Skip to main content

Abstract

Obesity is a crucial risk factor for mortality and morbidity not only for cardiovascular diseases but also for type 2 diabetes mellitus (T2DM), cancer, and musculoskeletal disorders. A significant amount of evidence has also documented that obesity represents an important risk factor for male hypogonadism as well. The specific pathogenetic mechanisms involved in this phenomenon are complex and not completely understood. The currently available clinical, experimental, and interventional evidence is reviewed and discussed here.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass index). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377:557–67.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Corona G, Rastrelli G, Filippi S, Vignozzi L, Mannucci E, Maggi M. Erectile dysfunction and central obesity: an Italian perspective. Asian J Androl. 2014. doi:10.4103/1008-682X.126386 [Epub ahead of print].

    Google Scholar 

  3. Corona G, Rastrelli G, Forti G, Maggi M. Update in testosterone therapy for men. J Sex Med. 2011;8:639–54.

    Article  CAS  PubMed  Google Scholar 

  4. Corona G, Rastrelli G, Vignozzi L, Maggi M. Emerging medication for the treatment of male hypogonadism. Expert Opin Emerg Drugs. 2012;17:239–59.

    Article  CAS  PubMed  Google Scholar 

  5. Buvat J, Maggi M, Guay A, Torres LO. Testosterone deficiency in men: systematic review and standard operating procedures for diagnosis and treatment. J Sex Med. 2013;10:245–84.

    Article  CAS  PubMed  Google Scholar 

  6. Corona G, Rastrelli G, Monami M, Saad F, Luconi M, Lucchese M, Facchiano E, Sforza A, Forti G, Mannucci E, Maggi M. Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis. Eur J Endocrinol. 2013;168(6):829–43.

    Article  CAS  PubMed  Google Scholar 

  7. Saad F, Aversa A, Isidori AM, Gooren LJ. Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review. Curr Diabetes Rev. 2012;8:131–43.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Corona G, Rastrelli G, Maggi M. Diagnosis and treatment of late-onset hypogonadism: systematic review and meta-analysis of TRT outcomes. Best Pract Res Clin Endocrinol Metab. 2013;27:557–79.

    Article  CAS  PubMed  Google Scholar 

  9. Morelli A, Corona G, Filippi S, Ambrosini S, Forti G, Vignozzi L, Maggi M. Which patients with sexual dysfunction are suitable for testosterone replacement therapy? J Endocrinol Invest. 2007;30:880–8.

    Article  CAS  PubMed  Google Scholar 

  10. Corona G, Rastrelli G, Vignozzi L, Mannucci E, Maggi M. How to recognize late-onset hypogonadism in men with sexual dysfunction. Asian J Androl. 2012;14:251–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Wu FC, Tajar A, Pye SR, Silman AJ, Finn JD, O’Neill TW, Bartfai G, Casanueva F, Forti G, Giwercman A, Huhtaniemi IT, Kula K, Punab M, Boonen S, Vanderschueren D, European Male Aging Study Group. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab. 2008;93:2737–45.

    Article  CAS  PubMed  Google Scholar 

  12. Corona G, Mannucci E, Lotti F, Fisher AD, Bandini E, Balercia G, Forti G, Maggi M. Pulse pressure, an index of arterial stiffness, is associated with androgen deficiency and impaired penile blood flow in men with ED. J Sex Med. 2009;6(1):285–93.

    Article  CAS  PubMed  Google Scholar 

  13. Corona G, Rastrelli G, Silverii A, Monami M, Sforza A, Forti G, Mannucci E, Maggi M. The identification of prediabetes condition with ARIC algorithm predicts long-term CV events in patients with erectile dysfunction. J Sex Med. 2013;10(4):1114–23.

    Article  PubMed  Google Scholar 

  14. Corona G, Rastrelli G, Balercia G, Lotti F, Sforza A, Monami M, Forti G, Mannucci E, Maggi M. Hormonal association and sexual dysfunction in patients with impaired fasting glucose: a cross-sectional and longitudinal study. J Sex Med. 2012;9(6):1669–80.

    Article  CAS  PubMed  Google Scholar 

  15. Corona G, Monami M, Rastrelli G, Aversa A, Sforza A, Lenzi A, Forti G, Mannucci E, Maggi M. Type 2 diabetes mellitus and testosterone: a meta-analysis study. Int J Androl. 2011;34(6 Pt 1):528–40.

    Article  CAS  PubMed  Google Scholar 

  16. Corona G, Monami M, Rastrelli G, Aversa A, Tishova Y, Saad F, Lenzi A, Forti G, Mannucci E, Maggi M. Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med. 2011;8(1):272–83.

    Article  CAS  PubMed  Google Scholar 

  17. Zumoff B, Strain GW, Miller LK, et al. Plasma free and non-sex-hormone-binding-globulin-bound testosterone are decreased in obese men in proportion to their degree of obesity. J Clin Endocrinol Metab. 1990;71:929–31.

    Article  CAS  PubMed  Google Scholar 

  18. Corona G, Mannucci E, Fisher AD, Lotti F, Petrone L, Balercia G, Bandini E, Forti G, Maggi M. Low levels of androgens in men with erectile dysfunction and obesity. J Sex Med. 2008;5:2454–63.

    CAS  PubMed  Google Scholar 

  19. Giagulli VA, Kaufman JM, Vermeulen A. Pathogenesis of the decreased androgen levels in obese men. J Clin Endocrinol Metab. 1994;79:997–1000.

    CAS  PubMed  Google Scholar 

  20. Vermeulen A, Kaufman JM, Deslypere JP, Thomas G. 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. 1993;76:1140–6.

    CAS  PubMed  Google Scholar 

  21. Loves S, de Jong J, van Sorge A, Telting D, Tack CJ, Hermus A, Westerterp K, de Boer H. Somatic and psychological effects of low-dose aromatase inhibition in men with obesity-related hypogonadotropic hypotestosteronemia. Eur J Endocrinol. 2013;169:705–14.

    Article  CAS  PubMed  Google Scholar 

  22. Michalakis K, Mintziori G, Kaprara A, Tarlatzis BC, Goulis DG. The complex interaction between obesity, metabolic syndrome and reproductive axis: a narrative review. Metabolism. 2013;62:457–78.

    Article  CAS  PubMed  Google Scholar 

  23. Morelli A, Sarchielli E, Comeglio P, et al. Metabolic syndrome induces inflammation and impairs gonadotropin-releasing hormone neurons in the preoptic area of the hypothalamus in rabbits. Mol Cell Endocrinol. 2014;382:107–19.

    Article  CAS  PubMed  Google Scholar 

  24. Filippi S, Vignozzi L, Morelli A, et al. Testosterone partially ameliorates metabolic profile and erectile responsiveness to PDE5 inhibitors in an animal model of male metabolic syndrome. J Sex Med. 2009;6:3274–88.

    Article  CAS  PubMed  Google Scholar 

  25. Vignozzi L, Morelli A, Filippi S, et al. Farnesoid X receptor activation improves erectile function in animal models of metabolic syndrome and diabetes. J Sex Med. 2011;8:57–77.

    Article  CAS  PubMed  Google Scholar 

  26. Vignozzi L, Morelli A, Sarchielli E, et al. Testosterone protects from metabolic syndrome-associated prostate inflammation: an experimental study in rabbit. J Endocrinol. 2012;212:71–84.

    Article  CAS  PubMed  Google Scholar 

  27. Vignozzi L, Filippi S, Comeglio P. Nonalcoholic steatohepatitis as a novel player in metabolic syndrome-induced erectile dysfunction: an experimental study in the rabbit. Mol Cell Endocrinol. 2014;25:143–54.

    Article  Google Scholar 

  28. Vignozzi L, Filippi S, Comeglio P, et al. Tadalafil effect on metabolic syndrome-associated bladder alterations: an experimental study in a rabbit model. J Sex Med. 2014. doi:10.1111/jsm.12478.

    Google Scholar 

  29. Morelli A, Comeglio P, Filippi S, et al. Testosterone and farnesoid X receptor agonist INT-747 counteract high fat diet-induced bladder alterations in a rabbit model of metabolic syndrome. J Steroid Biochem Mol Biol. 2012;132:80–92.

    Article  CAS  PubMed  Google Scholar 

  30. Morelli A, Comeglio P, Filippi S, et al. Mechanism of action of phosphodiesterase type 5 inhibition in metabolic syndrome-associated prostate alterations: an experimental study in the rabbit. Prostate. 2013;73:428–41.

    Article  CAS  PubMed  Google Scholar 

  31. Pinilla L, Aguilar E, Dieguez C, et al. Kisspeptins and reproduction: physiological roles and regulatory mechanisms. Physiol Rev. 2012;92:1235–316.

    Article  CAS  PubMed  Google Scholar 

  32. George JT, Millar RP, Anderson RA. Hypothesis: kisspeptin mediates male hypogonadism in obesity and type 2 diabetes. Neuroendocrinology. 2010;91:302–7.

    Article  CAS  PubMed  Google Scholar 

  33. Herde MK, Geist K, Campbell RA, Herbison AE. Gonadotropin-releasing hormone neurons extend complex highly branched dendritic trees outside the blood-brain barrier. Endocrinology. 2011;152:3832–41.

    Article  CAS  PubMed  Google Scholar 

  34. Vannelli GB, Ensoli F, Zonefrati R, et al. Neuroblast long-term cell cultures from human fetal olfactory epithelium respond to odors. J Neurosci. 1995;15:4382–94.

    CAS  PubMed  Google Scholar 

  35. Maggi M, Barni T, Fantoni G, et al. Expression and biological effects of endothelin-1 in human gonadotropin-releasing hormone-secreting neurons. J Clin Endocrinol Metab. 2000;85:1658–65.

    CAS  PubMed  Google Scholar 

  36. Morelli A, Fibbi B, Marini M, et al. Dihydrotestosterone and leptin regulate gonadotropin-releasing hormone (GnRH) expression and secretion in human GnRH-secreting neuroblasts. J Sex Med. 2009;6:397–407.

    Article  CAS  PubMed  Google Scholar 

  37. Morelli A, Marini M, Mancina R, et al. Sex steroids and leptin regulate the “first Kiss” (KiSS 1/G-protein-coupled receptor 54 system) in human gonadotropin-releasing-hormone-secreting neuroblasts. J Sex Med. 2008;5:1097–113.

    Article  CAS  PubMed  Google Scholar 

  38. Morelli A, Comeglio P, Sarchielli E, et al. Negative effects of high glucose exposure in human gonadotropin-releasing hormone neurons. Int J Endocrinol. 2013. doi:10.1155/2013/684659.

    PubMed Central  PubMed  Google Scholar 

  39. Camacho EM, Huhtaniemi IT, O’Neill TW, et al. Age-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study. Eur J Endocrinol. 2013;168:445–55.

    Article  CAS  PubMed  Google Scholar 

  40. Zitzmann M, Mattern A, Hanisch J, Gooren L, Jones H, Maggi M. IPASS: a study on the tolerability and effectiveness of injectable testosterone undecanoate for the treatment of male hypogonadism in a worldwide sample of 1,438 men. J Sex Med. 2013;10:579–88.

    Article  CAS  PubMed  Google Scholar 

  41. Saad F, Haider A, Doros G, Traish A. Long-term treatment of hypogonadal men with testosterone produces substantial and sustained weight loss. Obesity (Silver Spring). 2013. doi:10.1002/oby.20407 [Epub ahead of print].

    Google Scholar 

  42. Corona G, Vignozzi L, Sforza A, Maggi M. Risks and benefits of late onset hypogonadism treatment: an expert opinion. World J Mens Health. 2013;31(2):103–25. doi: 10.5534/wjmh.2013.31.2.103. Epub 2013 Aug 31.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giovanni Corona .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Maggi, M. et al. (2015). Hypogonadism and Obesity. In: Lucchese, M., Scopinaro, N. (eds) Minimally Invasive Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-15356-8_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15356-8_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15355-1

  • Online ISBN: 978-3-319-15356-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics