madman
Super Moderator
Conclusion
In this review on androgens and body fat distribution in men and women, we confirm that low androgen levels including reduced total testosterone but also free testosterone or adrenal C19 steroids in some reports, are frequently observed in men with abdominal and/or visceral obesity and the metabolic syndrome. Data on TRT are, however, much less consistent in showing a significant favorable effects when considering specifically body fat distribution. Our analysis lends support to the notion that, independent of study design, trials involving patients with initially low baseline testosterone (<11 nmol/L) and a high BMI are more likely to lead to lower WC in response to TRT. In women, the positive association between total testosterone or free testosterone levels and abdominal adiposity indices seems to be fairly consistent but only in women with androgen excess. Studies remain equivocal in women without androgen excess. At the functional level, testosterone and DHT inhibit adipogenesis and LPL activity in both men and women, pointing toward other mechanisms to explain the positive association between androgens and visceral fat accumulation in women with androgen excess. A stimulatory effect of androgens on lipolysis may be present, but is not unanimous in the literature. In addition, at the tissue level, many steroid-converting enzymes are expressed and active in the various cell types of adipose tissues including 17β-HSDs, 5α-reductases and aldoketoreductases, which may contribute to alter androgen dynamics in a depot-specific manner and in so doing, may contribute to explain the effect of androgens on body fat distribution in humans.
In this review on androgens and body fat distribution in men and women, we confirm that low androgen levels including reduced total testosterone but also free testosterone or adrenal C19 steroids in some reports, are frequently observed in men with abdominal and/or visceral obesity and the metabolic syndrome. Data on TRT are, however, much less consistent in showing a significant favorable effects when considering specifically body fat distribution. Our analysis lends support to the notion that, independent of study design, trials involving patients with initially low baseline testosterone (<11 nmol/L) and a high BMI are more likely to lead to lower WC in response to TRT. In women, the positive association between total testosterone or free testosterone levels and abdominal adiposity indices seems to be fairly consistent but only in women with androgen excess. Studies remain equivocal in women without androgen excess. At the functional level, testosterone and DHT inhibit adipogenesis and LPL activity in both men and women, pointing toward other mechanisms to explain the positive association between androgens and visceral fat accumulation in women with androgen excess. A stimulatory effect of androgens on lipolysis may be present, but is not unanimous in the literature. In addition, at the tissue level, many steroid-converting enzymes are expressed and active in the various cell types of adipose tissues including 17β-HSDs, 5α-reductases and aldoketoreductases, which may contribute to alter androgen dynamics in a depot-specific manner and in so doing, may contribute to explain the effect of androgens on body fat distribution in humans.
