title: Obesity and late-onset hypogonadism.
abstract: Obesity and male hypogonadism (HG) are often associated, as demonstrated in all cross-sectional studies. Prospective studies have indicated that i) having HG at baseline increases the risk of visceral obesity (and metabolic syndrome) and that ii) obesity induces incident HG. Hence, there is a bidirectional relationship between the two conditions. This is the main topic of this review, along with some pathogenic considerations. Meta-analysis of intervention studies indicates that treating obesity is a very efficient treatment for obesity-induced HG. The mechanism by which obesity induces HG has not yet been completely understood, but dietary-induced hypothalamic inflammation, along with a decreased GnRH release, is plausible. Among patients seeking medical care for obesity, the proportion of HG is relatively high. The prevalence of obesity among patients referring for sexual dysfunction is also elevated. Hence, in symptomatic, obese, hypogonadal subjects, testosterone supplementation (TS) can be considered. Whereas long-term uncontrolled register studies suggest that TS could decrease weight, analysis of controlled studies only support a parallel increase in lean mass and decrease in fat mass, with a resulting null effect on weight. Considering that T induces an increase in muscle mass, it is conceivable that the amount of activity obese people can undertake after TS will increase, allowing a closer adherence to physical exercise programs. Some studies, here meta-analyzed, support this concept.
authors.affiliation: Endocrinology Unit, Maggiore-Bellaria Hospital, Medical Department, Azienda-Usl Bologna, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corona
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Vignozzi
authors.affiliation: Endocrinology Unit, Maggiore-Bellaria Hospital, Medical Department, Azienda-Usl Bologna, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sforza
authors.affiliation: Diabetes Agency, Careggi Hospital, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Mannucci
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy. Electronic address: m.maggi@dfc.unifi.it.
authors.forename: M
authors.initials: M
authors.lastname: Maggi
mesh_terms: D017668:Age of Onset; D000818:Animals; D001835:Body Weight / Q000187:drug effects; D005058:Eunuchism / Q000188:drug therapy / Q000453:epidemiology*; D015444:Exercise / Q000502:physiology; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D018482:Muscle, Skeletal / Q000187:drug effects; D009765:Obesity / Q000188:drug therapy / Q000453:epidemiology*; D013739:Testosterone / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D013739:Testosterone
keywords: Erectile dysfunction; Late onset hypogonadism; Obesity; Testosterone