THE EFFECT OF TESTOSTERONE THERAPY ON MUSCLE MASS, BONE MASS AND HAEMOGLOBIN IN HYPOGONADAL MEN WITH CIRRHOSIS
M. Sinclair1,2, P. Gow1,2, M. Grossmann2,3, R. Hoermann2,
T. Scodellaro2, P. Angus1,2. 1Gastroenterology and Hepatology, Austin
Health; 2Medicine, The University of Melbourne; 3Endocrinology, Austin
Health, Melbourne, Australia
Background and Aims:
Low testosterone and sarcopenia are common in men with cirrhosis and both are associated with adverse outcome. The effect of testosterone therapy on body composition has not previously been investigated in this population.
Methods: We conducted a 12 month double-blinded, randomised, placebo-controlled trial of intramuscular testosterone decanoate in 101 men with established cirrhosis and low serum testosterone (total testosterone <12 nmol/L or free testosterone <230 pmol/L). Total body composition was quantified using dual-energy X-ray absorptiometry.
Results: Appendicular lean muscle mass was significantly higher in the active group compared to placebo at 12 months (mean adjusted
difference (MAD) 1.69 kg, CI 0.40–2.97 kg, p = 0.021). Total lean mass was similarly higher in the active group (MAD 4.74 kg, CI 1.75– 7.74 kg, p = 0.008). Fat mass was lower in the actively treated group (MAD−4.34 kg, CI−2.04 to −6.64 kg, p < 0.001). Bone mineral density was significantly higher at the femoral neck and total bone mass were both significantly higher in the active group (MAD in T score 0.287 points, CI 0.140–0.4340.140–0.434, p < 0.001; (MAD in bone mass 0.08 kg, CI 0.01–0.15 kg, p = 0.009). Haemoglobin was significantly higher in actively treated patients (MAD 10.2 g/L, CI 1.50–18.9 g/L, p = 0.041) and HbA1cwas lower (MAD −0.35%, CI −0.05 to −0.54, p = 0.028). No serious adverse effects were reported. There were more deaths on placebo (25.5%) than active treatment (16%) but this was not significant (p = 0.352).
Conclusions: Testosterone therapy in men with cirrhosis and low baseline testosterone levels safely improves muscle mass, bone mass and haemoglobin, and reduces fat mass and HbA1c. This is a promising new therapy for systemic complications of cirrhosis that targets a specific hormonal imbalance in men with cirrhosis.
Journal of Hepatology 2016 vol. 64 | S133–S158
1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Naïve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL:
NOT Detected

, FBG 11.9

17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72

(Accu-Chek Mobile & Omron Auto BP Monitor)
