Hobbs C J, Jones R E, Plymate S R
Department of Clinical Investigation, Madigan Army Medical Center, Tacoma Washington 98431, USA.
J Clin Endocrinol Metab. 1996 Apr;81(4):1582-5. doi: 10.1210/jcem.81.4.8636371.
The effect of exogenous androgens on glucose metabolism is controversial. This study was designed to clarify the impact of testosterone enanthate (TE), an aromatizable androgen, and nandrolone decanoate (ND), a nonaromatizable androgen, on glucose disposal. Eleven healthy men were enrolled in a randomized, double-blind cross-over study. All subjects completed two treatment cycles consisting of two weekly injections of placebo followed by six weekly injections of either TE (300 mg/week) or ND (300 mg/week). Treatment periods were separated by a 4-week washout. A tolbutamide-modified, frequently sampled, iv glucose tolerance test was used to assess insulin-dependent and insulin-independent glucose disposal. Data were analyzed using Bergman's minimal model. Parameters examined included acute insulin response to glucose, fasting insulin level, glucose disappearance constant, insulin sensitivity index, glucose effectiveness at basal insulin (SG), and glucose effectiveness at zero insulin (GEZI). Neither androgen adversely affected glucose disposal. To the contrary, treatment with ND actually improved noninsulin-mediated glucose disposal as expressed by SG and GEZI. In ND-treated men, SG (x 10(-2) min(-1)) rose from 2.4 +/- 0.2 at the end of the placebo period to 3.7 +/- 0.6 after treatment (P < 0.05), whereas GEZI (x 10(-2) min(-1)) increased from 1.8 +/- 0.2 to 3.1 +/- 0.6 (P < 0.01). We conclude that the treatment of normal men with supraphysiological doses of either TE or ND does not adversely affect glucose metabolism. Treatment with a nonaromatizable androgen, such as ND, actually improves glucose metabolism by enhancing noninsulin-mediated glucose disposal.
外源性雄激素对葡萄糖代谢的影响存在争议。本研究旨在阐明庚酸睾酮（TE，一种可芳香化的雄激素）和癸酸诺龙（ND，一种不可芳香化的雄激素）对葡萄糖处置的影响。11名健康男性参与了一项随机、双盲交叉研究。所有受试者完成了两个治疗周期，每个周期包括每周两次注射安慰剂，随后每周注射六次TE（300mg/周）或ND（300mg/周）。治疗期之间间隔4周的洗脱期。采用甲苯磺丁脲改良的、频繁采样的静脉葡萄糖耐量试验来评估胰岛素依赖和非胰岛素依赖的葡萄糖处置。使用伯格曼最小模型分析数据。检查的参数包括对葡萄糖的急性胰岛素反应、空腹胰岛素水平、葡萄糖消失常数、胰岛素敏感性指数、基础胰岛素水平下的葡萄糖效能（SG）和零胰岛素水平下的葡萄糖效能（GEZI）。两种雄激素均未对葡萄糖处置产生不利影响。相反，ND治疗实际上改善了由SG和GEZI表示的非胰岛素介导的葡萄糖处置。在接受ND治疗的男性中，SG（×10⁻²min⁻¹）从安慰剂期结束时的2.4±0.2升至治疗后的3.7±0.6（P<0.05），而GEZI（×10⁻²min⁻¹）从1.8±0.2增加至3.1±0.6（P<0.01）。我们得出结论，用超生理剂量的TE或ND治疗正常男性不会对葡萄糖代谢产生不利影响。用不可芳香化的雄激素（如ND）治疗实际上通过增强非胰岛素介导的葡萄糖处置来改善葡萄糖代谢。
