The Relation Between Metabolic Syndrome and Testosterone Level

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Metabolic syndrome is a group of conditions that increases the risk of developing diabetes and cardiovascular diseases. The most important pathogenic factors for metabolic syndrome are insulin resistance and obesity. The clinical presentation of this syndrome results from its influence on glucose and fat metabolism. Testosterone deficiency has a prevalence of up to 50% in men with metabolic syndrome and type 2 diabetes mellitus. A low level of testosterone is a factor for cardiovascular diseases and predictor of metabolic syndrome and, on the other hand, the components of metabolic syndrome can lead to low testosterone. This article reveals the bidirectional link between low testosterone level or hypogonadism and metabolic syndrome.

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  • 1. FontbonneA Charles MA Thibult N et al. Hyperinsulinemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study 15-year follow up. Diabetologia 34: 356-361 1991.

  • 2. Einhorn D Reaven GM Cobin RH et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 9: 237-252 2003

  • 3. International Diabetic Federation. The IDF consensus worldwide definition of the metabolic syndrome. The metabolic syndrome. IDF Communications pp 1-23 2006.

  • 4. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care 28: 2745-9 2005.

  • 5. Sharma SK GhimireA Radhakrishnan J et al. Prevalence of hypertension obesity diabetes and metabolic syndrome in Nepal. Int J Hypertens 2011: 821971 2011.

  • 6. Masharani UB Maddux BA et al. Insulin resistance in non-obese subjects is associated with activation of the JNK pathway and impaired insulin signalling in skeletal muscle. PLoS ONE 6(5): e19878 2011.

  • 7. Freeman ER Bloom DA McGuire EJ. A brief history of testosterone. J Urol 165: 371-73 2001.

  • 8. Feldman HA Longcope C Derby CA et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab 87: 589-598 2002.

  • 9. Brand JS van der Tweel I Grobbee DE Emmelot-Vonk MH van der Schouw YT. Testosterone sex hormone-binding globulin and the metabolic syndrome: a systematic review and meta-analysis of observation studies. Int J Epidmiol 40: 189-207 2010.

  • 10. Allan CA McLachlan RI. Androgens and obesity. Curr Opin Endocrinol Diabetes Obes 17: 224 2010.

  • 11. Hofstra J Loves S van Wageningen B et al. High prevalence of hypogonadotropic hypogonadism in men referred for obesity treatment. Neth J Med 66: 103-109 2008.

  • 12. Grossmann M Thomas MC Panagiotopoulos S et al. Low testosterone levels are common and associated with insulin resistance in men with diabetes. J Clin Endocrinol Metab 93: 1834-1840 2008.

  • 13. Singh SK Goyal R Pratyush DD. Is hypoandrogenemia a component of metabolic syndrome in males? Exp Clin Endocrinolo Diabetes 119: 30-35 2011.

  • 14. Bianchi VE Metabolic syndrome obesity paradox and testosterone level. Endocrinol Metab Synd 4: 172 2015.

  • 15. Cohen PG. The hypogonadal-obesity cycle: role of aromatase in modulating the testosterone-estradiol shunt--a major factor in the genesis of morbid obesity. Med Hypotheses 52: 49-51 1999.

  • 16. Jones TH. Testosterone associations with erectile dysfunction and the metabolic syndrpome. Eur Urol Suppl 6: 847-857 2007.

  • 17. Zhang J Pronyuk KHO Kuliesh OV Chenghe S. Adiponectin Resistin and Leptin: Possible Markers of Metabolic Syndrome. Endocrinol Metab Syndr 4: 212 2015.

  • 18. Schaffler A. Mechanisms of disease: adipocytokines and visceral adipose tissue - emerging role in nonalcoholic fatty liver disease. Nat Clin Pract Gastroenterol Hepatol 2: 237-280 2005.

  • 19. Tena-Sempere M Pinilla L Gonzalez LC Dieguez C Casanueva FF Aguilar E. Leptin inhibits testosterone secretion from adlut rats testis in vitro. J Endocrinol 161: 211-218 1999.

  • 20. Ding M Rzucidio EM Davey JC et al. Adiponectin in the heart and vascular system. Vitam Horm 90: 289-319 2012.

  • 21. Vermulen A Kaufman JM Deslypere JP Thomas G. Attenuated luteinizing hormone (LH) pulse amplitude but normal LH pulse frequency and its relation to plasma androgens in hypogonadism of obese me. J Clin Endocrinol Metab 76: 1140-1146 1993.

  • 22. Chalasani N Younossi Z Lavine JE et al. The diagnosis and management of non-alcoholic fatty liver disease: Practice guidelines by the American Association for the Study of Liver Diseases American College of Gastroenterology and the American Gastroenterological Association. Hepatology 55: 2005-2023 2012.

  • 23. Singh SP Singh A Pati G et al. A study of prevalence of diabetes and prediabetes in patients of non-alcoholic fatty liver disease and the impact of diabetes on liver histology in coastal eastern India. Journal of Diabetes Mellitus 4: 290-296 2014.

  • 24. Allan CA Peverill RE Strauss JGB Forbes AE McLachlan RI. Waist-to-height ratio as a predictor of serum testosterone in ageing men with symptoms of androgen deficiency. Asian J Androl 13: 424-431 2011.

  • 25. Svatberg J Jenssen T Sundsfjord J Jorde R. The associations of endogenous testosterone and sex hormone binding globulin with glycosylated hemoglobin levels in community dwelling men. The Tromso Study. Diabetes Metab 30: 29-34 2004.

  • 26. Laaksonen DE Niskanen L Punnonen K et al. Sex hormones inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol 149: 601-608 2003.

  • 27. Kupelian V Page ST Araujo AB Travison TG Bremner WJ McKinlay JB. Low sex hormone binding globulin total testosterone and symptomatic androgen deficiency are associated with development of the metabolic syndrome in non-obese men. J Clin Endocrinol Metab 91: 843-50 2006.

  • 28. Ding EL Song Y Malik VS Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 295: 1288-99 2006.

  • 29. Kapoor D Aldred H Clark S Channer KS Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes Care 30: 911-917 2007.

  • 30. Tomar R Dhindsa S Chaudhari A Mohanty P Garg R Dandona P. Contrasting testosterone concentrations in type 1 and type 2 diabetes. Diabetes Care 29: 1120-1122 2006.

  • 31. Chubb SA Hyde Z Almeida OP et al. Lower sex hormone-binding globulin is more strongly associated with metabolic syndrome than lower total testosterone in older men: the Health in Men Study. Eur J Endocrinol 158: 785-792 2008.

  • 32. Goncharov N Katsya G Gaivoronskaya L Zoloedov V Uskov V Gooren L. Effects of short-term testosterone administration on variables of the metabolic syndrome in particular aldosterone. Horm Mol Biol Clin Investig 12: 401-406 2012.

  • 33. Garvey WT Mechanick JI Brett EM et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity.. EndocrPract 22(Suppl 3): 1-203 2016.

  • 34. Sjöström L Narbro K Sjostrom CD et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357: 741-752 2007.

  • 35. Jones TH. A placebo-controlled study on the effects of transdermal testosterone gel in hypogonadal men with type II diabetes or metabolic syndrome in diabetic control and insulin sensitivity: the TIMES 2 study. Diabetes Care 34: 828-837 2011.

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