Role of endogenous androgen against insulin resistance and athero- sclerosis in men with type 2 diabetes.
Age-related decline in serum testosterone and dehydroepiandrosterone sulfate concentrations occur in men. Low concentrations of these endogenous androgens have been linked with insulin resistance, which is an important upstream driver for metabolic abnormalities such as hyperglycemia, hypertension, or hyperlipidemia, and increased cardiovascular risk. Moreover, men with diabetes have significantly less circulating androgen than nondiabetic men. Here, we summarize how androgen affects insulin resistance and atherosclerosis in men with type 2 diabetes. Low serum concentrations of endogenous androgens are associated with visceral fat accumulation. Androgen deprivation by castration to treat prostate cancer increases insulin resistance, while testosterone administration in type 2 diabetic men with androgen deficiency improves glucose homeostasis and decreases visceral fat, in addition to alleviating symptoms of androgen deficiency including erectile dysfunction. Androgen correlates inversely with severity of atherosclerosis and has beneficial effects upon vascular reactivity, inflammatory cytokine, adhesion molecules, insulin resistance, serum lipids, and hemostatic factors. Because men with type 2 diabetes have relative hypogonadism, testosterone supplementation could decrease both insulin resistance and atherosclerosis.
Fukui
Michiaki
M
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. sayarinapm@hotmail.com
Kitagawa
Yoshihiro
Y
Ose
Hiroyuki
H
Hasegawa
Goji
G
Yoshikawa
Toshikazu
T
Nakamura
Naoto
N
D000728:Androgens / Q000097:blood / Q000502:physiology*; D000818:Animals; D050197:Atherosclerosis / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D002986:Clinical Trials as Topic; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D013739:Testosterone / Q000097:blood / Q000627:therapeutic use
D000728:Androgens; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate