This Article Full Text Full Text (PDF) All Versions of this Article: 30/1/23    most recent Author Manuscript (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Traish, A. M. Articles by Guay, A. Search for Related Content PubMed PubMed Citation Articles by Traish, A. M. Articles by Guay, A.

Review

The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes and Insulin Resistance

FARID SAAD^,

ANDRE GUAY

From the ^* Department of Biochemistry and Urology, Boston University School of Medicine, Boston, Massachusetts; Bayer-Schering Pharma, Men's Healthcare, Berlin, Germany; the Gulf Medical College School of Medicine, Ajman, United Arab Emirates; and the Department of Endocrinology, Center for Sexual Function, Lahey Clinic, Peabody, Massachusetts.

Correspondence to: Dr Abdulmaged M. Traish, Professor of Biochemistry & Urology, Director, Laboratories for Sexual Medicine, Institute for Sexual Medicine, Boston University School of Medicine, Center for Advanced Biomedical Research, 700 Albany Street, W607, Boston, MA 02118 (e-mail: atraish{at}bu.edu).

Abstract

A considerable body of evidence exists suggesting a link among reduced testosterone plasma levels, type 2 diabetes (T2D), and insulin resistance (IR). Hypogonadal men are at higher risk for T2D. Here we evaluate the relationships between testosterone, metabolic syndrome (MetS), T2D, and IR and discuss the relationships among androgen deficiency and these factors, especially as it ultimately relates to the development of cardiovascular disease and erectile dysfunction (ED). Thus, a comprehensive literature search was carried out using PubMed, and relevant articles pertinent to androgen deficiency, T2D, IR, MetS, and ED were reviewed and discussed. Low testosterone precedes elevated fasting insulin, glucose, and hemoglobin A1c (HbA1C) values and may even predict the onset of diabetes. Treatment of prostate cancer patients with surgical or medical castration exacerbates IR and glycemic control, strengthening the link between testosterone deficiency and onset of T2D and IR. Androgen therapy of hypogonadal men improves insulin sensitivity, fasting glucose, and HbA1c levels. We suggest that androgen deficiency is associated with IR, T2D, MetS, and with increased deposition of visceral fat, which serves as an endocrine organ, producing inflammatory cytokines and thus promoting endothelial dysfunction and vascular disease.

     Key words: Erectile dysfunction, androgen deficiency, metabolic syndrome, vascular disease

This article has been cited by other articles:

				A. Chamson-Reig, S. M. Thyssen, D. J. Hill, and E. Arany Exposure of the Pregnant Rat to Low Protein Diet Causes Impaired Glucose Homeostasis in the Young Adult Offspring by Different Mechanisms in Males and Females Exp Biol Med, December 1, 2009; 234(12): 1425 - 1436. [Abstract] [Full Text] [PDF]

				A. E. Heufelder, F. Saad, M. C. Bunck, and L. Gooren Fifty-two-Week Treatment With Diet and Exercise Plus Transdermal Testosterone Reverses the Metabolic Syndrome and Improves Glycemic Control in Men With Newly Diagnosed Type 2 Diabetes and Subnormal Plasma Testosterone J Androl, November 1, 2009; 30(6): 726 - 733. [Abstract] [Full Text] [PDF]

				A. M. Traish, F. Saad, R. J. Feeley, and A. Guay The Dark Side of Testosterone Deficiency: III. Cardiovascular Disease J Androl, September 1, 2009; 30(5): 477 - 494. [Abstract] [Full Text] [PDF]