Journal of Clinical Medicine Research

As an important steroid hormone, testosterone plays a key role in male growth, sexual function maintenance and metabolism regulation. In recent years, the prevalence of metabolic diseases has continued to climb, and the two-way relationship between decreased testosterone levels and metabolic diseases has received increasing attention. Numerous epidemiological studies have shown that serum total and free testosterone levels are significantly reduced in men with metabolic syndrome, and testosterone levels decrease in steps with the extent of metabolic abnormalities. Obesity, insulin resistance, dyslipidemia, hypertension, hyperuricemia and other components of metabolic syndrome are closely related to hypotestosteronemia. The association between testosterone deficiency and metabolic diseases involves multi-level pathophysiological mechanisms, mainly including the imbalance of hypothalamus-pituitary-testicular axis regulation, insulin resistance, leptin resistance, chronic low-grade inflammatory state and mitochondrial-endoplasmic reticulum stress. In recent years, UGT2B-mediated enhanced mechanisms of hepatic testosterone clearance have provided new perspectives for understanding hormone depletion in metabolic diseases. At the intervention level, lifestyle interventions (weight loss, exercise) can significantly raise testosterone levels and improve metabolic status, while testosterone replacement therapy has shown to improve insulin sensitivity, lower blood glucose, and improve the potential of lipid profile in patients with metabolic diseases with hypogonadism, but its cardiovascular safety and adaptation population still need to be carefully evaluated. In-depth research on the relationship between testosterone and metabolic diseases will help to reveal the core role of sex hormones in metabolic regulation, and provide new theoretical basis and intervention strategies for the precise prevention and treatment of metabolic diseases.