TESTOSTERONE AND CARDIOVASCULAR RISK IN MEN 685

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5 TESTOSTERONE AND CARDIOVASCULAR RISK IN MEN 685 and bioavailable testosterone, SHBG, insulin, and cardiovascular risk factors in men, intervention studies are needed. Up to now, few clirùcal trials have been performed, and these studied small samples of middle-aged obese men with slightly decreased P1T levels. They have shown marked effects of androgens on adipose tissue metabolism, with trends for a reduction of abdominal fat tissue and an improvement in insulin sensitivity and lipid metabolism (27, 28). Afrer short term androgen treatment, normal healthy men have also shown a tendency for a decrease in insulin response curves (29) and a decline in total and LDL cholesterol (30). These preliminary data support the hypothesis that a causal relationship could explain the association we have shown between low PTT and insulin resistance. Additionallarger clinical trials are needed in healthy adult men with low PTT concentrations to further investigate the metabolic and cardiovascular benefits of androgen treatment and its cost-effectiveness. Acknowledgment. The authors are indebted ta Dr. Marc Roger, Prof. Jean-Roger Claude, and Beverley Balkau for scientific advice; ta Nadine Thibult, Edith Garat, and. Patricia Grand for their excellent technical support; and to the staff and the consultants of the Centre de Prévention Médicale des Télécommunications for their enthusiastic participation. References 1. Haffner SM, Katz MS, Stem MP, Dunn JF The relationsrup of sex hormones to hyperinsulinemia and hyperglycemia. Metabo1ism. 37: Cohen JC, Hiclanan R Insulin resistance and diminished glucose tolerance in powerlifters :ingesting anabolic steroids. J Clin Endocrinol Metab. 64: Simon D, Preziosi P, Barrett-Connor E, et al Interrelation between plasma testosterone and plasma insulin in healthy adult men: the Telecom Study. Diabetologia. 35: Haffner SM, Valdez RA.- Mykklinen L, Stern MP, Katz MS Decreased testosterone and dehydroepiandrosterone sulfate concentrations are associated with increased insulin and glucose concentrations in nondiabetic men. Metabolism. 43: Haffner SM, Karhapii P, Mykklinen L, Laaklo M Insulin resistance, body fat disbibution, and sex hormones in men. Diabetes. 43: Simon D, Preziosi P, Barrett-Connor E, et al The influence of aging on plasma &ex hormones in men: The Telecom Study. Am J Epidemiol 135, De Fronzo KA Glucose intolerance and aging. Diabetes Care. 4: Rowland M, Roberts J Blood pressure levels and hypertension in persans aged 6-74 years. United States, NCHS Advance Datano. 84. Vital and Health Statistics of the National Center for Health Statistics. Washington OC: DHHS. 9. Fontbonne A, Papoz L, Eschwêge E, Roger M, Saint-Paul M, Simon D Features of insulin-resistance syndrome in men from French Caribbean Islands. The Telecom Study. 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J Clin Endocrinol Metab. 76: Yki-Jarvinen H,Mikimattila S, Utriainen T, RutaDen EM.1995 Portal insulin concentrations rather than insulin sensitivity regulate serum sex hormonebinding globulin and insulin-like growth factor binding protein in uioo. J Clin Endocrinol Metab. 80: Marin P, Odén B, Bjiimtorp P Assimilation and mobilization of triglycerides in subcutaneous abdominal and feinorai adipose tissue in vivo in men: effects of androgens. J Clin Endocrinol Metab. 80: Marin P, Holmin:g S, Guatafslon C, et al Androgen treatment of abdominally obese men. Obes Res. 1: Fried.l KE, Jonel RE, Hannm Jr q, Plymate SR The administration of pharmacological doses of testosterone or 19-norteltosterone to normal men is not associated with increased insulin secretion or impaired glucose tolerance. J Clin Endocrinel Metab. 68: Tenover JS, 1992 Effects of testosterone supplementation in the aging male. J Clin Endocrinel Metab. 75: