Obesity and male hypogonadism: Tales of a vicious cycle
Tóm tắt
Obesity prevalence, particularly in children and young adults, is perilously increasing worldwide foreseeing serious negative health impacts in the future to come. Obesity is linked to impaired male gonadal function and is currently a major cause of hypogonadism. Besides signs and symptoms directly derived from decreased circulating testosterone levels, males with obesity also present poor fertility outcomes, further evidencing the parallelism between obesity and male reproductive function. In addition, males with androgen deficiency also exhibit increased fat accumulation and reduced muscle and mineral bone mass. Thus, compelling evidence highlights a vicious cycle where male hypogonadism can lead to increased adiposity, while obesity can be a cause for male hypogonadism. On the opposite direction, sustained weight loss can attain amelioration of male gonadal function. In this scenario, a thorough evaluation of gonadal function in men with obesity is crucial to dissect the causes from the consequences in order to target clinical interventions towards maximized improvement of reproductive health. This review will address the causes and consequences of the bidirectional relationship between obesity and hypogonadism, highlighting the implicit male reproductive repercussions.
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Tài liệu tham khảo
WHO.Obesity and overweight data sheet.2018.
WHO.Situation of child and adolescent health in Europe.Situation of child and adolescent health in Europe.2018.
Hales CM, 2017, Prevalence of Obesity Among Adults and Youth: United States, 2015‐2016
Spratt DI, 1988, Neuroendocrine‐gonadal axis in men: frequent sampling of LH, FSH, and testosterone, Am J Phys, 254, E658
Svartberg J, 2004, Waist circumference and testosterone levels in community dwelling men. The Tromsø Study, Eur J Endocrinol, 19, 657
Rebuffe‐Scrive M, 1991, Effect of testosterone on abdominal adipose tissue in men, Int J Obes, 15, 791
Marin P, 1996, Assimilation of triglycerides in subcutaneous and intraabdominal adipose tissues in vivo in men: effects of testosterone, J Clin Endocrinol Metab, 81, 1018
Vermeulen A, 1993, Attenuated luteinizing hormone (LH) pulse amplitude but normal LH pulse frequency, and its relation to plasma androgens in hypogonadism of obese men, J Clin Endocrinol Metab, 76, 1140
Hofstra J, 2008, High prevalence of hypogonadotropic hypogonadism in men referred for obesity treatment, Neth J Med, 66, 103
Roselli CE, 2009, Brain aromatization: classical roles and new perspectives, Semin Reprod Med, 207