Patients with Klinefelter’s syndrome have a higher incidence of diabetes mellitus and the percentage of insulin resistance
was reported to be high in these patients. However, little is known about the insulin sensitivity assessed by the hyperinsulinemic
euglycemic clamp in these patients. In the present study, subjects included 13 newly diagnosed patients with Klinefelter’s
syndrome, and 9 age- and body mass index-matched healthy males. The hyperinsulinemic euglycemic clamp was performed in all
patients and controls. Insulin resistance was present in five (38.5%) patients with Klinefelter’s syndrome. Compared with
control subjects, patients with Klinefelter’s syndrome had elevated plasma concentrations of fasting insulin, follicle-stimulating
hormone, luteinizing hormone, estradiol, and sex hormone-binding globulin, whereas they had reduced plasma free testosterone
and total testosterone concentrations. The multivariate linear regression analysis showed that fasting glucose, fasting insulin,
free testosterone, and total testosterone were independently associated with
M-value. In conclusion, the present study by using hyperinsulinemic euglycemic clamp indicates the high prevalence of insulin
resistance in Klinefelter’s syndrome patients. However, these patients did not have reduced mean
M-values compared with the controls, although their plasma insulin levels were significantly elevated. It is possible that
hyperinsulinemia may be the primary metabolic abnormality rather than insulin resistance.
Key Words Klinefelter’s syndrome - insulin resistance - hyperinsulinemia - hyperinsulinemic euglycemic clamp - testosterone