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Abstract

Volume 16, Issue 2 (March 2014) 16, 232–238; 10.4103/1008-682X.122589

Sex steroids and glucose metabolism

Carolyn A Allan

Prince Henry's Institute, Clayton,; Monash Health, Clayton; Department of Obstetrics and Gynaecology, Monash University, Clayton; Andrology Australia, c/o School of Public Health and Preventive Medicine, Monash University, Prahran, Australia

Correspondence: Assoc. Prof. CA Allan (carolyn.allan@princehenrys.org)

Received: 08 July 2013; Accepted: 12 July 2013

Abstract

Testosterone levels are lower in men with metabolic syndrome and type 2 diabetes mellitus (T2DM) and also predict the onset of these adverse metabolic states. Body composition (body mass index, waist circumference) is an important mediator of this relationship. Sex hormone binding globulin is also inversely associated with insulin resistance and T2DM but the data regarding estrogen are inconsistent. Clinical models of androgen deficiency including Klinefelter's syndrome and androgen deprivation therapy in the treatment of advanced prostate cancer confirm the association between androgens and glucose status. Experimental manipulation of the insulin/glucose milieu and suppression of endogenous testicular function suggests the relationship between androgens and insulin sensitivity is bidirectional. Androgen therapy in men without diabetes is not able to differentiate the effect on insulin resistance from that on fat mass, in particular visceral adiposity. Similarly, several small clinical studies have examined the efficacy of exogenous testosterone in men with T2DM, however, the role of androgens, independent of body composition, in modifying insulin resistance is uncertain.

Keywords: androgen; glucose metabolism; sex steroids; testosterone

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.