背景:心脏代谢综合征(CMS),作为一组以2型糖尿病(T2DM)为主要特征的代谢紊乱,高血压,动脉粥样硬化,中心性肥胖,腹部肥胖引发雄激素缺乏,是对男人最严重的威胁之一.尽管许多重要的临床前和临床发现解释了CMS,缺乏针对常见病理生理机制和合理治疗靶点的新方法。
目的:为了进一步了解雄激素水平在CMS各个方面的作用,例如心脏代谢危险因素,包括中心性肥胖,血脂异常,胰岛素抵抗,糖尿病,和动脉高血压,并确定有效治疗方式的未来发展方向。
方法:从2009年至2019年10月,通过科学文献数据库(PubMed)搜索临床和实验数据。
方法:从基础和临床研究中收集了关于雄激素对CMS的因果影响和治疗作用的证据。
结果:存在与雄激素水平和CMS风险有关的重要机制。低睾酮水平对男性的心脏代谢和糖代谢风险以及腹部肥胖有许多体征和症状。
结论:这些发现的意义可以揭示未来雄激素水平的改善,并增加CMS的潜在预测风险,以及T2DM,腹型肥胖早期指导临床管理。
■这篇综合综述是指雄激素与心血管健康之间的关联。这项研究的一个局限性是缺乏大量的,前瞻性基于人群的研究,分析睾酮治疗对CMS或死亡率的影响。
结论:低睾酮水平与代谢综合征有几个共同特征。因此,睾酮可能在代谢综合征和随后的T2DM的进展中具有预防作用,腹部肥胖,和心血管疾病,并可能主要通过内分泌和血管机制影响老年男性的健康。需要进一步的研究来评估旨在预防男性CMS的治疗干预措施。Kirlangicof,Yilmaz-OralD,Kaya-SezginerE,etal.雄激素对心脏代谢综合征的影响:当前的治疗概念。性医学2020;8:132-155。
BACKGROUND: Cardiometabolic syndrome (CMS), as a bunch of metabolic disorders mainly characterized by type 2 diabetes mellitus (T2DM), hypertension, atherosclerosis, central adiposity, and abdominal obesity triggering androgen deficiency, is one of the most critical threats to men. Although many significant preclinical and clinical findings explain CMS, new approaches toward common pathophysiological mechanisms and reasonable therapeutic targets are lacking.
OBJECTIVE: To gain a further understanding of the role of androgen levels in various facets of CMS such as the constellation of cardiometabolic risk factors including central adiposity, dyslipidemia, insulin resistance, diabetes, and arterial hypertension and to define future directions for development of effective therapeutic modalities.
METHODS: Clinical and experimental data were searched through scientific literature databases (PubMed) from 2009 to October 2019.
METHODS: Evidence from basic and clinical research was gathered with regard to the causal impact and therapeutic roles of androgens on CMS.
RESULTS: There are important mechanisms implicated in androgen levels and the risk of CMS. Low testosterone levels have many signs and symptoms on cardiometabolic and glycometabolic risks as well as abdominal obesity in men.
CONCLUSIONS: The implications of the findings can shed light on future improvements in androgen levels and add potentially predictive risk for CMS, as well as T2DM, abdominal obesity to guide clinical management in the early stage.
UNASSIGNED: This comprehensive review refers to the association between androgens and cardiovascular health. A limitation of this study is the lack of large, prospective population-based studies that analyze the effects of testosterone treatment on CMS or mortality.
CONCLUSIONS: Low testosterone levels have several common features with metabolic syndrome. Thus, testosterone may have preventive role in the progress of metabolic syndrome and subsequent T2DM, abdominal obesity, and cardiovascular disease and likely affect aging men\'s health mainly through endocrine and vascular mechanisms. Further studies are necessary to evaluate the therapeutic interventions directed at preventing CMS in men. Kirlangic OF, Yilmaz-Oral D, Kaya-Sezginer E, et al. The Effects of Androgens on Cardiometabolic Syndrome: Current Therapeutic Concepts. Sex Med 2020;8:132-155.