luis)|||/items/af529412-6d1b-47b7-956f-cd6fd200753aYubero-Serrano, E.M. (Elena M.)|||/items/133e700d-159b-4eb8-ac7e-f3de8668645cRius-Díaz, F. (Francisca)|||/items/b9312d2e-c945-417f-9d12-7a92b856b47bValdes, S. (Sergio)|||/items/018ae2cf-0a02-4601-bc06-8b62452b3319Martínez-González, M.A. (Miguel Ángel)|||/items/8b591471-4165-4697-8534-cfa0ad5eb1b7Jiménez-Moleón, J.J. (José Juan)|||/items/cb714f5d-4da0-4452-8033-a194006facecTinahones, F.J. (Francisco J.)|||/items/3c469348-deec-4066-bd93-383e05813c10Erectile dysfunctionInsulin resistanceMetforminObesityTestosteroneBackground: Men with obesity tend to be insulin resistant and often have low-normal testosterone concentrations. We conducted a clinical trial aimed to evaluate potential therapeutic strategies for low testosterone in men with obesity. Methods: We did a 1-year, parallel, randomized, double-blind, placebo-controlled trial, where we evaluated the independent and combined effects of metformin and testosterone in 106 men with obesity, aged 18-50 years, who had low levels of testosterone and no diabetes mellitus. The primary outcome was change in insulin resistance, measured as Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index. Secondary outcomes included changes in total and free serum testosterone, body composition, metabolic variables, erectile function, and health-related quality of life (HRQoL). Results: In the intention-to-treat analysis, the HOMA-IR index decreased significantly in all active groups compared to placebo (metformin -2.4, 95 % CI -4.1 to -0.8, p = 0.004; testosterone -2.7, 95 % CI -4.3 to -1.1, p = 0.001; combination -3.4, 95 % CI -5.0 to -1.8, p < 0.001). Combination therapy was not superior to testosterone alone in decreasing insulin resistance (-0.7, 95 % CI -2.3 to 0.9, p = 0.383). Only the combination of metformin plus testosterone significantly increased total and free testosterone concentrations, compared to placebo. No significant changes in body composition (except for a higher decrease in fat mass in the metformin and combination group), metabolic variables, erectile function, or HRQoL were found with any treatment. Conclusions: Among men with obesity and low testosterone concentrations, the combination of metformin plus testosterone, metformin only, and testosterone only, compared to placebo, reduced insulin resistance with no evidence of additive benefit.ElsevierDadun. Depósito Académico Digital Universidad de Navarra20222022-01-0120222022-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/124546reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dnet:dadun_______::4fa5168c6586b6805853f54c10f856452026-06-21T12:47:57Z
dc.title.none.fl_str_mv Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
title Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
spellingShingle Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
Fernández-García, J.C. (José Carlos)|||/items/88c911df-a83d-4be9-aca5-d298ee41f6cb
Erectile dysfunction
Insulin resistance
Metformin
Obesity
Testosterone
title_short Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
title_full Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
title_fullStr Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
title_full_unstemmed Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
title_sort Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial
dc.creator.none.fl_str_mv Fernández-García, J.C. (José Carlos)|||/items/88c911df-a83d-4be9-aca5-d298ee41f6cb
Barrios-Rodríguez, R. (Rocío)|||/items/a1817321-37c7-402b-b7bc-70d1464f3add
Asenjo-Plaza, M. (Maite)|||/items/70f1d7d2-fb4e-441d-aff2-2b490ee6ee25
Ramos-Molina, B. (Bruno)|||/items/728f7858-ad11-4f2a-b259-7dd369f72220
Molina-Vega, M. (María)|||/items/00d2b443-7ffa-4abb-a997-a8fc772af24a
Peinado-Guzmán, J. A. (José Antonio)|||/items/74ec3b93-c3d5-47d6-b8f0-95d9b528f48f
Moreno-León, L. (Luis)|||/items/af529412-6d1b-47b7-956f-cd6fd200753a
Yubero-Serrano, E.M. (Elena M.)|||/items/133e700d-159b-4eb8-ac7e-f3de8668645c
Rius-Díaz, F. (Francisca)|||/items/b9312d2e-c945-417f-9d12-7a92b856b47b
Valdes, S. (Sergio)|||/items/018ae2cf-0a02-4601-bc06-8b62452b3319
Martínez-González, M.A. (Miguel Ángel)|||/items/8b591471-4165-4697-8534-cfa0ad5eb1b7
Jiménez-Moleón, J.J. (José Juan)|||/items/cb714f5d-4da0-4452-8033-a194006facec
Tinahones, F.J. (Francisco J.)|||/items/3c469348-deec-4066-bd93-383e05813c10
author Fernández-García, J.C. (José Carlos)|||/items/88c911df-a83d-4be9-aca5-d298ee41f6cb
author_facet Fernández-García, J.C. (José Carlos)|||/items/88c911df-a83d-4be9-aca5-d298ee41f6cb
Barrios-Rodríguez, R. (Rocío)|||/items/a1817321-37c7-402b-b7bc-70d1464f3add
Asenjo-Plaza, M. (Maite)|||/items/70f1d7d2-fb4e-441d-aff2-2b490ee6ee25
Ramos-Molina, B. (Bruno)|||/items/728f7858-ad11-4f2a-b259-7dd369f72220
Molina-Vega, M. (María)|||/items/00d2b443-7ffa-4abb-a997-a8fc772af24a
Peinado-Guzmán, J. A. (José Antonio)|||/items/74ec3b93-c3d5-47d6-b8f0-95d9b528f48f
Moreno-León, L. (Luis)|||/items/af529412-6d1b-47b7-956f-cd6fd200753a
Yubero-Serrano, E.M. (Elena M.)|||/items/133e700d-159b-4eb8-ac7e-f3de8668645c
Rius-Díaz, F. (Francisca)|||/items/b9312d2e-c945-417f-9d12-7a92b856b47b
Valdes, S. (Sergio)|||/items/018ae2cf-0a02-4601-bc06-8b62452b3319
Martínez-González, M.A. (Miguel Ángel)|||/items/8b591471-4165-4697-8534-cfa0ad5eb1b7
Jiménez-Moleón, J.J. (José Juan)|||/items/cb714f5d-4da0-4452-8033-a194006facec
Tinahones, F.J. (Francisco J.)|||/items/3c469348-deec-4066-bd93-383e05813c10
author_role author
author2 Barrios-Rodríguez, R. (Rocío)|||/items/a1817321-37c7-402b-b7bc-70d1464f3add
Asenjo-Plaza, M. (Maite)|||/items/70f1d7d2-fb4e-441d-aff2-2b490ee6ee25
Ramos-Molina, B. (Bruno)|||/items/728f7858-ad11-4f2a-b259-7dd369f72220
Molina-Vega, M. (María)|||/items/00d2b443-7ffa-4abb-a997-a8fc772af24a
Peinado-Guzmán, J. A. (José Antonio)|||/items/74ec3b93-c3d5-47d6-b8f0-95d9b528f48f
Moreno-León, L. (Luis)|||/items/af529412-6d1b-47b7-956f-cd6fd200753a
Yubero-Serrano, E.M. (Elena M.)|||/items/133e700d-159b-4eb8-ac7e-f3de8668645c
Rius-Díaz, F. (Francisca)|||/items/b9312d2e-c945-417f-9d12-7a92b856b47b
Valdes, S. (Sergio)|||/items/018ae2cf-0a02-4601-bc06-8b62452b3319
Martínez-González, M.A. (Miguel Ángel)|||/items/8b591471-4165-4697-8534-cfa0ad5eb1b7
Jiménez-Moleón, J.J. (José Juan)|||/items/cb714f5d-4da0-4452-8033-a194006facec
Tinahones, F.J. (Francisco J.)|||/items/3c469348-deec-4066-bd93-383e05813c10
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Erectile dysfunction
Insulin resistance
Metformin
Obesity
Testosterone
topic Erectile dysfunction
Insulin resistance
Metformin
Obesity
Testosterone
description Background: Men with obesity tend to be insulin resistant and often have low-normal testosterone concentrations. We conducted a clinical trial aimed to evaluate potential therapeutic strategies for low testosterone in men with obesity. Methods: We did a 1-year, parallel, randomized, double-blind, placebo-controlled trial, where we evaluated the independent and combined effects of metformin and testosterone in 106 men with obesity, aged 18-50 years, who had low levels of testosterone and no diabetes mellitus. The primary outcome was change in insulin resistance, measured as Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index. Secondary outcomes included changes in total and free serum testosterone, body composition, metabolic variables, erectile function, and health-related quality of life (HRQoL). Results: In the intention-to-treat analysis, the HOMA-IR index decreased significantly in all active groups compared to placebo (metformin -2.4, 95 % CI -4.1 to -0.8, p = 0.004; testosterone -2.7, 95 % CI -4.3 to -1.1, p = 0.001; combination -3.4, 95 % CI -5.0 to -1.8, p < 0.001). Combination therapy was not superior to testosterone alone in decreasing insulin resistance (-0.7, 95 % CI -2.3 to 0.9, p = 0.383). Only the combination of metformin plus testosterone significantly increased total and free testosterone concentrations, compared to placebo. No significant changes in body composition (except for a higher decrease in fat mass in the metformin and combination group), metabolic variables, erectile function, or HRQoL were found with any treatment. Conclusions: Among men with obesity and low testosterone concentrations, the combination of metformin plus testosterone, metformin only, and testosterone only, compared to placebo, reduced insulin resistance with no evidence of additive benefit.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10171/124546
url https://hdl.handle.net/10171/124546
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
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