Lean Tissue Mass and Energy Expenditure are retained in Hypogonadal Men with Spinal Cord Injury after Discontinuing Testosterone Replacement Therapy

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 281-290-Comparative Effectiveness/Health Outcomes/Quality Improvement/Patient or Provider Education/Endocrine Emergencies
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-290
William A Bauman*1, Michael F LaFountaine1, Christopher M Cirnigliaro1, Steven C Kirshblum2 and Ann M Spungen1
1James J. Peters VA Medical Center, Bronx, NY, 2Kessler Institute for Rehabilitation, West Orange, NJ
Lean tissue mass (LTM) is dramatically lost after acute spinal cord injury (SCI) with an associated decrease in resting energy expenditure (REE) that may predispose to adiposity. The development of a hypogonadal state in a subset of men with SCI may exacerbate these adverse changes in body composition and energy expenditure. We determined in a group of hypogonadal males with SCI if the observed increases in LTM and REE after 12 months of physiological testosterone (T) replacement therapy (TRT) persist for an additional 6 months after discontinuation of treatment (WOTRT-6).  A prospective, open-label, controlled drug intervention trial was performed in otherwise healthy eugonadal (EU; n=9) and hypogonadal (HG; n=11) outpatient men with chronic SCI. HG subjects received a 5 or 10 mg transdermal T patch daily for 12 months, with dose adjusted to normalize the serum T concentrations in the physiological range.  Total body dual energy x-ray absorptiometry (DXA) for LTM and REE were performed at baseline (BL), after 12 months of TRT (TRT12), and after WOTRT-6.  To indentify interventional changes, separate 2 factor analysis of variance (ANOVA) with repeated measures on visit (baseline, TRT 12-M, and WOTRT-6) were performed to determine the retention of body composition, energy expenditure and T.  Post-hoc paired t-tests were performed to characterize significant group, time or interaction main effects.   The groups were well matched at BL for all study outcomes. Between BL and TRT12, significant increases in T, LTM and REE were observed in HG, but not EU. In HG at WOTRT-6, T returned to BL concentrations, whereas LTM and REE were lower than, but not statistically different from, TRT12 and remained significantly elevated compared to BL.  Body composition and energy expenditure changes were favorable after a 1 year course of TRT in HG men with SCI.  As demonstrated herein for the first time, these LTM changes were retained in HG men with SCI for at least 6 months after termination of TRT, despite T reverting to BL levels. The sustained improvements in LTM and REE may be hypothesized to have beneficial effects on health and physical function of HG men with chronic SCI.

Nothing to Disclose: WAB, MFL, CMC, SCK, AMS

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: Veterans Affairs Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury (#B9212-C)
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