Effect of androgen replacement therapy on atherosclerotic risk markers in young‐to‐middle‐aged men with idiopathic hypogonadotropic hypogonadism

Summary Objective Idiopathic hypogonadotropic hypogonadism is a rare disorder. This study evaluated the effect of androgen replacement therapy on atherosclerotic risk markers in young‐to‐middle‐aged men with this disorder. Design and methods Forty‐three male patients aged 30 (range: 24–39 years) who were newly diagnosed with idiopathic hypogonadotropic hypogonadism and 20 age‐, sex‐ and weight‐matched controls (range: 26–39 years) were included in the study. Androgen replacement therapy was given according to the Algorithm of Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes (2010; Journal of Clinical Endocrinology and Metabolism , 95, 2536). The patients were assessed at a pretreatment visit and 3 and 6 months after the treatment. Inflammatory markers and lipid parameters were evaluated. Endothelial function was assessed with brachial flow‐mediated dilation of a brachial artery and high‐resolution ultrasonography of the carotid intima‐media thickness. Results The carotid intima‐media thickness ( P  <   0·001) was higher and the brachial flow‐mediated diameter ( P  =   0·002) was lower in patients with idiopathic hypogonadotropic hypogonadism compared to the control subjects at the pretreatment visit. There was a negative correlation between the total testosterone level and carotid intima‐media thickness ( r  =   −0·556, P  = <0·001). The carotid intima‐media thickness and per cent flow‐mediated diameter were significantly improved in the patient group 6 months after the androgen replacement therapy ( P  =   0·002 and 0·026, respectively). Conclusions This study indicated that low total testosterone levels can be considered a significant marker of atherosclerosis in patients with idiopathic hypogonadotropic hypogonadism and that androgen replacement therapy significantly reduces atherosclerotic risk markers in these patients after 6 months.