Clinical Endocrinology

Androgens, insulin resistance and vascular disease in men

Authors

  • D. Kapoor,

    1. Centre for Diabetes and Endocrinology, Barnsley NHS Foundation Trust Hospital, Barnsley,
    2. Academic Unit of Endocrinology, Division of Genomic Medicine, University of Sheffield, UK
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  • C. J. Malkin,

    1. Department of Cardiology, Royal Hallamshire Hospital, Sheffield and
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  • K. S. Channer,

    1. Department of Cardiology, Royal Hallamshire Hospital, Sheffield and
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  • T. H. Jones

    Corresponding author
    1. Centre for Diabetes and Endocrinology, Barnsley NHS Foundation Trust Hospital, Barnsley,
    2. Academic Unit of Endocrinology, Division of Genomic Medicine, University of Sheffield, UK
      T. H. Jones, Centre for Diabetes and Endocrinology, Barnsley District General Hospital, Gawber Road, Barnsley S75 2EP, UK. Tel.: 01226 777 947; Fax: 01226 777 947; E-mail: hugh.jones@bdgh-tr.trent.nhs.uk
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T. H. Jones, Centre for Diabetes and Endocrinology, Barnsley District General Hospital, Gawber Road, Barnsley S75 2EP, UK. Tel.: 01226 777 947; Fax: 01226 777 947; E-mail: hugh.jones@bdgh-tr.trent.nhs.uk

Summary

Type 2 diabetes mellitus is increasing globally and is an established risk factor for the development of atherosclerotic vascular disease. Insulin resistance is the hallmark feature of type 2 diabetes and is also an important component of the metabolic syndrome. There is evidence to suggest that testosterone is an important regulator of insulin sensitivity in men. Observational studies have shown that testosterone levels are low in men with diabetes, visceral obesity (which is strongly associated with insulin resistance), coronary artery disease and metabolic syndrome. Short-term interventional studies have also demonstrated that testosterone replacement therapy produces an improvement in insulin sensitivity in men. Thus hypotestosteronaemia may have a role in the pathogenesis of insulin-resistant states and androgen replacement therapy could be a potential treatment that could be offered for improvements in glycaemic control and reduction in cardiovascular risk, particularly in diabetic men.

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