Traish Abdulamaged M, Saad Farid, Guay Andre
Department of Biochemistry and Urology, Boston University School of Medicine, Boston, MA 02118, USA.
J Androl. 2009 Jan-Feb;30(1):23-32. doi: 10.2164/jandrol.108.005751. Epub 2008 Sep 4.
A considerable body of evidence exists suggesting a link among reduced testosterone plasma levels, type 2 diabetes (T2D), and insulin resistance (IR). Hypogonadal men are at higher risk for T2D. Here we evaluate the relationships between testosterone, metabolic syndrome (MetS), T2D, and IR and discuss the relationships among androgen deficiency and these factors, especially as it ultimately relates to the development of cardiovascular disease and erectile dysfunction (ED). Thus, a comprehensive literature search was carried out using PubMed, and relevant articles pertinent to androgen deficiency, T2D, IR, MetS, and ED were reviewed and discussed. Low testosterone precedes elevated fasting insulin, glucose, and hemoglobin A1c (HbA1C) values and may even predict the onset of diabetes. Treatment of prostate cancer patients with surgical or medical castration exacerbates IR and glycemic control, strengthening the link between testosterone deficiency and onset of T2D and IR. Androgen therapy of hypogonadal men improves insulin sensitivity, fasting glucose, and HbA1c levels. We suggest that androgen deficiency is associated with IR, T2D, MetS, and with increased deposition of visceral fat, which serves as an endocrine organ, producing inflammatory cytokines and thus promoting endothelial dysfunction and vascular disease.
大量证据表明，血浆睾酮水平降低、2型糖尿病（T2D）和胰岛素抵抗（IR）之间存在联系。性腺功能减退的男性患T2D的风险更高。在此，我们评估睾酮、代谢综合征（MetS）、T2D和IR之间的关系，并讨论雄激素缺乏与这些因素之间的关系，尤其是其最终与心血管疾病和勃起功能障碍（ED）发展的关系。因此，我们使用PubMed进行了全面的文献检索，并对与雄激素缺乏、T2D、IR、MetS和ED相关的文章进行了综述和讨论。低睾酮先于空腹胰岛素、血糖和糖化血红蛋白（HbA1C）水平升高，甚至可能预测糖尿病的发病。对前列腺癌患者进行手术或药物去势治疗会加剧IR和血糖控制，强化睾酮缺乏与T2D和IR发病之间的联系。对性腺功能减退的男性进行雄激素治疗可改善胰岛素敏感性、空腹血糖和HbA1C水平。我们认为，雄激素缺乏与IR、T2D、MetS以及内脏脂肪沉积增加有关，内脏脂肪作为一个内分泌器官，会产生炎性细胞因子，从而促进内皮功能障碍和血管疾病。
