Hypogonadotropic Hypogonadism Associated With Obesity: A Case Report
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Abstract
One of the critical factors with a broad impact on health is obesity. Besides its cardiovascular comorbidities, obesity’s probable association with hypogonadotropic hypogonadism in men will be discussed in this article by reporting a severely obese boy, presenting with the absence of secondary sexual characteristics and hypertension. The hypothalamus-pituitary- gonadal axis can be influenced by several mechanisms at different levels of the axis. Some of these pathophysiological mechanisms, related to our case are explained to explore the association of obesity with reproductive disorders. Adipose tissue plays a prominent role in the metabolism of hormones that are secreted by other glands. Obesity as a preventable risk factor is valuable to be researched, to decrease the burden of its morbidity and mortality. Thus more studies should be done in the future to determine the complex network of factors contributing to hormonal imbalances seen in obese people.
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[13] Escobar-Morreale HF, Alvarez-Blasco F, Botella-Carretero JI, Luque- Ramírez M. The striking similarities in the metabolic associations of female androgen excess and male androgen deficiency. Human Re- production. 2014; 29(10):2083-91. [DOI:10.1093/humrep/deu198]
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[15] Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prev- alence of hypogonadism in males aged at least 45 years: The HIM study. International Journal of Clinical Practice 2006; 60(7):762-9. [DOI:10.1111/j.1742-1241.2006.00992.x] [PMID] [PMCID]
[16] Silveira LF, Latronico AC. Approach to the patient with hypogonad- otropic hypogonadism. The Journal of Clinical Endocrinology & Me- tabolism. 2013; 98(5):1781-8. [DOI:10.1210/jc.2012-3550] [PMID]
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[19] American Association of Clinical Endocrinologists. Medical Guide- lines for Clinical Practice for the Evaluation and Treatment of Hypog- onadism in adult male patients. Endocrine Practice. 2002; 8(6):440- 56. [DOI:10.4158/EP.8.6.439]
[20] Seftel A. Male hypogonadism. Part II: etiology, pathophysiology, and diagnosis. International Journal of Impotence Research. 2006; 18(3):223-8. [DOI:10.1038/sj.ijir.3901365] [PMID]
[21] Lamm S, Chidakel A, Bansal R. Obesity and Hypogonadism. Urologic Clinics. 2016; 43(2):239-45. [DOI:10.1016/j.ucl.2016.01.005] [PMID]
[22] Corona G, Vignozzi L, Sforza A, Mannucci E, Maggi M. Obesity and late-onset hypogonadism. Molecular And Cellular Endocrinology. 2015; 418(Pt 2):120-33. [DOI:10.1016/j.mce.2015.06.031] [PMID]
[23] Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Archives of Disease in Childhood. 1970; 45(239):13- 23. [DOI:10.1136/adc.45.239.13] [PMID] [PMCID]
[24] Corona G, Rastrelli G, Monami M, Saad F, Luconi M, Lucchese M, et al. (2013). Body weight loss reverts obesity-associated hy- pogonadotropic hypogonadism: A systematic review and meta- analysis. European Journal of Endocrinology. 2013; 168(6):829-43. [DOI:10.1530/EJE-12-0955] [PMID]
[25] Dandona P, Dhindsa S. Update: Hypogonadotropic hypogonadism in type 2 diabetes and obesity. The Journal of Clinical Endocrinology & Metabolism. 2011; 96(9):2643-51. [DOI:10.1210/jc.2010-2724] [PMID] [PMCID]
[26] Roth MY, Amory JK, Page ST. Treatment of male infertility second- ary to morbid obesity. Nature clinical practice. Endocrinology & me- tabolism. 2008; 4(7):415-9. [DOI:10.1038/ncpendmet0844]
[27] Isidori AM, Giannetta E, Greco EA, Gianfrilli D, Bonifacio V, Isidori A, et al. Effects of testosterone on body composition, bone metabo- lism and serum lipid profile in middle-aged men: A meta-analysis. Clinical Endocrinology. 2005; 63(3):280-93. [DOI:10.1111/j.1365- 2265.2005.02339.x] [PMID]
[28] Corona G, Bianchini S, Sforza A, Vignozzi L, Maggi M. Hypog- onadism as a possible link between metabolic diseases and erectile dysfunction in aging men. Hormones (Athens). 2015; 14(4):569-78. [DOI:10.14310/horm.2002.1635] [PMID]
[29] Brüning JC, Gautam D, Burks DJ, Gillette J, Schubert M, Orban PC, et al. Role of brain insulin receptor in control of body weight and reproduction. Science. 289(5487):2122-5. [DOI:10.1126/sci- ence.289.5487.2122] [PMID]
[30] Hofstra J, Loves S, van Wageningen B, Ruinemans-Koerts J, Jansen I, de Boer H. High prevalence of hypogonadotropic hypogonadism in men referred for obesity treatment. The Netherlands Journal of Medicine. 2008; 66(3):103-9.[PMID]
[31] Samavat J, Facchiano E, Lucchese M, Forti G, Mannucci E, Maggi M, et al. Hypogonadism as an additional indication for bariatric sur- gery in male morbid obesity? European Journal of Endocrinology. 171(5):555-60. [DOI:10.1530/EJE-14-0596] [PMID]
[32] Tsai EC, Matsumoto AM, Fujimoto WY, Boyko EJ. Association of bioavailable, free, and total testosterone with insulin resistance: Influence of sex hormone-binding globulin and body fat. Diabetes Care. 2004; 27(4):861-8. [DOI:10.2337/diacare.27.4.861] [PMID]
[2] Chambers TJ, Richard RA. The impact of obesity on male fer- tility. Hormones (Athens). 2015; 14(4):563-8. [DOI:10.14310/ horm.2002.1621] [PMID]
[3] Boddi V, Barbaro V, McNieven P, Maggi M, Rotella CM. Present and future association between obesity and hypogonadism in Italian males. Archivio Italiano di Urologia e Andrologia. 2014; 86(1):26-32. [DOI:10.4081/aiua.2014.1.26] [PMID]
[4] Mihalca R, Fica S. The impact of obesity on the male reproductive axis. Journal of Medicine and Life. 7(2):296-300. [PMID] [PMCID]
[5] Obesity and overweight Fact sheet N°311 [Internet] [Updated: 1 April 2020]. WHO. January 2015. Retrieved 2 February 2016. Avail- able from: http://www.who.int/mediacentre/factsheets/fs311/en/ index.html
[6] Alberti KG, Zimmet P, Shaw J. Metabolic syndrome: A new world- wide definition. A Consensus Statement from the International Diabetes Federation. Diabetic Medicine. 2006; 23(5):469-80. [DOI:10.1111/j.1464-5491.2006.01858.x] [PMID]
[7] Saad F, Yassin A, Doros G, Haider A. Effects of long-term treatment with testosterone on weight and waist size in 411 hypogonadal men with obesity classes I-III: Observational data from two regis- try studies. International Journal of Obesity. 2016; 40(1):162-70. [DOI:10.1038/ijo.2015.139] [PMID] [PMCID]
[8] Haslam DW, James WP. Obesity. Lancet. 2005; 366(9492):1197- 209. [DOI:10.1016/S0140-6736(05)67483-1] [PMID]
[9] Narayan KM, Boyle JP, Thompson TJ, Gregg EW, Williamson DF. Ef- fect of BMI on lifetime risk for diabetes in the U.S. Diabetes Care. 2007; 30(6):1562-6. [DOI:10.2337/dc06-2544] [PMID]
[10] Escobar-Morreale HF, Santacruz E, Luque-Ramírez M, Botella Car- retero JI. Prevalence of 'obesity-associated gonadal dysfunction' in severely obese men and women and its resolution after bariatric sur- gery: A systematic review and meta-analysis. Human Reproduction Update. 23(4):390-408. [DOI:10.1093/humupd/dmx012] [PMID]
[11] Björntorp P. Abdominal fat distribution and disease: An over- view of epidemiological data. Annals of Medicine. 24(1):15-8. [DOI:10.3109/07853899209164140] [PMID]
[12] Wells JC. Sexual dimorphism of body composition. Best Practice & Research Clinical Endocrinology & Metabolism. 2007; 21(3): 415- 30. [DOI:10.1016/j.beem.2007.04.007] [PMID]
[13] Escobar-Morreale HF, Alvarez-Blasco F, Botella-Carretero JI, Luque- Ramírez M. The striking similarities in the metabolic associations of female androgen excess and male androgen deficiency. Human Re- production. 2014; 29(10):2083-91. [DOI:10.1093/humrep/deu198]
[14] Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010; 33(6):1186-92. [DOI:10.2337/dc09-1649] [PMID] [PMCID]
[15] Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prev- alence of hypogonadism in males aged at least 45 years: The HIM study. International Journal of Clinical Practice 2006; 60(7):762-9. [DOI:10.1111/j.1742-1241.2006.00992.x] [PMID] [PMCID]
[16] Silveira LF, Latronico AC. Approach to the patient with hypogonad- otropic hypogonadism. The Journal of Clinical Endocrinology & Me- tabolism. 2013; 98(5):1781-8. [DOI:10.1210/jc.2012-3550] [PMID]
[17] Carnegie C. Diagnosis of hypogonadism: clinical assessments and labo- ratory tests. Reviews in Urology. 2004; 6(Suppl 6):S3-8. [PMID] [PMCID]
[18] Carruthers M. Summary from the second annual Andropause consensus meeting. The Endocrine Society; 2004.
[19] American Association of Clinical Endocrinologists. Medical Guide- lines for Clinical Practice for the Evaluation and Treatment of Hypog- onadism in adult male patients. Endocrine Practice. 2002; 8(6):440- 56. [DOI:10.4158/EP.8.6.439]
[20] Seftel A. Male hypogonadism. Part II: etiology, pathophysiology, and diagnosis. International Journal of Impotence Research. 2006; 18(3):223-8. [DOI:10.1038/sj.ijir.3901365] [PMID]
[21] Lamm S, Chidakel A, Bansal R. Obesity and Hypogonadism. Urologic Clinics. 2016; 43(2):239-45. [DOI:10.1016/j.ucl.2016.01.005] [PMID]
[22] Corona G, Vignozzi L, Sforza A, Mannucci E, Maggi M. Obesity and late-onset hypogonadism. Molecular And Cellular Endocrinology. 2015; 418(Pt 2):120-33. [DOI:10.1016/j.mce.2015.06.031] [PMID]
[23] Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Archives of Disease in Childhood. 1970; 45(239):13- 23. [DOI:10.1136/adc.45.239.13] [PMID] [PMCID]
[24] Corona G, Rastrelli G, Monami M, Saad F, Luconi M, Lucchese M, et al. (2013). Body weight loss reverts obesity-associated hy- pogonadotropic hypogonadism: A systematic review and meta- analysis. European Journal of Endocrinology. 2013; 168(6):829-43. [DOI:10.1530/EJE-12-0955] [PMID]
[25] Dandona P, Dhindsa S. Update: Hypogonadotropic hypogonadism in type 2 diabetes and obesity. The Journal of Clinical Endocrinology & Metabolism. 2011; 96(9):2643-51. [DOI:10.1210/jc.2010-2724] [PMID] [PMCID]
[26] Roth MY, Amory JK, Page ST. Treatment of male infertility second- ary to morbid obesity. Nature clinical practice. Endocrinology & me- tabolism. 2008; 4(7):415-9. [DOI:10.1038/ncpendmet0844]
[27] Isidori AM, Giannetta E, Greco EA, Gianfrilli D, Bonifacio V, Isidori A, et al. Effects of testosterone on body composition, bone metabo- lism and serum lipid profile in middle-aged men: A meta-analysis. Clinical Endocrinology. 2005; 63(3):280-93. [DOI:10.1111/j.1365- 2265.2005.02339.x] [PMID]
[28] Corona G, Bianchini S, Sforza A, Vignozzi L, Maggi M. Hypog- onadism as a possible link between metabolic diseases and erectile dysfunction in aging men. Hormones (Athens). 2015; 14(4):569-78. [DOI:10.14310/horm.2002.1635] [PMID]
[29] Brüning JC, Gautam D, Burks DJ, Gillette J, Schubert M, Orban PC, et al. Role of brain insulin receptor in control of body weight and reproduction. Science. 289(5487):2122-5. [DOI:10.1126/sci- ence.289.5487.2122] [PMID]
[30] Hofstra J, Loves S, van Wageningen B, Ruinemans-Koerts J, Jansen I, de Boer H. High prevalence of hypogonadotropic hypogonadism in men referred for obesity treatment. The Netherlands Journal of Medicine. 2008; 66(3):103-9.[PMID]
[31] Samavat J, Facchiano E, Lucchese M, Forti G, Mannucci E, Maggi M, et al. Hypogonadism as an additional indication for bariatric sur- gery in male morbid obesity? European Journal of Endocrinology. 171(5):555-60. [DOI:10.1530/EJE-14-0596] [PMID]
[32] Tsai EC, Matsumoto AM, Fujimoto WY, Boyko EJ. Association of bioavailable, free, and total testosterone with insulin resistance: Influence of sex hormone-binding globulin and body fat. Diabetes Care. 2004; 27(4):861-8. [DOI:10.2337/diacare.27.4.861] [PMID]
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| Issue | Vol 5 No 4 (2020): Autumn | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v5i4.5054 | |
| Keywords | ||
| Obesity Hypogonadotropic hypogonadism | ||
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How to Cite
1.
Johari Varnoosfaderani N, Karimpour Reihan S, Abbaszadeh M, Khajavirad N. Hypogonadotropic Hypogonadism Associated With Obesity: A Case Report. CRCP. 2021;5(4):113-117.
