Androgens, insulin resistance and vascular disease in men
Abstract
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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Tobacco consumption exerts effects on adrenal androgen secretion; high levels of androstenedione and dehydroepiandrosterone sulfate are usually found in smokers.
“In addition, tobacco consumption has also been shown to exert effects on adrenal androgen secretion; in fact, high levels of androstenedione and dehydropiandrosterone sulfate (DHEAS) are usually found in smokers [40].”
From Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic (2021) · cites this paper as [40]
Increased release of cortisol into the circulation due to an upstream increase in ACTH could represent a causal indirect effect of smoking contributing to reduced bone mineral density, because increased circulating cortisol correlates with increased osteoporosis risk.
“As increased high levels of circulating cortisol correlate with an increased risk of osteoporosis, this could represent a causal indirect effect of smoking contributing to the reduction of BMD [40,41].”
From Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic (2021) · cites this paper as [40]
Low testosterone levels in men are associated with reduced insulin sensitivity and type 2 diabetes.
“It is being increasingly recognized that low testosterone levels in men are associated with reduced insulin sensitivity and type 2 diabetes (1).”
From Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes (2007) · cites this paper as [1]
There is increased deposition of abdominal adipose tissue in hypogonadal subjects, which leads to a further decrease in testosterone concentrations through conversion to estradiol by aromatase.
“There is increased deposition of abdominal adipose tissue in hypogonadal subjects, which in turn leads to a further decrease in testosterone concentrations, through conversion to estradiol by aromatase.”
From Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes (2007) · cites this paper as [1]
Studies of testosterone in non-heart-failure males suggest that physiological testosterone therapy improves insulin sensitivity.
“Studies of testosterone in non-(CHF) males suggest that physiological testosterone therapy improves insulin sensitivity.”
From The Effect of Testosterone on Insulin Sensitivity in Men with Heart Failure (2007) · cites this paper as [10]
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Androgen Deficiency and Abnormal Penile Duplex Parameters in Obese Men with Erectile Dysfunction
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- Authors
- Kapoor, D., Malkin, C. J., Channer, K. S., & Jones, T. H.
- Affiliations
- Barnsley Hospital NHS Foundation Trust (GB)
- Royal Hallamshire Hospital (GB)
- Corresponding author
- Jones, T. H.
- ORCID
- Jones, T. H.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2005-06-15
- Volume
- 63
- Issue
- 3
- Pages
- 239-250
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2137783284
- Cited by
- 317
- References
- 120
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 13 · 2023: 8 · 2022: 8 · 2021: 11 · 2020: 10 · 2019: 7 · 2018: 12 · 2017: 8 · 2016: 10 · 2015: 16 · 2014: 23 · 2013: 13 · 2012: 23
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Keywords
- androgens, testosterone, insulin resistance, type 2 diabetes, atherosclerosis, coronary artery disease, metabolic syndrome, visceral obesity, hypogonadism, testosterone replacement therapy, glycemic control, cardiovascular risk, men
- MeSH terms
- Aged, Aging, Arteriosclerosis, Dehydroepiandrosterone, Diabetes Mellitus, Type 2, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Sex Hormone-Binding Globulin, Testosterone, Vascular Diseases
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