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The associations of TT and cFT with age and BMI were preserved independently of diabetic status. It should be noted that the higher TT and steeper age-related decline in T1D, compared with T2D and controls, persisted after adjustment for covariates (BMI and SHBG) in the GLM (p? http://www.selleckchem.com/products/VX-765.html BMI, independent of age and diabetes status. These findings are consistent with previous data suggesting that obesity is a major correlate of lowered testosterone in ageing men (Allan & McLachlan, 2010) and extends this to a younger population, including men with T1D. It also demonstrates that adiposity is a major determinant of low testosterone, irrespective of whether men have diabetes or not. This inverse association of low testosterone with BMI is less evident for cFT, because of elimination http://www.selleckchem.com/products/pf-562271.html of the confounding effects of SHBG (Wallace et?al., 2013). Whether lowered testosterone is a cause or consequence of obesity cannot be answered in a cross-sectional study but current evidence suggests that this relationship is bi-directional: on the one hand, studies in men with prostate cancer receiving androgen deprivation therapy show that (very) low testosterone leads to metabolically unfavourable changes in body composition, termed ��sarcopenic obesity��, with associated increases in insulin resistance (Grossmann & Zajac, 2011b). In addition, randomized controlled trials (RCTs) have shown that testosterone therapy reduces fat mass (by 1.6�C2.0?kg) and increases muscle mass (by 1.6�C2.7?kg) (Bhasin http://www.selleck.cn/products/azd6738.html et?al., 2006), and more significant fat loss has been observed in uncontrolled studies (Saad et?al., 2012). On the other hand, there is also evidence for the reverse: in prospective studies, weight gain and development of diabetes are major drivers of the age-related decline in testosterone levels (Travison et?al., 2007). Weight loss increases testosterone levels, suggesting that the lowered testosterone status is functional, and to a degree reversible (Grossmann, 2011c). The dominant association of testosterone with BMI has implications for the clinical management of such men. Although this relationship is partially mediated by low SHBG, low SHBG by itself may be causally related to diabetes (Ding et?al., 2009; Wallace et?al., 2013). Lifestyle measures including weight loss may safely raise testosterone and SHBG levels and have other health benefits (Grossmann, 2011c). However, recent studies suggest that the degree of weight loss required to significantly increase testosterone levels may be substantial, around 15% of body weight, an amount that may be difficult to achieve and maintain for the majority of such men (Camacho et?al.