© 2007 European Society of Cardiology
The effect of testosterone on insulin sensitivity in men with heart failure
a Department of Cardiology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust Sheffield, S10 2JF, United Kingdom
b Centre for Diabetes and Endocrinology, Barnsley District General Hospital, Barnsley District General Hospital NHS Trust Barnsley, S57 5RT, United Kingdom
c Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Sheffield, S10 2BD, United Kingdom
* Corresponding author. Room M131, Department of Cardiology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, S10 2JF. United Kingdom. Tel.: +44 114 271 3472; fax: +44 114 271 2042. E-mail address: Kevin.Channer{at}sth.nhs.uk
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Abstract |
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Resistance to insulin occurs in chronic heart failure (CHF) and is related to prognosis. Studies of testosterone in non-(CHF) males suggest that physiological testosterone therapy improves insulin sensitivity. This was a single-blind placebo controlled crossover trial to determine the effect of testosterone replacement on insulin sensitivity in 13 men with moderate to severe CHF (ejection fraction 30.5±1.3). The primary outcome was the homeostatic model index (HOMA-IR) of fasting insulin sensitivity and secondary outcomes were body composition as measured by bioelectrical impedance and glucose tolerance to a standard 75 g oral glucose load. Analysis was performed on the delta values with the treatment effect of placebo compared with that of testosterone.
At baseline HOMA-IR correlated with measures of body fat [% fat mass (rP=0.84, p=0.0001) and body mass index (rP=0.79, p=0.01)] but not with CHF severity. Testosterone reduced HOMA-IR (–1.9±0.8, p=0.03) indicating improved fasting insulin sensitivity. Testosterone also increased total mass (+1.5±0.5 kg, p=0.008) and decreased body fat (–0.8±0.3%, p=0.02).
Testosterone improves fasting insulin sensitivity in men with CHF and may also increase lean body mass, these data suggest a favourable effect of testosterone on an important metabolic component of CHF.
Key Words: Testosterone • Insulin resistance • Chronic heart failure • Hormones
Received June 9, 2005; Revised April 11, 2006; Accepted April 11, 2006
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