Putta Swathi, Peluso Ilaria, Yarla Nagendra Sastry, Kilari Eswar Kumar, Bishayee Anupam, Lu Da-Yong, Barreto George E, Ashraf Ghulam Md, Scotti Luciana, Scotti Marcus T, Singla Rajeev K, Alexiou Thonos, Atanasov Atanas G, Tarasov Vadim V, Bramhachari P Veera, Imandi Sarat Babu, Chintala Madhuri, Sharma Bechan, Reale Marcella, Filosa Rosanna, Aliev Gjumrakch, Kamal Mohammad Amjad
Pharmacology Division, University College of Pharmaceutical Sciences, Andhra University, Visakhapatnam-530 003, Andhra Pradesh, India.
Center of Nutrition, Council for Agricultural Research and Economics (CREA-NUT), Via Ardeatina 546, 00178 Rome, Italy.
Curr Pharm Des. 2017;23(30):4475-4483. doi: 10.2174/1381612823666170823103830.
Andropause or male menopause is defined as androgen decline and onset of hypogonadism in the aging male. Testosterone deficiency in adult male is associated with diabetes mellitus, coronary artery disease, and heart failure. Type 2 diabetic male patients aged above 30 years showed low testosterone levels which is common in diabetic men and had symptoms of hypogonadism. Male sexual dysfunction among diabetic patients can include disorders of libido, ejaculatory problems, and erectile dysfunctions are common among people with diabetes, particularly in older men who had diabetes for years. Older diabetics tend to have both impaired insulin release as well as insulin resistance. There is growing evidence indicating the pathophysiological connections among the mechanisms of oxidative damage by disruption of the oxidative balance, increased levels of enzymatic glycation products in testicular region and glucose transporters, obesity and proinflammatory cytokines in male infertile patients with diabetes. Epidemiological studies suggest that many clinical findings in diabetics are linked to low testosterone levels. This article reviews pathophysiological mechanisms, observational studies, and clinical implications of testosterone therapy in type 2 diabetes mellitus.
男性更年期或雄性激素缺乏症被定义为老年男性雄激素水平下降和性腺功能减退的开始。成年男性睾酮缺乏与糖尿病、冠状动脉疾病和心力衰竭有关。30岁以上的2型糖尿病男性患者睾酮水平较低，这在糖尿病男性中很常见，且伴有性腺功能减退症状。糖尿病患者中的男性性功能障碍可包括性欲障碍、射精问题，勃起功能障碍在糖尿病患者中很常见，尤其是在患有多年糖尿病的老年男性中。老年糖尿病患者往往存在胰岛素释放受损以及胰岛素抵抗的问题。越来越多的证据表明，在患有糖尿病的男性不育患者中，氧化平衡破坏导致的氧化损伤机制、睾丸区域酶糖化产物水平升高、葡萄糖转运蛋白、肥胖和促炎细胞因子之间存在病理生理联系。流行病学研究表明，糖尿病患者的许多临床发现与低睾酮水平有关。本文综述了睾酮治疗2型糖尿病的病理生理机制、观察性研究及临床意义。
