Huang Xinshuang, Zhao Hui, Wu Xiaodong, Liang Yun, Guan Qingbo, Luo Dandan, Yu Chunxiao
Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Endocrinology, Shandong Provincial Hospital, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Med Sci Monit. 2025 Aug 3;31:e948180. doi: 10.12659/MSM.948180.
The rising prevalence of overweight, obesity, and late-onset hypogonadism (LOH) is seriously affecting the quality of life of middle-aged and older men. LOH is a testosterone deficiency syndrome that is closely associated with aging. Its main symptoms are erectile dysfunction, loss of libido, fatigue, and loss of bone density. Testicular Leydig cells are located in the connective tissue between the spermatogenic tubules and are the primary sites producing testosterone. Metabolic disorders such as obesity and hyperlipidemia accelerate Leydig cell aging, reduce testosterone levels, and contribute to the development of LOH. The pathogenesis of LOH mainly includes oxidative stress, inflammation, mitochondrial dysfunction, and endoplasmic reticulum stress. The treatments for LOH include testosterone replacement therapy, senolytic therapy, stem cell therapy, and traditional Chinese medicine therapy. Obesity may be one of the important mechanisms of obesity-related LOH by promoting Leydig cell aging, changing the endocrine environment, and worsening chronic inflammation, and research in this field is still deepening. Therefore, this article reviews the mechanisms of testicular interstitial cell senescence and obesity-related delayed hypogonadism, as well as possible obesity management methods.
超重、肥胖和迟发性性腺功能减退（LOH）患病率的上升正严重影响中老年男性的生活质量。LOH是一种与衰老密切相关的睾酮缺乏综合征。其主要症状为勃起功能障碍、性欲减退、疲劳和骨密度降低。睾丸间质细胞位于生精小管之间的结缔组织中，是产生睾酮的主要部位。肥胖和高脂血症等代谢紊乱会加速间质细胞衰老，降低睾酮水平，并促使LOH的发生。LOH的发病机制主要包括氧化应激、炎症、线粒体功能障碍和内质网应激。LOH的治疗方法包括睾酮替代疗法、衰老细胞溶解疗法、干细胞疗法和中医治疗。肥胖可能是通过促进间质细胞衰老、改变内分泌环境和加重慢性炎症而导致肥胖相关性LOH的重要机制之一，该领域的研究仍在不断深入。因此，本文综述了睾丸间质细胞衰老和肥胖相关性迟发性性腺功能减退的机制以及可能的肥胖管理方法。
