The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetes
The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetes
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DOI：
10.1530/eje-06-0737
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发表时间：
2007-05-01
影响因子：
5.8
通讯作者：
Jones, T. H.
中科院分区：
文献类型：
--
作者：
Kapoor, D.;Clarke, S.;Jones, T. H.
目的：已知血清睾酮水平与男性胰岛素敏感性和肥胖呈负相关。此外，有证据表明睾酮替代疗法可以降低2型糖尿病男性的胰岛素抵抗和内脏脂肪。脂肪细胞因子是由脂肪组织分泌的激素，有助于胰岛素抵抗。我们研究了睾酮替代治疗对2型糖尿病男性各种脂肪细胞因子和c反应蛋白（CRP）的影响。设计：对20名性腺功能低下的2型糖尿病男性进行双盲安慰剂对照交叉研究。患者以随机顺序每2周肌肉注射一次睾酮（200毫克）或安慰剂，持续3个月，然后在交替治疗阶段之前进行1个月的洗脱期。方法：瘦素、脂联素、抵抗素。治疗前后分别检测肿瘤坏死因子- α (tnf - α)、白细胞介素-6 （IL -6）和CRP水平。同时记录体重指数（BMI）和腰围。结果：基线。瘦素水平与BMI和腰围显著相关。基线IL-6与总睾酮（r= -0.68: P=0.002）和生物可利用睾酮水平（r= -0.73: P=0.007）呈显著负相关。CRP水平也与总睾酮水平显著相关（r= -0.59； P=0.01）。睾酮治疗降低了瘦素（- 7141.9 +/- 1461.8 pg/ml； P=0.0001）和脂联素水平（-2075.8 +/- 852.3 ng/ml； P=0.02）。腰围明显减小。睾酮治疗对抵抗素、tnf - α、IL-6或CRP水平无显著影响。结论：睾酮替代治疗可降低2型糖尿病患者瘦素和脂联素水平。此外，男性睾酮水平低与促炎相关，尽管睾酮治疗超过3个月对炎症标志物没有影响。
Objective: Serum testosterone levels are known to inversely correlate with insulin sensitivity and obesity in men. Furthermore, there is evidence to suggest that testosterone replacement therapy reduces insulin resistance and visceral adiposity in type 2 diabetic men. Adipocytokines are hormones secreted by adipose tissue and contribute to insulin resistance. We examined the effects of testosterone replacement treatment on various adipocytokines and C-reactive protein (CRP) in type 2 diabetic men.Design: Double-blinded placebo-controlled crossover study in 20 hypogonadal type 2 diabetic men. Patients were treated with testosterone (sustanon 200 mg) or placebo intramuscularly every 2 weeks for 3 months in random order followed by a washout period of 1 month before the alternate treatment phase.Methods: Leptin, adiponectin, resistin. tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-6 and CRP levels were measured before and after each treatment phase. Body mass index (BMI) and waist circumference were also recorded.Results: At baseline. leptin levels significantly correlated with BMI and waist circumference. There was a significant inverse correlation between baseline IL-6 and total testosterone (r= -0.68: P=0.002) and bioavailable testosterone levels (r= -0.73: P=0.007). CRP levels also correlated significantly with total testosterone levels (r= -0.59; P=0.01). Testosterone treatment reduced leptin (- 7141.9 +/- 1461.8 pg/ml; P=0.0001) and adiponectin levels (-2075.8 +/- 852.3 ng/ml; P=0.02). There was a significant reduction in waist circumference. No significant effects of testosterone therapy on resistin, TNF-alpha, IL-6 or CRP levels were observed.Conclusion: Testosterone replacement treatment decreases leptin and adiponectin levels in type 2 diabetic men. Moreover, low levels of testosterone in men are associated with pro-inflammatory profile, though testosterone treatment over 3 months had no effect on inflammatory markers.