Nutrition and Metabolism, Clinical Center Stella Maris, Falciano, San Marino.
Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
Obes Rev. 2018 Apr;19(4):557-575. doi: 10.1111/obr.12633. Epub 2018 Jan 21.
Metabolic syndrome (MetS) is highly correlated with cardiovascular diseases. Although an excess of body fat is a determinant factor for MetS development, a reduced level of testosterone plays a fundamental role in its regulation. Low testosterone level is highly related to insulin resistance, visceral obesity and MetS. We have searched in Pubmed clinical trial with the password: testosterone and insulin resistance, and testosterone and MetS. We found 19 studies on the correlation between testosterone level with insulin resistance and 18 on the effect of testosterone therapy on MetS. A high correlation between low testosterone and insulin resistance has been found in men, but not in women. Testosterone administration in hypogonadal men improved MetS and reduced the mortality risk. Androgen and oestrogen receptors are expressed in adipocytes, muscle and liver tissue, and their activation is necessary to improve metabolic control. Normalization of testosterone level should be the primary treatment in men, along with caloric restriction and physical exercise. These findings come mainly from correlative data, and there remains a need for randomized trials to strengthen this evidence. This review will consider the effects of testosterone on the regulation and development of MetS in men and women.
代谢综合征（MetS）与心血管疾病高度相关。虽然体内脂肪过多是 MetS 发展的决定因素，但睾丸酮水平降低在其调节中起着根本性作用。低睾丸酮水平与胰岛素抵抗、内脏肥胖和 MetS 密切相关。我们在 Pubmed 临床试验中以“睾丸酮和胰岛素抵抗”和“睾丸酮和 MetS”为密码进行了搜索。我们发现了 19 项关于睾丸酮水平与胰岛素抵抗之间相关性的研究，以及 18 项关于睾丸酮治疗对 MetS 影响的研究。在男性中发现低睾丸酮与胰岛素抵抗之间存在高度相关性，但在女性中则没有。在低睾丸酮的男性中给予睾丸酮治疗可改善 MetS 并降低死亡率风险。雄激素和雌激素受体在脂肪细胞、肌肉和肝组织中表达，其激活对于改善代谢控制是必要的。正常化睾丸酮水平应该是男性的主要治疗方法，同时还需要限制热量摄入和进行体育锻炼。这些发现主要来自相关性数据，仍需要随机试验来加强这一证据。本综述将考虑睾丸酮对男性和女性 MetS 调节和发展的影响。
