Kapoor Dheeraj, Jones T Hugh
Robert Hague Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK.
Drugs Aging. 2008;25(5):357-69. doi: 10.2165/00002512-200825050-00001.
The prevalence of metabolic syndrome is increasing globally and is an important risk factor for the development of cardiovascular disease. Longitudinal population studies have found that low testosterone status in men is a risk factor for the later development of metabolic syndrome. Men with metabolic syndrome and type 2 diabetes mellitus have a higher incidence of hypotestosteronaemia. Furthermore, in men, testosterone levels are inversely associated with the degree of carotid and aortic atherosclerosis. Early interventional, short-term studies have shown that testosterone replacement therapy has a beneficial effect on visceral obesity, insulin sensitivity, glycaemic control and lipid profiles in men with diagnosed hypogonadism with and without diabetes. The effect of testosterone therapy on atherogenesis in men is unknown; however, animal studies have shown that testosterone is atheroprotective and can ameliorate the degree of atherosclerosis. Testosterone is an arterial vasodilator and has been shown to improve myocardial ischaemia in men with coronary artery disease. This review discusses the role that testosterone may play in the pathogenesis of metabolic syndrome in men and also examines the potential role of testosterone replacement therapy in this condition.
代谢综合征在全球范围内的患病率正在上升，并且是心血管疾病发生的重要危险因素。纵向人群研究发现，男性睾酮水平低是后期发生代谢综合征的一个危险因素。患有代谢综合征和2型糖尿病的男性低睾酮血症的发生率更高。此外，在男性中，睾酮水平与颈动脉和主动脉粥样硬化程度呈负相关。早期的干预性短期研究表明，睾酮替代疗法对已诊断为性腺功能减退的男性（无论有无糖尿病）的内脏肥胖、胰岛素敏感性、血糖控制和血脂谱有有益影响。睾酮疗法对男性动脉粥样硬化形成的影响尚不清楚；然而，动物研究表明，睾酮具有抗动脉粥样硬化作用，可改善动脉粥样硬化程度。睾酮是一种动脉血管扩张剂，已被证明可改善患有冠状动脉疾病男性的心肌缺血。本综述讨论了睾酮在男性代谢综合征发病机制中可能发挥的作用，并探讨了睾酮替代疗法在这种情况下的潜在作用。
