睾酮凝胶可改善胰岛素抵抗

文章来源:互联网 时间:2017-11-29
文献标题:Testosterone Replacement in Hypogonadal Men With Type 2 Diabetes and/or Metabolic Syndrome (the TIMES2 Study).
文献出处:Diabetes Care. 2011 Apr;34(4):828-37.
期刊影响因子:6.718
PMID:
21386088

据英国制药商资助的一项研究,睾酮治疗似乎能改善某些男性II型糖尿病患者的胰岛素抵抗。

研究人员发现,对性腺机能减退合并糖尿病或代谢综合症的男性应用睾酮凝胶能够减少这种问题的发生。

与安慰剂凝胶相比,睾酮凝胶还降低了他们的胆固醇水平,且对性功能有一定的影响。

英国巴恩斯利医院的T. Hugh Jones博士和他的同事3月8日在《糖尿病护理》在线写道,他们的研究结果支持对睾丸激素水平低下和糖尿病或代谢综合症的人实施睾酮治疗。

在新的研究中,研究人员对220例中老年男子应用睾丸激素凝胶Tostran及安慰剂凝胶进行了对比测试。这些男子应用凝胶每天一次,持续一年。

尽管许多人实际上已在服用二甲双胍,应用Tostran的男性其胰岛素抵抗降低了16%。

尽管如此,在作为糖尿病护理最终目标的血糖控制方面仍没有任何整体差异。

研究人员还发现,应用睾酮凝胶者的一般性功能略有改善,但并没有勃起功能障碍或总体性满意度的差异。

两组的不良反应相似。

睾酮已被用于治疗男性性腺机能减退。凝胶的每月费用超过250美元,关于睾酮水平降低至多少他们才可处方药,专家不能达成一致意见。

随着美国每年出现数百万计的处方,一些专家认为它被滥用了。

去年,奥地利维也纳大学医学院泌尿科主任Michael Marberger博士告诉《路透社健康》记者,对于性功能,我们需要的睾酮量要比过去人们通常认为的合适剂量少很多。

推荐英文摘要
Diabetes Care. 2011 Apr;34(4):828-37.
Testosterone Replacement in Hypogonadal Men With Type 2 Diabetes and/or Metabolic Syndrome (the TIMES2 Study).
Jones TH, Arver S, Behre HM

OBJECTIVE This study evaluated the effects of testosterone replacement therapy (TRT) on insulin resistance, cardiovascular risk factors, and symptoms in hypogonadal men with type 2 diabetes and/or metabolic syndrome (MetS).

RESEARCH DESIGN AND METHODS The efficacy, safety, and tolerability of a novel transdermal 2% testosterone gel was evaluated over 12 months in 220 hypogonadal men with type 2 diabetes and/or MetS in a multicenter, prospective, randomized, double-blind, placebo-controlled study. The primary outcome was mean change from baseline in homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes were measures of body composition, glycemic control, lipids, and sexual function. Efficacy results focused primarily on months 0−6 (phase 1; no changes in medication allowed). Medication changes were allowed in phase 2 (months 6−12).

RESULTS TRT reduced HOMA-IR in the overall population by 15.2% at 6 months (P = 0.018) and 16.4% at 12 months (P = 0.006). In type 2 diabetic patients, glycemic control was significantly better in the TRT group than the placebo group at month 9 (HbA1c: treatment difference, −0.446%; P = 0.035). Improvements in total and LDL cholesterol, lipoprotein a (Lpa), body composition, libido, and sexual function occurred in selected patient groups. There were no significant differences between groups in the frequencies of adverse events (AEs) or serious AEs. The majority of AEs (>95%) were mild or moderate.

CONCLUSIONS Over a 6-month period, transdermal TRT was associated with beneficial effects on insulin resistance, total and LDL-cholesterol, Lpa, and sexual health in hypogonadal men with type 2 diabetes and/or MetS.

更多阅读
Testosterone Gel Shows Effects on Insulin Resistance. medscape.2011.3.24

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