The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes and Insulin Resistance

被引:208
作者
Traish, Abdulmaged M. [1 ]
Saad, Farid [2 ,3 ]
Guay, Andre [4 ]
机构
[1] Boston Univ, Sch Med, Dept Biochem & Urol, Boston, MA 02118 USA
[2] Mens Healthcare, Bayer Schering Pharma, Berlin, Germany
[3] Gulf Med Coll, Sch Med, Ajman, U Arab Emirates
[4] Lahey Clin Fdn, Ctr Sexual Funct, Dept Endocrinol, Peabody, MA USA
来源
JOURNAL OF ANDROLOGY | 2009年 / 30卷 / 01期
关键词
Erectile dysfunction; androgen deficiency; metabolic syndrome; vascular disease; ANDROGEN-DEPRIVATION THERAPY; HORMONE-BINDING-GLOBULIN; ENDOGENOUS SEX-HORMONES; LOW SERUM TESTOSTERONE; NECROSIS-FACTOR-ALPHA; MIDDLE-AGED MEN; ERECTILE DYSFUNCTION; METABOLIC SYNDROME; PROSTATE-CANCER; RISK-FACTORS;
D O I
10.2164/jandrol.108.005751
中图分类号
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
摘要
A considerable body of evidence exists suggesting a link among reduced testosterone plasma levels, type 2 diabetes (T2D), and insulin resistance (IR). Hypogonadal men are at higher risk for T2D. Here we evaluate the relationships between testosterone, metabolic syndrome (MetS), T2D, and IR and discuss the relationships among androgen deficiency and these factors, especially as it ultimately relates to the development of cardiovascular disease and erectile dysfunction (ED). Thus, a comprehensive literature search was carried out using PubMed, and relevant articles pertinent to androgen deficiency, T2D, IR, MetS, and ED were reviewed and discussed. Low testosterone precedes elevated fasting insulin, glucose, and hemoglobin At c (HbA1C) values and may even predict the onset of diabetes. Treatment of prostate cancer patients with surgical or medical castration exacerbates IR and glycemic control, strengthening the link between testosterone deficiency and onset of T2D and IR. Androgen therapy of hypogonadal men improves insulin sensitivity, fasting glucose, and HbA1c levels. We suggest that androgen deficiency is associated with IR, T2D, MetS, and with increased deposition of visceral fat, which serves as an endocrine organ, producing inflammatory cytokines and thus promoting endothelial dysfunction and vascular disease.
引用
收藏
页码:23 / 32
页数:10
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