Saad Farid, Gooren Louis
Men's Healthcare, Scientific Affairs Bayer Schering Pharma AG, Berlin, Germany.
J Steroid Biochem Mol Biol. 2009 Mar;114(1-2):40-3. doi: 10.1016/j.jsbmb.2008.12.022.
Over the last three decades it has become apparent that testosterone plays a significant role in the maintenance of bone and muscle mass, in erythropoiesis, and in mental functions. But testosterone is also a key player in glucose homeostasis and lipid metabolism. The metabolic syndrome is a clustering of risk factors predisposing to late onset diabetes mellitus, atherosclerosis and cardiovascular morbidity and mortality. The main components of the syndrome are visceral obesity, glucose intolerance, raised blood pressure and dyslipidaemia (elevated triglycerides, low levels of high-density lipoprotein cholesterol),and a pro-inflammatory and thrombogenic 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 now evidence to argue that hypotestosteronaemia should be an element in the definition of the metabolic syndrome. Administration of testosterone to hypogonadal men reverses the unfavorable risk profile for the development of diabetes and atherosclerosis. Testosterone should be regarded as a pivotal hormone for men's health.
在过去三十年中，睾酮在维持骨量和肌肉量、红细胞生成以及心理功能方面发挥重要作用已变得显而易见。但睾酮在葡萄糖稳态和脂质代谢中也是关键因素。代谢综合征是一组易引发迟发性糖尿病、动脉粥样硬化以及心血管疾病发病和死亡的危险因素。该综合征的主要组成部分包括内脏肥胖、葡萄糖不耐受、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降低），以及促炎和血栓形成状态。横断面流行病学研究报告了血浆睾酮与胰岛素敏感性之间存在直接关联，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。总睾酮和性激素结合球蛋白（SHBG）水平较低预示着代谢综合征的发病率较高。现在有证据表明，低睾酮血症应成为代谢综合征定义中的一个要素。对性腺功能减退男性给予睾酮可逆转糖尿病和动脉粥样硬化发展的不利风险状况。睾酮应被视为男性健康的关键激素。
