Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy.
Int J Mol Sci. 2022 Jul 25;23(15):8194. doi: 10.3390/ijms23158194.
Obesity is a chronic illness associated with several metabolic derangements and comorbidities (i.e., insulin resistance, leptin resistance, diabetes, etc.) and often leads to impaired testicular function and male subfertility. Several mechanisms may indeed negatively affect the hypothalamic-pituitary-gonadal health, such as higher testosterone conversion to estradiol by aromatase activity in the adipose tissue, increased ROS production, and the release of several endocrine molecules affecting the hypothalamus-pituitary-testis axis by both direct and indirect mechanisms. In addition, androgen deficiency could further accelerate adipose tissue expansion and therefore exacerbate obesity, which in turn enhances hypogonadism, thus inducing a vicious cycle. Based on these considerations, we propose an overview on the relationship of adipose tissue dysfunction and male hypogonadism, highlighting the main biological pathways involved and the current therapeutic options to counteract this condition.
肥胖是一种与多种代谢紊乱和合并症（如胰岛素抵抗、瘦素抵抗、糖尿病等）相关的慢性疾病，常导致睾丸功能受损和男性不育。几种机制可能确实会对下丘脑-垂体-性腺健康产生负面影响，例如脂肪组织中芳香酶活性导致的睾酮向雌二醇的转化增加、ROS 生成增加，以及通过直接和间接机制释放几种影响下丘脑-垂体-睾丸轴的内分泌分子。此外，雄激素缺乏症可能进一步加速脂肪组织的扩张，从而加重肥胖，进而加剧性腺功能减退，从而导致恶性循环。基于这些考虑，我们提出了脂肪组织功能障碍与男性性腺功能减退症之间关系的概述，强调了涉及的主要生物学途径以及目前对抗这种情况的治疗选择。
