The role of testosterone in type 2 diabetes and metabolic syndrome in men
The role of testosterone in type 2 diabetes and metabolic syndrome in men
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DOI：
10.1590/s0004-27302009000800002
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发表时间：
2009-11-01
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影响因子：
--
通讯作者：
Saad, Farid
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文献类型：
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作者：
Saad, Farid
在过去的三十年中，很明显，睾酮在葡萄糖稳态和脂质代谢中起着重要作用。代谢综合征是2型糖尿病、动脉粥样硬化和心血管疾病发病率和死亡率的危险因素聚集。该综合征的主要组成部分是内脏肥胖、胰岛素抵抗、葡萄糖耐受不良、血压升高和血脂异常（甘油三酯升高、高密度脂蛋白胆固醇水平低）以及促炎和促血栓形成状态。横断面流行病学研究报告了血浆睾酮和胰岛素敏感性之间的直接相关性，低睾酮水平与2型糖尿病风险增加相关，前列腺癌男性雄激素剥夺显著说明了这一点。较低的总睾酮和性激素结合球蛋白（SHBG）预测代谢综合征的发病率较高。有证据表明，低睾酮血症应该是代谢综合征定义中的一个要素，因为低水平的睾酮与代谢综合征和糖尿病的发展相关或预测代谢综合征和糖尿病的发展。对性腺功能减退的男性给予睾酮可逆转部分不利的糖尿病和动脉粥样硬化风险。到目前为止，关于性腺功能减退男性睾酮正常化对葡萄糖稳态的影响的研究是有限的，但令人信服的，如果在代谢综合征的背景下看待糖尿病，目前睾酮治疗的结果是非常令人鼓舞的。Arq布拉斯内分泌代谢2009;53（8）：901-7
Over the last three decades, it has become apparent that testosterone plays a significant role in glucose homeostasis and lipid metabolism. The metabolic syndrome is a clustering of risk factors predisposing to diabetes mellitus type 2, atherosclerosis and cardiovascular morbidity and mortality. The main components of the syndrome are visceral obesity, insulin resistance, glucose intolerance, raised blood pressure and dyslipidemia (elevated triglycerides, low levels of high-density lipoprotein cholesterol), and a pro-inflammatory and thrombogonic state. Cross-sectional epidemiological studies have reported a direct correlation between plasma testosterone and insulin sensitivity, and low testosterone levels are associated with an increased risk of type 2 diabetes mellitus, dramatically illustrated by androgen deprivation in men with prostate carcinoma. Lower total testosterone and sex hormone-binding globulin (SHBG) predict a higher incidence of the metabolic syndrome. There is evidence that hypotestosteronemia should be an element in the definition of the metabolic syndrome since low levels of testosterone are associated with or predict the development of the metabolic syndrome and of diabetes mellitus. Administration of testosterone to hypogonadal men reverses part of the unfavorable risk profile for the development of diabetes and atherosclerosis. So far, studies on the effects of normalization of testosterone in hypogonadal man on glucose homeostasis are limited, but convincing, and if diabetes mellitus is viewed in the context of the metabolic syndrome, the present results of testosterone treatment are very encouraging. Arq Bras Endocrinol Metab. 2009;53(8):901-7