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Low testosterone concentrations have previously been associated with the metabolic syndrome [ 4].
Therefore, low testosterone concentrations are not the consequence of estradiol dependent suppression of the hypothalamo-hypophyseal-gonadal axis.
These observations have several clinical implications, since low testosterone concentrations may contribute to the impairment of sexual function, diminished libido, and erectile dysfunction.
Indeed, low testosterone concentrations in male subjects are known to be associated with enhanced cardiovascular risk in observational studies (17, 18).
Men with type 2 diabetes often have low testosterone concentrations, and inappropriately low LH indicating a hypothalamic/pituitary basis (George et al., 2010).
We evaluate testosterone concentrations routinely in diabetic patients in view of the high frequency (one in three) of low testosterone concentrations.
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Furthermore, the association between low testosterone concentration and insulin resistance may be partially caused by impaired Leydig cell function (22).
Mice with a higher circulating testosterone concentration had more precise clocks and ran much faster, but for a shorter duration, than their counterparts with a low testosterone concentration.
Although in all cited studies above testosterone concentrations were inversely related to BMI but low testosterone concentration was not closely depended upon high BMI.
This is in agreement with the observations that a diminished testicular nonantioxidant enzyme ascorbic acid in diabetes could be identified with low testosterone concentration [ 62].
Philibert et al. (2010) identified NR5A1 mutations as a frequent cause of 'primary amenorrhea' in 46,XY phenotypic female adolescents with a low testosterone concentration.
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