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Vol 68, No 3 (2017)
Original paper
Submitted: 2016-01-17
Accepted: 2016-06-04
Published online: 2017-02-22
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Effect of testosterone replacement therapy on vitamin D and FGF-23 levels in congenital hypogonadism

Cem Haymana1, Alper Sonmez1, Aydogan Aydogdu1, Serkan Tapan2, Yalcin Basaran1, Coskun Meric1, Kamil Baskoy3, Abdullah Taslipinar1, Mahmut Ilker Yilmaz4, Omer Azal1
DOI: 10.5603/EP.a2017.0009
·
Pubmed: 28230890
·
Endokrynol Pol 2017;68(3):311-616.
Affiliations
  1. Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018 Etlik Ankara, Turkey
  2. Department of Biochemistry, Gulhane School of Medicine, 06018 Etlik Ankara, Turkey
  3. Department of Endocrinology and Metabolism, Gulhane School of Medicine Haydarpasa Training Hospital, 34668 Istanbul, Turkey
  4. Department of Nephrology, Gulhane School of Medicine, 06018 Etlik Ankara, Turkey

open access

Vol 68, No 3 (2017)
Original Paper
Submitted: 2016-01-17
Accepted: 2016-06-04
Published online: 2017-02-22

Abstract

Introduction: Patients with hypogonadism are at increased risk of cardiac and metabolic diseases and osteoporosis. Vitamin D and Fibroblast growth factor-23 (FGF-23) play role in the regulation of bone mineral metabolism and endothelial functions. Low vitamin D levels are reported in hypogonadism, while there is no data about the effect of testosterone replacement therapy (TRT). We investigated the effect of TRT on vitamin D and FGF-23 levels along with endothelial functions and insulin resistance in hypogonadal patients.

Material and methods: Patients with congenital hypogonadotrophic hypogonadism (CHH) (n=32, age 20.6 ±1.58 years) were enrolled. TRT was implemented in transdermal form. The demographic parameters, FGF-23, 25(OH)D3, Asymmetric dimethylarginine (ADMA) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured both before and after TRT.

Results: After a follow-up period of 3.63±1.33 months, ADMA and FGF-23 levels were significantly increased (p=0.03 and p=0.005 respectively), while the 25(OH)D3 and HOMA-IR index were not significantly changed. The body mass index and waist circumference levels of the patients were also increased (p<0.001 and p=0.02) along with a significant decrease in the HDL cholesterol levels (p=0.006).

Conclusions: The results show that a short term TRT increases plasma FGF-23 and ADMA levels, in young, treatment naive patients with CHH. Whether this is an early implication of TRT related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardio-metabolic morbidity and mortality in this specific population.

Abstract

Introduction: Patients with hypogonadism are at increased risk of cardiac and metabolic diseases and osteoporosis. Vitamin D and Fibroblast growth factor-23 (FGF-23) play role in the regulation of bone mineral metabolism and endothelial functions. Low vitamin D levels are reported in hypogonadism, while there is no data about the effect of testosterone replacement therapy (TRT). We investigated the effect of TRT on vitamin D and FGF-23 levels along with endothelial functions and insulin resistance in hypogonadal patients.

Material and methods: Patients with congenital hypogonadotrophic hypogonadism (CHH) (n=32, age 20.6 ±1.58 years) were enrolled. TRT was implemented in transdermal form. The demographic parameters, FGF-23, 25(OH)D3, Asymmetric dimethylarginine (ADMA) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured both before and after TRT.

Results: After a follow-up period of 3.63±1.33 months, ADMA and FGF-23 levels were significantly increased (p=0.03 and p=0.005 respectively), while the 25(OH)D3 and HOMA-IR index were not significantly changed. The body mass index and waist circumference levels of the patients were also increased (p<0.001 and p=0.02) along with a significant decrease in the HDL cholesterol levels (p=0.006).

Conclusions: The results show that a short term TRT increases plasma FGF-23 and ADMA levels, in young, treatment naive patients with CHH. Whether this is an early implication of TRT related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardio-metabolic morbidity and mortality in this specific population.

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Keywords

hypogonadism; vitamin D; fibroblast growth factor-23; asymmetric dimethyl arginine

About this article
Title

Effect of testosterone replacement therapy on vitamin D and FGF-23 levels in congenital hypogonadism

Journal

Endokrynologia Polska

Issue

Vol 68, No 3 (2017)

Article type

Original paper

Pages

311-616

Published online

2017-02-22

Page views

2374

Article views/downloads

2391

DOI

10.5603/EP.a2017.0009

Pubmed

28230890

Bibliographic record

Endokrynol Pol 2017;68(3):311-616.

Keywords

hypogonadism
vitamin D
fibroblast growth factor-23
asymmetric dimethyl arginine

Authors

Cem Haymana
Alper Sonmez
Aydogan Aydogdu
Serkan Tapan
Yalcin Basaran
Coskun Meric
Kamil Baskoy
Abdullah Taslipinar
Mahmut Ilker Yilmaz
Omer Azal

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