A cluster of risk factors including hypertension, hyperlipidemia, glucose intolerance and insulin resistance are prevalently observed in men and women with increased accumulation of intra abdominal fat. This cluster of symptoms is commonly referred to as the metabolic syndrome although the interrelationship between the different perturbances has not been clarified. In men, these symptoms are also associated with a high prevalence of low testosterone levels and it has been suggested that low testosterone levels facilitate development of the metabolic syndrome, Furthermore, changes in testosterone levels influence insulin sensitivity and a decrease in testosterone levels decreases insulin sensitivity. It has also been suggested that testosterone therapy reverses some of the symptoms of the metabolic syndrome, including the abdominal fat accumulation. In a recently concluded randomized placebo-controlled double blind study with testosterone therapy to men with advanced stages of type 2 diabetes and abdominal obesity we could demonstrate significant metabolic changes and changes in body composition with a moderate increment (40%) in circulating testosterone levels. It was also evident that testosterone therapy also caused a decrease in liver steatosis, possibly indirectly achieved by a decrease in abdominal fat mass.
Copyright © 2006 ISSAM