Institute of Endocrinology, Prague, Czech Republic.
Physiol Res. 2020 Sep 30;69(Suppl 2):S273-S278. doi: 10.33549/physiolres.934510.
Obesity increases the incidence of hypogonadism in men, and hypogonadism in turn plays a role in obesity. One of the first mechanisms proposed to explain this was a hypothesis based on the principle that obese men have higher estrogen levels, and that increased estrogens provide feedback to the hypothalamic-pituitary-testicular axis, reducing the secretion of gonadotropins and leading to a decrease of overall testosterone levels. This concept has since been questioned, though never completely disproven. In this study we compared hormone levels in three groups of men with differing BMI levels (between 18-25, 25-29, and 30-39), and found correlations between lowering overall testosterone, SHBG and increased BMI. At the same time, there were no significant changes to levels of free androgens, estradiol or the gonadotropins LH and FSH. These findings are in line with the idea that estrogen production in overweight and obese men with BMI up to 39 kg/m(2) does not significantly influence endocrine testicular function.
肥胖会增加男性性腺功能减退症的发病率,而性腺功能减退症反过来又会对肥胖产生影响。最早提出的解释这一现象的机制之一是基于这样一个假设:肥胖男性的雌激素水平较高,而增加的雌激素会对下丘脑-垂体-睾丸轴产生反馈作用,减少促性腺激素的分泌,导致总睾酮水平下降。尽管这一概念后来受到了质疑,但从未被完全否定。在这项研究中,我们比较了三组 BMI 水平不同的男性(18-25、25-29 和 30-39)的激素水平,发现总睾酮、SHBG 降低和 BMI 增加之间存在相关性。与此同时,游离雄激素、雌二醇或促性腺激素 LH 和 FSH 的水平没有明显变化。这些发现与超重和肥胖男性的雌激素产生在 BMI 高达 39 kg/m(2) 时不会显著影响内分泌睾丸功能的观点一致。