Effect of 2 years of testosterone replacement on insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance, and postprandial glucose turnover in elderly men
Effect of 2 years of testosterone replacement on insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance, and postprandial glucose turnover in elderly men
复制标题
DOI：
10.2337/dc07-0359
复制
发表时间：
2007-08-01
期刊：
影响因子：
16.2
通讯作者：
Rizza, Robert A.
中科院分区：
文献类型：
--
作者：
Basu, Rita;Dalla Man, Chiara;Rizza, Robert A.
目的：我们试图确定睾酮替代是否能改善碳水化合物耐受性，如果是的话，其机制是什么。研究设计和方法-55名相对睾酮缺乏的老年男性摄入标记的混合餐，并在安慰剂或睾酮贴剂（5 mg/天）治疗2年前后进行频繁采样的标记静脉葡萄糖耐量试验。结果-尽管将生物可利用的睾酮恢复到年轻男性中观察到的值，但空腹和餐后葡萄糖、胰岛素和C肽浓度以及膳食外观、葡萄糖处置和内源性葡萄糖产生的变化（24个月减去基线值）与安慰剂2年后观察到的变化几乎相同。静脉注射葡萄糖后胰岛素和C肽浓度随时间的变化也没有差异。此外，随着时间的推移，胰岛素作用和葡萄糖有效性（用C肽模型测量）的变化，因为我们和静脉注射未标记和标记的口服和肝脏胰岛素清除率（用C肽模型测量），在睾酮组和安慰剂组中没有差异。结论：我们得出结论，2年的睾酮治疗老年男性不改善碳水化合物耐量或改变胰岛素分泌，胰岛素作用，葡萄糖的有效性，肝胰岛素清除率，或餐后葡萄糖代谢的模式。因此，睾酮缺乏不太可能是老年男性中常见的与年龄相关的葡萄糖耐量恶化的原因。
OBJECTIVE - We sought to determine whether, and if so the mechanism by which, testosterone replacement improves carbohydrate tolerance. RESEARCH DESIGN AND METHODS - Fifty-five elderly men with relative testosterone deficiency ingested a labeled mixed meal and underwent a frequently sampled labeled intravenous glucose tolerance test before and after either placebo or treatment with testosterone patch (5 mg/day) for 2 years. RESULTS - Despite restoring bioavailable testosterone to values observed in young men, the change (24 months minus baseline values) in fasting and postprandial glucose, insulin, and C-peptide concentrations and meal appearance, glucose disposal, and endogenous glucose production were virtually identical to those observed after 2 years of placebo. The change over time in insulin and C-peptide concentrations post-intravenous glucose injection also did not differ. Furthermore, the change over time in insulin action and glucose effectiveness (measured with the C-peptide model), as we and intravenous the unlabeled and labeled oral and hepatic insulin clearance (measured with the C-peptide model), did not differ in the testosterone and placebo groups. CONCLUSIONS - We conclude that 2 years of treatment with testosterone in elderly men does not improve carbohydrate tolerance or alter insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance, or the pattern of postprandial glucose metabolism. Thus, testosterone deficiency is unlikely the cause of the age-associated deterioration in glucose tolerance commonly observed in elderly men.