Androgens, visceral obesity and the risks for cardiovascular disease and diabetes mellitus

Given that there is a sex difference in cardiovascular disease, testosterone has long been regarded as the culprit for this difference. This position is no longer tenable. In epidemiological studies low plasma testosterone levels predict cardiovascular disease and diabetes mellitus, often clustered in the metabolic syndrome. Acute deprivation of testosterone, as in men treated for prostate cancer, leads to impairment of the risk factors for diabetes mellitus and cardiovascular disease. Testosterone administration to hypogonadal men decreases fat mass, increases lean body mass and leads to a reduction in plasma cholesterol, triglycerides and low-density lipoprotein (LDL)-cholesterol levels.Further studies are needed to investigate whether maintaining plasma testosterone levels in the mid-normal range improves the risk for cardiovascular disease and diabetes mellitus.