Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Department of Endocrinology and Metabolism, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People's Republic of China.
Int J Clin Pract. 2020 Aug;74(8):e13513. doi: 10.1111/ijcp.13513. Epub 2020 May 8.
Male obesity-associated secondary hypogonadism (MOSH) is becoming a public health issue. We aimed to know MOSH among young and middle-aged men in our hospital, to analyse their sex hormones and other index, and to determine leptin as a risk factor for MOSH.
In total, 258 men (ages ranging from 20 to 60, mean 38 ± 15) were enrolled in this study, and 242 of these men had their complete data, body mass index (BMI), waist circumference and sex hormones retrospectively investigated. The leptin and lipid levels were also evaluated, and comparisons were made between young (20-39 years old) and middle-aged (40-60 years old) men.
Among all the participants, 7 were thin, with a BMI < 18.5 kg/m , 95 had a normal BMI (18.5 ≤ BMI < 23.9 kg/m ), 87 (35.9%) were overweight (24 ≤ BMI ≤ 27.9 kg/m ) and 53 (21.9%) were obese (BMI ≥ 28 kg/m ), 173 (71.5%) had a waist sized ≥ 85 cm. Among the 242 men, 104 (43%) had hypogonadism (TT ≤ 331.412 ng/dL). Compared with the men of normal weight, the level of testosterone of the obese men decreased (P = .006), while the level of serum lipids (including total cholesterol, TG and low-density lipoprotein cholesterol, P < .05) was elevated, higher UA, FSH and leptin were also present in the obese men. There were 83 (34.2%) men with MOSH. Compared with middle-aged men with MOSH, the FSH in young men was significantly reduced (P < .05); no significant increase in estradiol was observed in the MOSH group. The leptin levels in the MOSH group were significantly higher than those in the hypogonadism only group (P < .001).
Obesity increases the prevalence of hypogonadism. The decrease in testosterone levels in young men maybe due to inhibition of the hypothalamic pituitary gonadal axis. Leptin is an independent risk factor for MOSH.
男性肥胖相关性性腺功能减退症（MOSH）正成为一个公共卫生问题。我们旨在了解我院中青年男性 MOSH 的患病情况，分析其性激素等指标，确定瘦素是否为 MOSH 的危险因素。
共纳入 258 名男性（年龄 20-60 岁，平均 38±15 岁），其中 242 名男性的体重指数（BMI）、腰围和性激素等数据完整，回顾性分析这些数据。还评估了瘦素和血脂水平，并比较了青年（20-39 岁）和中年（40-60 岁）男性之间的差异。
所有参与者中，7 人消瘦（BMI＜18.5kg/m²），95 人正常体重（18.5kg/m²≤BMI＜23.9kg/m²），87 人超重（24kg/m²≤BMI≤27.9kg/m²），53 人肥胖（BMI≥28kg/m²），173 人腰围≥85cm。242 名男性中，104 人（43%）患有性腺功能减退症（TT≤331.412ng/dL）。与正常体重男性相比，肥胖男性的睾酮水平降低（P=.006），而血清脂质水平（包括总胆固醇、甘油三酯和低密度脂蛋白胆固醇，P＜.05）升高，尿酸（UA）、卵泡刺激素（FSH）和瘦素水平也升高。83 名（34.2%）男性患有 MOSH。与中年 MOSH 男性相比，青年 MOSH 男性的 FSH 明显降低（P＜.05）；MOSH 组雌二醇水平未见明显升高。MOSH 组的瘦素水平明显高于单纯性腺功能减退症组（P＜.001）。
肥胖增加了性腺功能减退症的患病率。青年男性睾酮水平降低可能是由于下丘脑-垂体-性腺轴受到抑制。瘦素是 MOSH 的独立危险因素。
