Prevalence of male secondary hypogonadism in moderate to severe obesity and its relationship with insulin resistance and excess body weight
Open accessAbstract
Summary: To study the prevalence of male obesity‐secondary hypogonadism (MOSH) in patients with moderate to severe obesity, we performed a prospective prevalence study including 100 male patients with moderate to severe obesity at a university tertiary hospital. Total testosterone (TT) and sex hormone‐binding globulin (SHBG) concentrations among others were assayed in all patients. Serum‐free testosterone (FT) concentration was calculated from TT and SHBG levels. Semen analysis was conducted in 31 patients. We found a prevalence of 45% (95% CI: 35–55%) when considering decreased TT and/or FT concentrations. Serum concentrations of TT were correlated negatively with glucose (r = −0.328, p < 0.001) and insulin resistance (r = −0.261, p = 0.011). The same occurred with FT and glucose (r = −0.340, p < 0.001) and insulin resistance (r = −0.246, p = 0.016). Sixty‐two percent (95% CI: 39–85%) of the patients with seminogram also presented abnormal results in semen analysis. The frequencies of low TT or low FT values were similar in patients with abnormal or normal semen analysis (p = 0.646 and p = 0.346, respectively). Ejaculate volume inversely correlated with BMI (ρ = −0.400, p = 0.029) and with excess body weight (ρ = −0.464, p = 0.010). Our data show the prevalence of MOSH in patients with moderate to severe obesity is high. Low circulating testosterone is associated with insulin resistance and low ejaculate volume with higher BMI and excess body weight. Semen analysis must be performed in these patients when considering fertility whether or not presenting low circulating testosterone.
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Multiple studies confirmed the association between low or inappropriate T levels in men and T2D and obesity.
“In fact, multiple studies confirmed the association between low or inappropriate T levels in men and T2D and obesity [167–170].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [170]
The Abstract reports a high prevalence of low testosterone in men with moderate to severe obesity and correlations between testosterone, glucose, and insulin resistance. That supports the obesity association, but the paper’s reported results do not establish an association specifically with type 2 diabetes; glucose and insulin resistance are not equivalent to a T2D diagnosis. The paper lists studies on diabetes in its References, but those titles alone do not establish this study’s finding. (LLM, conf=0.86)
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A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
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Metabolic regulation of kisspeptin — the link between energy balance and reproduction
Navarro, V. M. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-0363-7 · Cited by 240 · see citing works
European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity
Pasquali, R., Casanueva, F., Haluzik, M., van Hulsteijn, L., Ledoux, S., Monteiro, M. P., Salvador, J., Santini, F., Toplak, H., & Dekkers, O. M. (2020) · European Journal of Endocrinology · doi:10.1530/eje-19-0893 · Cited by 180 · see citing works
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- Authors
- Calderón, B., Gómez‐Martín, J. M., Vega‐Piñero, B., Martín‐Hidalgo, A., Galindo, J., Luque‐Ramírez, M., Escobar‐Morreale, H. F., & Botella‐Carretero, J. I.
- Affiliations
- Instituto Ramón y Cajal de Investigación Sanitaria (ES)
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (ES)
- Hospital Universitario Ramón y Cajal (ES)
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (ES)
- Department of Endocrinology and Nutrition Hospital Universitario Ramón y Cajal & Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) Madrid Spain
- Venue
- Andrology
- Publisher
- Wiley
- Published
- 2015-12-11
- Volume
- 4
- Issue
- 1
- Pages
- 62-67
- ISSN
- 2047-2919 (ISSN-L)
- 2047-2927
- OpenAlex
- W2193832301
- Cited by
- 105
- References
- 8
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 14 · 2023: 18 · 2022: 10 · 2021: 9 · 2020: 11 · 2019: 10 · 2018: 8 · 2017: 10 · 2016: 4
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Andrology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Instituto de Salud Carlos III (PI1100357)
- Federación Española de Enfermedades Raras
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Keywords
- obesity, insulin resistance, testosterone, sex hormone-binding globulin, free testosterone, semen analysis, semen volume, body mass index, male infertility, prevalence
- MeSH terms
- Adult, Blood Glucose, Body Weight, Ejaculation, Humans, Hypogonadism, Insulin, Insulin Resistance, Male, Obesity, Prospective Studies, Sex Hormone-Binding Globulin, Testosterone, Body Mass Index, Sleep Apnea, Obstructive, Semen Analysis
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