Serum testosterone levels may influence body composition and cardiometabolic health in men with spinal cord injury

Spinal Cord, 2019 · DOI: 10.1038/s41393-018-0207-7 · Published: March 1, 2019

Simple Explanation

Spinal cord injury (SCI) leads to dramatic changes in body composition and metabolic profile, which represents an accelerated form of aging. Testosterone (T) is widely recognized as the primary male sex hormone. Its anabolic effects contribute to increased muscle mass, improved bone mineral density and musculoskeletal strength. Men with low serum T have more unfavorable body composition and cardiometabolic health outcomes after SCI. Testosterone replacement therapy may serve as a potential strategy in preventing cardiometabolic disorders after SCI.

Study Duration

Not specified

Participants

Thirty-six men with chronic motor complete SCI

Evidence Level

Cross-sectional study

Key Findings

1
Low range serum T group had greater total (9.6%, P= 0.04) percentage fat mass and visceral adipose tissue (VAT) area (72%, P= 0.01) compared to normal range serum T group.
2
Serum T was related to the absolute whole thigh muscle area (r= 0.40, P< 0.05) after controlling for body mass index.
3
Serum T was negatively related to fasting plasma glucose (r= −0.46, P= 0.006) and insulin (r= −0.42, P= 0.01), HbA1c (r= −0.39, P= 0.02) and triglycerides (r= −0.36, P= 0.03).

Research Summary

The findings demonstrated that multiple indicators of cardiometabolic health and body composition variables are associated with serum T levels in men with motor complete SCI. The low range serum T group had 9.6% greater total and 12.7% greater trunk % fat mass compared to normal range serum T group. Serum T was positively related to whole thigh muscle CSA after controlling for BMI, and was negatively related to biomarkers of carbohydrate and lipid metabolism including fasting glucose, insulin, HbA1c, TG and positively related to insulin sensitivity.

Practical Implications

Testosterone Replacement Therapy (TRT)

TRT may attenuate or restore the loss in lean mass in persons with SCI and may help improve lean mass within the first three to six months of therapy.

Ectopic Adiposity Reduction

TRT may be beneficial in hypogonadal men with SCI by decreasing accumulation of fat mass, VATCSA and thigh % IMF.

Improved Cardiometabolic Profile

TRT may improve cardiometabolic profile by possibly inducing mitochondrial biogenesis.

Study Limitations

1
Small sample size, especially volunteers with motor complete SCI.
2
Cross-sectional design, causality cannot be established.
3
Total serum T levels measured without measuring free or bioavailable T concentrations.

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