Testosterone deficiency, insulin resistance and the metabolic syndrome
Top Cited Papers
- 27 October 2009
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Endocrinology
- Vol. 5 (12), 673-681
- https://doi.org/10.1038/nrendo.2009.212
Abstract
Changing lifestyles and an excess of food supply in developed countries have resulted in an increasing prevalence of overweight and obesity. As a consequence, a disorder of complex pathophysiology involving visceral adipose tissue as an endocrine organ, dyslipidemia, insulin resistance and hypertension has emerged-the so-called metabolic syndrome. This disorder can lead to the manifestation of type 2 diabetes mellitus and cardiovascular disease. In men, testosterone deficiency may contribute to the development of the metabolic syndrome. In turn, states of hyperinsulinemia and obesity lead to a reduction of testicular testosterone production. Testosterone has reciprocal effects on the generation of muscle and visceral adipose tissue by influencing the commitment of pluripotent stem cells and by inhibiting the development of preadipocytes. Insulin sensitivity of muscle cells is increased by augmenting mitochondrial capacity and fostering expression of oxidative phosphorylation genes. Testosterone has a protective effect on pancreatic beta cells, which is possibly exerted by androgen-receptor-mediated mechanisms and influence of inflammatory cytokines. As some, but not all, epidemiological and interventional studies indicate, testosterone substitution might be helpful in preventing or attenuating the metabolic syndrome in aging men with late-onset hypogonadism and in hypogonadal patients with type 2 diabetes mellitus, but larger controlled trials are needed to confirm such hypotheses.Keywords
This publication has 104 references indexed in Scilit:
- Investigation, Treatment, and Monitoring of Late‐Onset Hypogonadism in Males: ISA, ISSAM, EAU, EAA, and ASA RecommendationsJournal of Andrology, 2009
- Left ventricular dysfunction in Klinefelter syndrome is associated to insulin resistance, abdominal adiposity and hypogonadismClinical Endocrinology, 2008
- Physiological, Pharmacological, and Nutritional Regulation of Circulating Adiponectin Concentrations in HumansMetabolic Syndrome and Related Disorders, 2008
- Inhibition of Luteinizing Hormone Secretion by Testosterone in Men Requires Aromatization for Its Pituitary But Not Its Hypothalamic Effects: Evidence from the Tandem Study of Normal and Gonadotropin-Releasing Hormone-Deficient MenJournal of Clinical Endocrinology & Metabolism, 2008
- Low Serum Testosterone and Mortality in Older MenJournal of Clinical Endocrinology & Metabolism, 2008
- The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetesActa Endocrinologica, 2007
- Diabetes and Cardiovascular Disease During Androgen Deprivation Therapy for Prostate CancerJournal of Clinical Oncology, 2006
- Serum adiponectin levels in hypogonadal males: influence of testosterone replacement therapyClinical Endocrinology, 2004
- PGC-1α-responsive genes involved in oxidative phosphorylation are coordinately downregulated in human diabetesNature Genetics, 2003
- The Anti‐Androgen Hydroxyflutamide and Androgens Inhibit Interleukin‐6 Production by an Androgen‐Responsive Human Osteoblastic Cell LineJournal of Bone and Mineral Research, 1999