The Dark Side of Testosterone Deficiency: I. Metabolic Syndrome and Erectile Dysfunction

Traish, Abdulmaged M.; Guay, André T.; Feeley, Robert J.; Saad, Farid

doi:10.2164/jandrol.108.005215

Cited by 251 publications

(228 citation statements)

References 134 publications

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“…OSAS is associated with an increased risk of hypertension, arrhythmia, myocardial infarction, stroke, and sudden death. Sexual dysfunction associated with OSAS may also be explained by the metabolic syndrome [175,176]. Men with OSAS have lowered plasma testosterone levels [177] but this association was largely explained by adiposity in agreement with the finding that the metabolic syndrome is associated with reduced plasma testosterone values [178,175].…”

Section: Sleep Apneasupporting

confidence: 83%

Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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Many signs of aging, such as sexual dysfunction, visceral obesity, impaired bone and muscle strength, bear a close resemblance to features of hypogonadism in younger men. The statistical decline of serum testosterone in aging men is solidly documented. It has been presumed that the above features of aging are related to the concurrent decline of androgens, and that correction of the lower-than-normal circulating levels of testosterone will lead to improvement of symptoms of aging. But in essence, the pivotal question whether the age-related decline of testosterone must be viewed as hypogonadism, in the best case reversed by testosterone treatment, has not been definitively resolved. Studies in elderly men with lower-than-normal testosterone report improvement of features of the metabolic syndrome, bone mineral density, of mood and of sexual functioning. But as yet there is no definitive proof of the beneficial effects of restoring testosterone levels to normal in elderly men on clinical parameters. Few of these studies meet as yet rigorous standards of scientific enquiry: double-blind, placebo-controlled design of the study. The above applies also to the assessment of safety of testosterone administration to elderly men. There is so far no convincing evidence that testosterone is a main factor in the development of prostate cancer in elderly men and guidelines for monitoring the development of prostate disease have been developed. It is of note that there are presently no long-term safety data with regard to the prostate. Polycythemia is another potential complication of testosterone treatment. It is dose dependent and can be managed with dose adjustment.

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Section: Sleep Apneasupporting

confidence: 83%

Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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“…Androgen deficiency syndromes and hypogonadism, clinical conditions characterized by a deregulation of sex hormones, are associated with aging, obesity, type 2 diabetes, and cardiovascular disease (Soler et al 1989, Haffner et al 1996, Stellato et al 2000, Oh et al 2002, Farrell et al 2008, Traish et al 2009). We tested the hypothesis that testosterone or E 2 sex hormone treatment plays an important role in metabolism in primary skeletal muscle cells, and that an intrinsic sex difference may become apparent following exogenous sex hormone exposure on metabolism.…”

Section: Discussionmentioning

confidence: 99%

Testosterone or 17β-estradiol exposure reveals sex-specific effects on glucose and lipid metabolism in human myotubes

Salehzadeh¹,

Rune²,

Osler³

et al. 2011

Journal of Endocrinology

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Changes in sex hormone levels with aging or illness may lead to metabolic disorders. Moreover, the ratio changes in men versus women may have distinct pathological responses. Since little is known about sex hormone action on muscle metabolism, we examined the role of testosterone or 17b-estradiol (E 2 ) in metabolism and investigated whether either hormone may mediate a sex-specific effect. Myotubes from postmenopausal women and age-matched male donors were treated with 10 nM testosterone or E 2 for 4 days, and assays were performed to measure metabolic readouts, signal transduction, and mRNA expression. Testosterone and E 2 treatment enhanced insulin-stimulated glucose incorporation into glycogen and AKT phosphorylation in myotubes from female donors, highlighting a sexspecific role of sex hormone in glucose metabolism. Testosterone treatment increased palmitate oxidation in myotubes from both female and male donors, while E 2 enhanced palmitate oxidation in myotubes from male donors only. Testosterone-mediated increase in palmitate oxidation was attenuated at the presence of androgen receptor antagonist, which may indicate a role of nuclear steroid receptor in muscle lipid oxidation. Testosterone treatment increased mRNA expression of the insulin receptor substrate 2 in myotubes from male and female donors, whereas it increased mRNA expression of glycogen synthase 1 only in myotubes from male donors. E 2 treatment increased pyruvate dehydrogenase kinase 4 mRNA expression in myotubes from female donors. Thus, our data suggest that testosterone or E 2 modulates muscle glucose and lipid metabolism and may play a role in metabolism in a sex-dependent manner.

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“…Neither is it a life-style hormone for those men seeking eternal youth. Its deficiency leads to a serious deterioration of the health of men expressing itself in the metabolic syndrome and its sequelae: diabetes mellitus type 2 and atherosclerotic disease accelerating morbidity and mortality (32). Intervention studies in men with diabetes mellitus are limited in number, but hold promise.…”

Section: Discussionmentioning

confidence: 99%

The role of testosterone in type 2 diabetes and metabolic syndrome in men

Saad

2009

Arq Bras Endocrinol Metab

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Over the last three decades, it has become apparent that testosterone plays a significant role in glucose homeostasis and lipid metabolism. The metabolic syndrome is a clustering of risk factors predisposing to diabetes mellitus type 2, atherosclerosis and cardiovascular morbidity and mortality. The main components of the syndrome are visceral obesity, insulin resistance, glucose intolerance, raised blood pressure and dyslipidemia (elevated triglycerides, low levels of high-density lipoprotein cholesterol), and a pro-inflammatory and thrombogenic state. Crosssectional 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 evidence that hypotestosteronemia should be an element in the definition of the metabolic syndrome since low levels of testosterone are associated with or predict the development of the metabolic syndrome and of diabetes mellitus. Administration of testosterone to hypogonadal men reverses part of the unfavorable risk profile for the development of diabetes and atherosclerosis. So far, studies on the effects of normalization of testosterone in hypogonadal men on glucose homeostasis are limited, but convincing, and if diabetes mellitus is viewed in the context of the metabolic syndrome, the present results of testosterone treatment are very encouraging. Arq Bras Endocrinol Metab. 2009;53(8):901-7 Keywords Testosterone; metabolic syndrome; cardiovascular risk factors; insulin sensitivity; diabetes mellitus resumo Ao longo das últimas três décadas, tornou-se evidente que a testosterona desempenha um papel significativo na homeostase da glicose no metabolismo lipídico. A síndrome metabólica é um agrupamento de fatores de risco que predispõem ao diabetes melito tipo 2, aterosclerose e morbidade e mortalidade cardiovasculares. Os principais componentes da síndrome são: obesidade visceral, resistência insulínica, intolerância à glicose, hipertensão arterial e dislipidemia (triglicerídeos elevados, baixos níveis de HDL-colesterol), além de um estado pró-inflamatório e trombogênico. Estudos epidemiológicos transversais relataram uma correlação direta entre testosterona plasmática e sensibilidade à insulina, e níveis baixos de testosterona se associam com risco aumentado de diabetes tipo 2, ilustrado dramaticamente pela privação androgênica em homens com carcinoma de próstata. Baixos níveis de testosterona total e globulina transportadora de hormônios sexuais (SHBG) predizem maior incidência de síndrome metabólica. Existem agora evidências de que a hipotestosteronemia deveria ser um elemento na definição da síndro-me metabólica, uma vez que baixos níveis de testosterona estão associados ou predizem o desenvolvimento de síndrome metabólica e de...

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The Dark Side of Testosterone Deficiency: I. Metabolic Syndrome and Erectile Dysfunction

Cited by 251 publications

References 134 publications

Androgens and male aging: current evidence of safety and efficacy

Androgens and male aging: current evidence of safety and efficacy

Testosterone or 17β-estradiol exposure reveals sex-specific effects on glucose and lipid metabolism in human myotubes

The role of testosterone in type 2 diabetes and metabolic syndrome in men

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