文献詳細
特集 LOH症候群診療—最近の進歩
文献概要
要旨 LOH症候群の症状の1つに内臓脂肪の蓄積が挙げられており,以前からメタボリックシンドロームとの密接な関係が指摘されてきた。すでに,日本人を含めたさまざまな解析で,メタボリックシンドローム患者は血中テストステロンが低下していることが示されている。メタボリックシンドロームを呈する低テストステロン血症男性にテストステロン補充療法を行うと,肥満,高血圧,高血糖,脂質代謝異常のみならず動脈硬化までが改善したとする報告がある。テストステロン補充療法はメタボリックシンドロームに対する治療選択肢の1つとして,今後ますます期待が高まるであろう。
参考文献
1)日本泌尿器科学会/日本Men's Health医学会「LOH症候群診療ガイドライン」検討ワーキング委員会:加齢男性性腺機能低下症候群(LOH症候群)診療の手引き.In:男性ホルモン低下による男性更年期障害,ED,心身症などの診療マニュアル.じほう,東京,2007
2)メタボリックシンドローム診断基準検討委員会:メタボリックシンドロームの定義と診断基準.日本内科学会雑誌94:1-16,2005
3)Tsai EC, Boyko EJ, Leonetti DL, et al:Low serum testosterone level as a predictor of increased visceral fat in Japanese-American men. Int J Obes Relat Metab Disord 24:485-491, 2000
4)Yeap BB, Chubb SA, Hyde Z, et al:Lower serum testosterone is independently associated with insulin resistance in non-diabetic older men:the Health In Men Study. Eur J Endocrinol 161:591-598, 2009
5)Seidell JC, Bjorntorp P, Sjostrom L, et al:Visceral fat accumulation in men is positively associated with insulin, glucose, and C-peptide levels but negatively with testosterone levels. Metabolism 39:897-901, 1990
6)Phillips GB, Pinkernell BH and Jing TY:The association of hypotestosteronemia with coronary artery disease in men. Arterioscler Thromb 14:701-706, 1994
7)Makinen JI, Perheentupa A, Irjala K, et al:Endogenous testosterone and serum lipids in middle-aged men. Atherosclerosis 197:688-693, 2008
8)Tsujimura A, Miyagawa Y, Takezawa K, et al:Is low testosterone concentration a risk factor for metabolic syndrome in healthy middle-aged men? Urology 82:814-819, 2013
9)Bojesen A, Kristensen K, Birkebaek NH, et al:The metabolic syndrome is frequent in Klinefelter's syndrome and is associated with abdominal obesity and hypogonadism. Diabetes Care 29:1591-1598, 2006
10)Muller M, Grobbee DE, den Tonkelaar I, et al:Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab 90:2618-2623, 2005
11)Laaksonen DE, Niskanen L, Punnonen K, et al:Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care 27:1036-1041, 2004
12)Brand JS, van der Tweel, Grobbee DE, et al:Testosterone, sex hormone-binding globulin and the metabolic syndrome:a systematic review and meta-analysis of observational studies. Int J Epidemiol 40:189-207, 2011
13)Tsujimura A, Yamamoto R, Okuda H, et al:Low serum free testosterone level is associated with carotid intima-media thickness in middle aged Japanese men. Endocrine J 59:809-815, 2012
14)Fukui M, Ose H, Kitagawa Y, et al:Relationship between low serum endogenous androgen concentrations and arterial stiffness in men with type 2 diabetes mellitus. Metabolism 56:1167-1173, 2007
15)Emmelot-Vonk MH, Verhaar HJ, Nakhai Pour HR, et al:Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men:a randomized controlled trial. JAMA 299:39-52, 2008
16)Heufelder AE, Saad F, Bunck MC, et al:Fifty-two-week treatment with diet and exercise plus transdermal testosterone reverses the metabolic syndrome and improves glycemic control in men with newly diagnosed type 2 diabetes and subnormal plasma testosterone. J Androl 30:726-733, 2009
17)Traish AM, Haider A, Doros G, et al:Long-term testosterone therapy in hypogonadal men ameliorates elements of the metabolic syndrome:an observational, long-term registry study. Int J Clin Pract 68:314-329, 2014
18)Francomano D, Lenzi A and Aversa A:Effects of five-year treatment with testosterone undecanoate on metabolic and hormonal parameters in ageing men with metabolic syndrome. Int J Endocrinol 2014:527470, 2014
19)Aversa A, Bruzziches R, Francomano D, et al:Effects of testosterone undecanoate on cardiovascular risk factors and atherosclerosis in middle-aged men with late-onset hypogonadism and metabolic syndrome:results from a 24-month, randomized, double-blind, placebo-controlled study. J Sex Med 10:3495-3503, 2010
20)Vigen R, O'Donnell CI, Barón AE, et al:Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA 310:1829-1836, 2013
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