Cited by 321Hypothalamic control of reproductive hormonesOvarian function and disordersAdipokines, Inflammation, and Metabolic Diseases

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The complex interaction between obesity, metabolic syndrome and reproductive axis: A narrative review

Michalakis, Konstantinos, Mintziori, Gesthimani, Kaprara, Athina, Tarlatzis, Basil C., Goulis, Dimitrios G.·2013·Metabolism

DOI 10.1016/j.metabol.2012.08.012

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Abstract

The aim of this narrative review is to provide current evidence for the interaction between obesity, metabolic syndrome (MS) and reproductive axis. Gonadotropin-releasing hormone (GnRH) pulses and, consequently, normal function of reproductive (hypothalamus-pituitary-gonadal) axis depend on normal energy balance, which presupposes sufficient food intake, reasonable energy consumption and average thermoregulatory costs. In case of an energy imbalance, reproductive dysfunction may occur. In young women, excessive leanness is accompanied by puberty delay, whereas premature puberty might be a manifestation of obesity. In a similar way, obesity in men affects fertility. Excess adipose tissue results in increased conversion of testosterone to estradiol, which may lead to secondary hypogonadism through reproductive axis suppression. Moreover, oxidative stress at the level of the testicular micro-environment may result in decreased spermatogenesis and sperm damage. Products of the adipocyte, such as leptin, adiponectin and resistin, and gut peptides, such as ghrelin, are considered to be crucial in the interaction between energy balance and reproduction. Finally, an indirect evidence for the interplay between MS and reproductive axis is the fact that when treating components of one, parameters of the other can be improved as well. These therapeutic interventions include lifestyle modifications, pharmacological agents, such as sex hormone replacement therapy, and surgical procedures. Although many issues remain unclear, the elucidation of the complex interaction between MS and reproductive axis will have obvious clinical implications in the therapeutic approach of both entities.

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Authors: Michalakis, K., Mintziori, G., Kaprara, A., Tarlatzis, B. C., & Goulis, D. G.
Affiliations: Aristotle University of Thessaloniki (GR)
Corresponding author: Goulis, Dimitrios G.
ORCID: Michalakis, Konstantinos
Mintziori, Gesthimani
Kaprara, Athina
Tarlatzis, Basil C.
Goulis, Dimitrios G.
Venue: Metabolism
Publisher: Elsevier BV
Published: 2013-04
Volume: 62
Issue: 4
Pages: 457-478
ISSN: 0026-0495 (ISSN-L)
DOI: 10.1016/j.metabol.2012.08.012
OpenAlex: W2115987699
Cited by: 321
References: 272
Citations by year: 2026: 10 · 2025: 15 · 2024: 19 · 2023: 16 · 2022: 18 · 2021: 21 · 2020: 29 · 2019: 30 · 2018: 23 · 2017: 26 · 2016: 27 · 2015: 35 · 2014: 38 · 2013: 14
FWCI: 3.76
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Metabolism (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Keywords: obesity, metabolic syndrome, reproductive axis, hypothalamic-pituitary-gonadal axis, energy balance, puberty, precocious puberty, male infertility, secondary hypogonadism, oxidative stress, spermatogenesis, leptin, adiponectin, resistin, ghrelin, sex hormone replacement therapy, bariatric surgery, lifestyle modification
MeSH terms: Adult, Female, Fertility, Gastrointestinal Hormones, Humans, Infertility, Life Style, Male, Obesity, Pregnancy, Reproduction, Gonadal Steroid Hormones, Metabolic Syndrome, Bariatric Surgery

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The complex interaction between obesity, metabolic syndrome and reproductive axis: A narrative review

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