CPAP Boosts Testosterone in Obesity-Related Hypogonadism

Researchers in Italy conducted a cross‑sectional study to determine how the severity of OSAS affects testosterone levels in men with severe obesity and to evaluate effects of 3 months of successful CPAP therapy on gonadal function in patients newly diagnosed with OSAS.
They included 204 men (mean age, 56.71 years) with grade 2 complicated or grade 3 obesity, of whom 112 had severe or decompensated OSAS and 127 had low total testosterone levels (≤ 10.4 nmol/L).
In a subset of 14 newly diagnosed patients with severe OSAS who adhered to CPAP therapy, total testosterone levels and BMI were measured after 3 months of successful CPAP therapy to assess the treatment's independent effect on gonadal function.
Inflammatory markers, glycaemic measures, and lipid and hormonal profiles were evaluated; patients without a prior diagnosis of OSAS underwent polysomnography, whereas those previously diagnosed had overnight pulse oximetry during CPAP therapy.

Severe or decompensated OSAS (P = .014), along with BMI (P = .039), type 2 diabetes (P = .006), and C-reactive protein levels (P = .003), was significantly associated with lower total testosterone levels.
After 3 months of CPAP therapy, testosterone levels significantly improved (P = .009), with an average improvement of 3.75 nmol/L.
A significant negative correlation was observed between total testosterone levels and the oxygen desaturation index (P = .04), independent of BMI.

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