State of lipid metabolism in patients receiving androgen replacement therapy

Objective. To assess the state of lipid metabolism indicators and predict cardiovascular risk in patients with secondary (acquired) hypogonadism on the background of androgen replacement therapy. Testosterone replacement therapy is often used in modern medicine for diagnosed androgen deficiency in patients of any age group. There are quite a lot of publications devoted to diagnosis and treatment, but the effectiveness and safety of any therapy is determined by several factors, of which two were considered in the presented study dose-dependent effect and compliance. Material and methods. Sixty two patients aged 30 to 52 years with androgen deficiency and a low risk of developing cardiovascular diseases were examined according to the Princeton Consensus criteria. Patients were divided into groups depending on the severity of androgen deficiency and the duration of therapy. Complaints, objective status, muscle strength, daily blood pressure and heart rate monitoring data, lipidogram and sex hormone indicators were evaluated. Results. The obtained data suggest that androgen replacement therapy in doses that lead to an increase in the level of testosterone in the blood above the upper limit of reference values had a negative impact on the lipid spectrum and increased cardiovascular risk for this group of patients. Conclusions. The analyzed approach to therapy of androgen deficiency should provide an individual adjustment of dosage on the background of determining the target blood testosterone level.

Characteristic features of correcting testosterone deficiency syndrome in young men with obesity

Aim. To assess the approaches to treatment of testosterone deficiency syndrome (TDS) in fertile (young) men with obesity. Materials and methods. Comparative analysis of peculiarities of TDS correction in 120 men aged 21–35, suffering from class III abdominovisceral obesity, was performed taking into account the personified approach. Testosterone deficiency syndrome was detected in all the examined men. The examined patients were divided into two completely comparable groups: in group I, androgen replacement therapy was administered to patients, in group II – individual balanced diet, combined with individual physical loads and course of inhibitor of gastrointestinal lipases. Results. In both groups, identical efficiency of TDS therapy in young men with obesity was established: when applying androgen replacement therapy and body mass decreasing therapy. However, the most favorable conditions for restoration of fertility are created when using complex multifactor therapy without testosterone preparations, since along with correction of erectile dysfunction, there is observed optimization of spermogram indices. Conclusions. Differentiated approach to correction of testosterone deficiency syndrome among patients with obesity permits to optimize financial expenditure for treatment and preserve reproductive function. The body mass decrease leads to liquidation of testosterone deficiency syndrome, normalization of erectile function and lipid spectrum.