Metabolic Disorders and Male Hypogonadotropic Hypogonadism

Several studies highlight that testosterone deficiency is associated and predicts increased risk of developing metabolic disorders, and, that it is highly prevalent in obesity, metabolic syndrome and type-2 diabetes mellitus. Models of gonadotropin releasing hormone deficiency and androgen deprivation in patients with prostate cancer suggest that hypogonadotropic hypogonadism might contribute to onset or further worsen metabolic conditions by means of increased fat mass and insulin resistance. Nevertheless, in functional hypogonadism, such as late onset hypogonadism, the relationship between hypogonadotropic hypogonadism and metabolic disorders is bidirectional, and a vicious circle between the two components has been documented. The mechanisms underlying the crosstalk between testosterone deficiency and metabolic disorders include increased visceral adipose tissue and insulin resistance, leading to development of metabolic disorders, which in turn contribute to a further reduction of testosterone, determined by insulin resistance- and possibly pro-inflammatory cytokine-mediated, decrease of sex hormone binding globulin, resulting in increased free testosterone available for aromatization in visceral adipose tissue, a subsequent decrease in free testosterone, due to the excess of visceral adipose tissue and aromatization, and reduced gonadotropin secretion induced by estradiol, inflammatory mediators, leptin resistance, and insulin resistance, with determination of substantia...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research

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