Cellular Mechanisms of Testosterone in Metabolic Disorders

A Special Issue of Cells (ISSN 2073-4409).

Deadline for manuscript submissions: 1 December 2026 | Viewed by 1379

Editor


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Guest Editor
1. Biomolecular Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK
2. Division of Clinical Medicine, Faculty of Health, University of Sheffield, Sheffield S10 2RX, UK
Interests: testosterone

Special Issue Information

Dear Colleagues,

Testosterone exerts multifaceted effects on energy homeostasis, body composition, and cardiometabolic health, yet the precise cellular and molecular mechanisms underlying its actions in metabolic disease remain elusive due to the tissue-specific and context-dependent nature of its signalling, the interplay with other endocrine and metabolic pathways, and the limited integration of preclinical and clinical data. Although clinical studies have investigated testosterone’s impact on type 2 diabetes, obesity, body composition, and cardiometabolic parameters, results are often heterogeneous, highlighting the critical need for mechanistic research to delineate tissue and pathway-specific actions. The escalating prevalence of obesity, type 2 diabetes, metabolic syndrome, and metabolic dysfunction-associated steatotic liver disease (MASLD) underscores the urgency of understanding these mechanisms, not only to advance disease pathophysiology but also to inform novel, targeted therapeutic strategies. Likewise, with the growing clinical use of testosterone replacement therapy to manage symptomatic testosterone deficiency, mechanistic studies are critical to delineate whether testosterone can be leveraged as a targeted metabolic intervention.

At the cellular level, testosterone regulates metabolic tissue function through diverse, interconnected mechanisms controlling energy utilisation, cellular signalling, tissue remodelling, and inter-organ crosstalk. These mechanisms are particularly pertinent in the context of contemporary metabolic therapies such as GLP-1 receptor agonists, which effectively promote weight loss but are known to often compromise lean mass, highlighting the potential complementary value of testosterone’s anabolic and metabolic effects.

This Special Issue welcomes high-quality original research, mechanistic studies, and reviews exploring testosterone’s cellular and molecular actions in metabolic tissues. Submissions addressing tissue-specific effects, sex differences, and translational relevance are encouraged, but all work advancing our understanding of testosterone in metabolic health and disease will be considered.

Dr. Daniel M. Kelly
Guest Editor

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Keywords

  • testosterone
  • metabolism
  • type 2 diabetes
  • obesity
  • metabolic syndrome
  • MASLD
  • skeletal muscle
  • adipose tissue
  • insulin resistance
  • endocrine signalling

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Published Papers (2 papers)

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17 pages, 1314 KB  
Article
Supraphysiological Testosterone Differentially Regulates Aortic Atheroma and Cardiac Remodelling in the Testicular Feminised Mouse
by Daniel M. Kelly, Joanne E. Nettleship, Marta M. Gillett and T. Hugh Jones
Cells 2026, 15(18), 1633; https://doi.org/10.3390/cells15181633 - 9 Sep 2026
Abstract
The cardiovascular actions of testosterone remain controversial, particularly regarding the safety of testosterone replacement therapy (TTh) in hypogonadal men. We investigated the effects of sustained supraphysiological testosterone exposure on aortic atherogenesis and cardiac remodelling in the testicular feminised (Tfm) mouse, a model of [...] Read more.
The cardiovascular actions of testosterone remain controversial, particularly regarding the safety of testosterone replacement therapy (TTh) in hypogonadal men. We investigated the effects of sustained supraphysiological testosterone exposure on aortic atherogenesis and cardiac remodelling in the testicular feminised (Tfm) mouse, a model of functional androgen receptor (AR) deficiency. Male Tfm mice and AR-intact XY littermate controls were fed a cholesterol-enriched diet for 28 weeks and received fortnightly intramuscular injections of saline or supraphysiological testosterone, alone or in combination with fulvestrant (oestrogen receptor antagonist) or anastrozole (aromatase inhibitor). Aortic lipid deposition was quantified by Oil Red O staining, while cardiac remodelling was assessed by heart weight, cardiomyocyte cross-sectional area and myocardial gene expression. Supraphysiological testosterone significantly reduced aortic fatty streak formation in Tfm mice compared with saline-treated controls (1.25 ± 0.36% vs 2.85 ± 0.37%, p < 0.01), an effect preserved following fulvestrant or anastrozole treatment, consistent with mechanisms that do not require classical AR or oestrogen receptor signalling. No additional reduction in aortic lipid deposition was observed in AR-intact XY littermates. In contrast, supraphysiological testosterone increased heart weight, cardiomyocyte size and expression of hypertrophic markers exclusively in XY mice, with no evidence of cardiac remodelling in Tfm mice. Collectively, these findings demonstrate divergent tissue-specific cardiovascular actions of testosterone, whereby supraphysiological exposure promotes AR-dependent cardiac remodelling without conferring additional vascular benefit, supporting maintenance of physiological testosterone concentrations during TTh. Full article
(This article belongs to the Special Issue Cellular Mechanisms of Testosterone in Metabolic Disorders)

Other

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22 pages, 492 KB  
Systematic Review
Metabolic Reversal of Functional Hypogonadism? GLP-1 Receptor Agonists and Male Reproductive Endocrinology—A Systematic Review
by Zakhi Zafrani, Sarah Suleman Khan and Michael Zitzmann
Cells 2026, 15(15), 1319; https://doi.org/10.3390/cells15151319 - 23 Jul 2026
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Abstract
Background: Testosterone deficiency is highly prevalent in men with obesity and type 2 diabetes mellitus and often reflects functional suppression of the hypothalamic–pituitary–gonadal (HPG) axis. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in these conditions, but their effects on male reproductive [...] Read more.
Background: Testosterone deficiency is highly prevalent in men with obesity and type 2 diabetes mellitus and often reflects functional suppression of the hypothalamic–pituitary–gonadal (HPG) axis. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in these conditions, but their effects on male reproductive endocrinology remain incompletely defined. Objective: To systematically review the effects of GLP-1 receptor agonists on testosterone, HPG axis hormones, and male reproductive outcomes. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Cochrane, and Google Scholar were searched (January 2021–January 2026) for studies evaluating GLP-1 RA therapy in adult men with reported endocrine or reproductive outcomes. Results: Eight studies met inclusion criteria, including one randomised placebo-controlled crossover trial and six observational or interventional studies. In men with obesity, type 2 diabetes, or functional hypogonadism, GLP-1 RAs were associated with modest increases in testosterone and improvements in erectile function or selected semen parameters. In contrast, a placebo-controlled trial in healthy eugonadal men showed no significant endocrine or reproductive effects. Responses appeared dependent on baseline metabolic status. Conclusions: GLP-1 RAs are associated with improvements in male reproductive endocrinology in metabolically compromised populations with metabolic hypogonadism while remaining neutral in healthy individuals. Larger prospective studies are needed. Full article
(This article belongs to the Special Issue Cellular Mechanisms of Testosterone in Metabolic Disorders)
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