Testosterone and the prevention of type 2 diabetes mellitus: therapeutic implications from recent trials.

IF 2.6 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2024-09-10 DOI:10.1097/MED.0000000000000884

Gary Wittert, Mahesh M Umapathysivam

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Abstract

Purpose of review: Type 2 diabetes (T2D) is increasing to epidemic proportions and frequently associated with obesity and a low serum testosterone concentration in men. This review valuates recent randomized controlled trials (RCTs) investigating the effect of testosterone treatment on glycemic control and T2D prevention.

Recent findings: The 2-year Testosterone for the Prevention of Type 2 diabetes Trial (T4DM) study showed that in men aged 50 years and over with visceral obesity and impaired glucose tolerance, testosterone treatment on the background of a lifestyle intervention reduced T2D risk by 40%. The Testosterone Effects on Atherosclerosis Progression in Aging Men and Testosterone Trials demonstrated modest improvements in insulin sensitivity and body composition. However, the Testosterone Replacement Therapy for Assessment of Long-Term Vascular Events and Efficacy Response in Hypogonadal Men trial found no significant glycemic benefits over 2 years. Recent data from the Diabetes Prevention Program Outcome Study support the cost efficacy and durability of metformin.

Summary: In men at high risk of T2D, treatment with testosterone prevents the disease; however, there are caveats to its use and other approaches may be more applicable. Differences in trial designs, age groups, and outcome measures contribute to varying results. HbA1C is a suboptimal outcome measure. Future research should explore potential synergies between testosterone and GLP-1 receptor agonists in T2D management, while considering cost-effectiveness.

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睾酮与 2 型糖尿病的预防：近期试验的治疗意义。

综述的目的：2 型糖尿病（T2D）的发病率正呈上升趋势，而且经常与肥胖和男性血清睾酮浓度低有关。本综述评估了近期研究睾酮治疗对血糖控制和 T2D 预防效果的随机对照试验 (RCT)：为期两年的睾酮预防 2 型糖尿病试验（T4DM）研究表明，对于 50 岁及以上患有内脏肥胖和糖耐量受损的男性，在生活方式干预的基础上进行睾酮治疗可将 2 型糖尿病风险降低 40%。睾酮对老年男性动脉粥样硬化进展的影响和睾酮试验表明，胰岛素敏感性和身体成分略有改善。然而，睾酮替代疗法评估性腺功能低下男性的长期血管事件和疗效反应试验发现，两年内血糖没有明显改善。糖尿病预防计划结果研究的最新数据支持二甲双胍的成本效益和持久性。小结：对于罹患 T2D 的高危男性，使用睾酮治疗可预防该疾病；但使用睾酮也有注意事项，其他方法可能更适用。试验设计、年龄组和结果衡量标准的差异导致了不同的结果。HbA1C 是一种次优的结果测量指标。未来的研究应探索睾酮和 GLP-1 受体激动剂在治疗 T2D 方面的潜在协同作用，同时考虑成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Endocrinology & Diabetes and Obesity ENDOCRINOLOGY & METABOLISM-

CiteScore

5.80

自引率

3.10%

发文量

128

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Endocrinology, Diabetes and Obesity delivers a broad-based perspective on the most recent and exciting developments in the field from across the world. Published bimonthly and featuring twelve key topics – including androgens, gastrointestinal hormones, diabetes and the endocrine pancreas, and neuroendocrinology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.