Hypogonadism and Metabolic Syndrome: Implications for Testosterone Therapy

Makhsida, Nawras; Shah, Jay; Yan, Grace W.; Fisch, Harry; Shabsigh, Ridwan

doi:10.1097/01.ju.0000169490.78443.59

Cited by 196 publications

(130 citation statements)

References 60 publications

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“…Serum testosterone levels were comparable with untreated age-matched controls 12 weeks post-transplantation, whereas testosterone was undetectable in surgical controls. Importantly, although gonadotropins (luteotrophic hormone [LH] and follicle-stimulating hormone [FSH]) were not measured in this study, their fluctuating levels during pubertal onset and sexual maturation may have enhanced the implantation success [26]. Further investigation concerning the responsiveness of the hypothalamic-pituitary gonadal axis to Leydig cell transplantation is warranted.…”

Section: Discussionmentioning

confidence: 99%

Leydig cell transplantation restores androgen production in surgically castrated prepubertal rats

Sun¹,

Yang²,

Zhang³

et al. 2009

Asian J Androl

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Prepubertal testicular dysfunction and the subsequent development of hypogonadism affects an estimated one in 200 children worldwide. As the testosterone levels are dynamic during development and puberty, traditional hormone treatment regimens are often inadequate, thereby leaving associated physiological conditions unresolved. Therefore, we have investigated the potential therapeutic effect of mature Leydig cell transplantation for the treatment of prepubertal primary hypogonadism through the use of a surgically induced hypogonadistic rat model system. In the experiment, Leydig cells were surgically isolated from mature Sprague-Dawley rats and transplanted into prepubertal recipients. Serum testosterone levels and microscopic analysis of the stained testicular interstitium were compared with sham-treated controls, as well as with castrated and intact rats during sexual development. At 4 weeks post-implantation, serum testosterone was detectable in Leydig cell recipients, but not in surgical controls, and progressively increased as a function of time until reaching levels comparable with sexually mature males at 12 weeks post-implantation. Histological analysis revealed a high rate of Leydig cell survival as well as steroidogenic secretory activity. Therefore, we conclude that mature Leydig cell transplantation in prepubertal hypogonadism recipients has therapeutic potential in rats and merits further investigation for clinical application.

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Section: Discussionmentioning

confidence: 99%

Leydig cell transplantation restores androgen production in surgically castrated prepubertal rats

Sun¹,

Yang²,

Zhang³

et al. 2009

Asian J Androl

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show abstract

“…On the other hand, the state of hypogonadism would favor, by itself, the development of insulin resistance, central obesity, type 2 diabetes mellitus and increased cardiovascular risk (8,37,38,54,56).…”

Section: Discussionmentioning

confidence: 99%

Relationship between insulin and hypogonadism in men with metabolic syndrome

Caldas

Porto

Motta

et al. 2009

Arq Bras Endocrinol Metab

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Objective: To evaluate the incidence of hypogonadism in men with metabolic syndrome and its correlation with serum insulin levels. Methods: Observational, transversal study with 80 men with metabolic syndrome. The individuals were divided into two groups: Group 1: 56 patients (70%) with total testosterone ≥ 300 ng/dL (normal gonadal function); Group 2: 24 patients (30%) with total testosterone < 300 ng/dL (hypogonadic). Results: The subjects from Group 2 compared to Group 1 presented higher body mass index (BMI), waist and hip circumferences, insulin, homeostasis model assessment insulin resistance index (Homa-IR) and beta cell (Homa-β), and triglycerides, but lower SHBG and free testosterone values. Inverse correlations between insulin levels and total testosterone and SHBG, as well as between Homa-IR and total testosterone were observed. Conclusion: In this series of men with metabolic syndrome, hypogonadism was associated with insulin resistance and may be a marker of metabolic abnormalities. Arq Bras Endocrinol Metab. 2009;53(8):1005-11

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“…Metabolic syndrome is also associated with low serum testosterone, and several studies have examined the effect of metabolic syndrome on androgens and the effect of replacement. [43][44][45][46][47][48] Conclusions are varied because of the difficulty in separating the components of the metabolic syndrome and the interrelationship between the factors governing the syndrome. Most studies show that exogenous testosterone treatment of hypogonadal men has favorable effects on body composition, insulin sensitivity, lipids and hypertension.…”

Section: Obesity Metabolic Syndrome Type 2 Diabetes Mellitus and Lomentioning

confidence: 99%

Obesity, low testosterone levels and erectile dysfunction

et al. 2008

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Obesity is an important risk factor for many common diseases including cardiovascular disease (CVD), type 2 diabetes, cancer and erectile dysfunction (ED). Adipose tissues produce a number of adipokines and cytokines, which affect endothelial and metabolic function resulting in insulin resistance and the metabolic syndrome (risks factors for CVD). Both ED and metabolic syndrome improve with a reduction in body mass index (BMI). The relationships among obesity, metabolic syndrome, ED, sex hormonebinding globulin (SHBG) and serum total and free testosterone levels are complex and often confusing to the physician. It is known that BMI is inversely proportional to serum total testosterone concentrations; low serum SHBG levels in obesity contribute to the low serum total testosterone. Recent studies show that BMI is also inversely proportional to free testosterone concentration. The characteristic low serum testosterone concentrations observed in obese men are also present in men with the metabolic syndrome and type 2 diabetes mellitus. A small proportion of men with ED have hypogonadism; however, the proportion increases if these men are obese with manifestations of the metabolic syndrome or type 2 diabetes mellitus. ED is a common symptom in patients with type 2 diabetes who also have low testosterone levels. This review describes the relationships between low serum testosterone concentrations and ED in obese patients and those with metabolic syndrome and type 2 diabetes mellitus.

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Hypogonadism and Metabolic Syndrome: Implications for Testosterone Therapy

Cited by 196 publications

References 60 publications

Leydig cell transplantation restores androgen production in surgically castrated prepubertal rats

Leydig cell transplantation restores androgen production in surgically castrated prepubertal rats

Relationship between insulin and hypogonadism in men with metabolic syndrome

Obesity, low testosterone levels and erectile dysfunction

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