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Reviews in Endocrine and Metabolic Disorders

, Volume 16, Issue 3, pp 249–268 | Cite as

The complex and multifactorial relationship between testosterone deficiency (TD), obesity and vascular disease

  • Abdulmaged M. Traish
  • Michael Zitzmann
Article

Abstract

Testosterone deficiency (TD) is a well-established and recognized medical condition that contributes to several co-morbidities, including metabolic syndrome, visceral obesity and cardiovascular disease (CVD). More importantly, obesity is thought to contribute to TD. This complex bidirectional interplay between TD and obesity promotes a vicious cycle, which further contributes to the adverse effects of TD and obesity and may increase the risk of CVD. Testosterone (T) therapy for men with TD has been shown to be safe and effective in ameliorating the components of the metabolic syndrome (Met S) and in contributiong to increased lean body mass and reduced fat mass and therefore contributes to weight loss. We believe that appropriate T therapy in obese men with TD is a novel medical approach to manage obesity in men with TD. Indeed, other measures of lifestyle and behavioral changes can be used to augment but not fully replace this effective therapeutic approach. It should be noted that concerns regarding the safety of T therapy remain widely unsubstantiated and considerable evidence exists supporting the benefits of T therapy. Thus, it is paramount that clinicians managing obese men with TD be made aware of this novel approach to treatment of obesity. In this review, we discuss the relationship between TD and obesity and highlight the contemporary advancement in management of obesity with pharmacological and surgical approaches, as well as utilization of T therapy and how this intervention may evolve as a novel approach to treatment of obesity in men with TD .

Keywords

Testosterone deficiency Hypogonadism Obesity Testosterone therapy Type 2 diabetes Metabolic syndrome Endocrine disruption 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Traish declares no conflict of interest.

Prof. Dr. Michael Zitzmann has no conflict of interest to declare in regard to the content of this manuscript.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of UrologyBoston University School of MedicineBostonUSA
  2. 2.Clinical AndrologyCentre for Reproductive Medicine and AndrologyMuensterGermany

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