Department of Microscopy, Laboratory of Cell Biology, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.
i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
Obes Rev. 2019 Aug;20(8):1148-1158. doi: 10.1111/obr.12863. Epub 2019 Apr 29.
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.
肥胖症的患病率，尤其是在儿童和青少年中，在全球范围内呈危险地上升趋势，预计未来会对健康产生严重的负面影响。肥胖与男性性腺功能障碍有关，目前是导致性腺功能减退的主要原因。除了由循环睾酮水平下降直接导致的迹象和症状外，肥胖男性的生育能力也较差，这进一步证明了肥胖症和男性生殖功能之间的平行关系。此外，患有雄激素缺乏症的男性还表现出脂肪堆积增加、肌肉和矿物质骨量减少。因此，有力的证据突显了一个恶性循环，即男性性腺功能减退症可导致肥胖增加，而肥胖症又可能导致男性性腺功能减退症。相反，持续减肥可以改善男性性腺功能。在这种情况下，对肥胖男性的性腺功能进行全面评估至关重要，以便从因果关系中区分病因，从而针对临床干预措施，最大限度地改善生殖健康。这篇综述将探讨肥胖症和性腺功能减退症之间双向关系的原因和后果，强调其对男性生殖系统的潜在影响。
