Poster Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

The impact of testosterone treatment on inflammatory markers in adult males a systematic review and meta-analysis (126184)

Alebachew Fasil Ashagre 1 2 , Leonie Heilbronn 1 3 , Mahesh Umapathysivam 4 , Andrew Vincent 1 3 , Andrzej Januszewski 5 , Meseret Molla 6 , Gary Wittert 1 3
  1. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
  2. Department of Clinical Chemistry, Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, Gondar, Amhara, Ethiopia
  3. Lifelong Health Theme, South Australia Health, and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia, South Australia, SA, Australia
  4. Endocrine and Metabolic Health Unit, , Royal Adelaide Hospital, South Australia; School of Medicine, University of Adelaide, South Australia., South Australia, SA, Australia
  5. Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney School of Pharmacy, The University of Sydney, NSW, Australia, Sydney, NSW, Australia
  6. Flinders Health and Medical Research Institute, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia, Adelaide, SA, Australia

Abstract

Background and objectives: Although data suggest a bidirectional relationship between serum testosterone and inflammation, studies on treatment with exogenous testosterone report inconsistent effects on markers of inflammation. We performed a systematic review and meta-analysis to synthesize evidence on how testosterone therapy affects circulating inflammatory biomarkers in adult males.

Materials and methods: PubMed (MEDLINE), Scopus, Embase, and Web of Science were searched from inception to May 2024 for trials in which testosterone was administered for any indication and inflammatory cytokine concentrations were measured. Methodological quality was assessed with the modified Joanna Briggs Institute critical appraisal checklist.

Results: From 6,502 records, 17 studies (n = 1,765) met inclusion criteria; 955 participants received testosterone therapy and 871 served as controls. Testosterone had no significant effect on IL-6 (SMD = –0.04, 95% CI = [–0.09, 0.16]; p = 0.56), TNF-α (SMD = –0.17, 95% CI = [–0.47, 0.14]; p = 0.29), hs-CRP (SMD = –0.19, 95% CI = [–0.41, 0.04]; p = 0.10) or adiponectin (SMD = –0.07, 95% CI = [–0.70, 0.56]; p = 0.82). It produced a marked reduction in IL-1β (SMD = –0.66, 95% CI = [–1.01, –0.32]; p < 0.0001). Leptin fell significantly (SMD = –0.87, 95% CI = [–1.36, –0.38]; p = 0.0005), all studies consistently reporting decrement. Two trials also reported an increase in IL-10 relative to placebo.

Conclusions: Testosterone therapy exerts selective anti-inflammatory effects, particularly lowering IL-1β and leptin, while leaving several other cytokines unchanged. These findings highlight the complex, context-dependent nature of testosterone’s immunomodulatory actions and support further mechanistic research.