Academic Unit of Diabetes, Endocrinology and Metabolism, School of Medicine and Biomedical Sciences, University of Sheffield, UK.
Nat Rev Endocrinol. 2013 Aug;9(8):479-93. doi: 10.1038/nrendo.2013.122. Epub 2013 Jun 25.
Obesity, type 2 diabetes mellitus and the metabolic syndrome are major risk factors for cardiovascular disease. Studies have demonstrated an association between low levels of testosterone and the above insulin-resistant states, with a prevalence of hypogonadism of up to 50% in men with type 2 diabetes mellitus. Low levels of testosterone are also associated with an increased risk of all-cause and cardiovascular mortality. Hypogonadism and obesity share a bidirectional relationship as a result of the complex interplay between adipocytokines, proinflammatory cytokines and hypothalamic hormones that control the pituitary-testicular axis. Interventional studies have shown beneficial effects of testosterone on components of the metabolic syndrome, type 2 diabetes mellitus and other cardiovascular risk factors, including insulin resistance and high levels of cholesterol. Biochemical evidence indicates that testosterone is involved in promoting glucose utilization by stimulating glucose uptake, glycolysis and mitochondrial oxidative phosphorylation. Testosterone is also involved in lipid homeostasis in major insulin-responsive target tissues, such as liver, adipose tissue and skeletal muscle.
肥胖、2 型糖尿病和代谢综合征是心血管疾病的主要危险因素。研究表明，睾丸激素水平低与上述胰岛素抵抗状态有关，2 型糖尿病患者中高达 50%的人患有性腺功能减退症。睾丸激素水平低也与全因和心血管死亡率的增加有关。由于控制垂体-睾丸轴的脂肪细胞因子、促炎细胞因子和下丘脑激素之间的复杂相互作用，性腺功能减退症和肥胖症之间存在双向关系。干预研究表明，睾丸激素对代谢综合征、2 型糖尿病和其他心血管危险因素（包括胰岛素抵抗和高胆固醇水平）的成分有有益的影响。生化证据表明，睾丸激素通过刺激葡萄糖摄取、糖酵解和线粒体氧化磷酸化来促进葡萄糖利用。睾丸激素还参与肝脏、脂肪组织和骨骼肌等主要胰岛素反应靶组织中的脂质稳态。
