Insights into the implication of obesity in hypogonadism among adolescent boys

Abstract

Objectives This research aimed at uncovering the mechanisms behind obesity-related hypogonadism in adolescent boys and to investigate the association between anthropometric characteristics and testicular functions of these boys. Methods This study included 60 adolescent boys (12–18 years) with exogenous obesity (BMI≥95th percentile) and 30 age matched lean controls (BMI=15th–85th percentile). Full clinical examination, anthropometric measurements and pubertal assessment were performed. Laboratory investigations included hemoglobin, hematocrit, lipid panel, LH, FSH, free and total testosterone, inhibin B and estradiol. Results The results indicated the presence of positive family history of obesity in 85% of obese boys vs. 40% of the lean counterparts. Concerning SBP of obese boys, 7% were hypertensive (95th percentile), 25% were prehypertensive (between 90th and 95th percentiles) while, DBP findings showed that 33% are hypertensive and 33% are prehypertensive. Meanwhile, 13.3% of lean controls were prehypertensive. Anthropometric measurements and lipid profile values revealed a significant difference between obese and lean boys. Compared to obese boys the normal weight boys had higher levels of free testosterone (21.15 ± 2.90 pg/mL vs. 11.38 ± 3.96 pg/mL, p<0.001), total testosterone (10.59 ± 6.63 ng/dL vs. 3.23 ± 1.70 ng/dL, p<0.001), FSH (7.33 ± 3.75 mIU/mL vs. 5.63 ± 3.96 mIU/mL, p=0.026) and inhibin B (83.28 ± 27.66 pg/mL vs. 62.90 ± 17.85 pg/mL, p=0.001) and they registered lower level of estradiol (18.48 ± 7.33 pg/mL vs. 40.20 ± 7.91 pg/mL, p<0.001). In obese boys, BMI SDS significantly correlated with lipid profile and estradiol whereas, it showed significant negative correlation with LH, free and total testosterone and inhibin B. Penile length significantly correlated with LH while it revealed significant negative correlation with cholesterol. Conclusions This study evidenced a close association between obesity and hypogonadism in adolescent boys which could be due to the increased estradiol level and decreased T/E2 ratio.

Not Only Metabolic Complications of Childhood Obesity

“…The interactions between sex hormones, excessive aromatase activity in adipose tissue, hormone production by fat cells, and the presence of inflammatory markers occurring in the course of obesity lead to reduced testosterone production and thus contribute to hypogonadism [ 113 ]. It has been shown that normal-weight adolescents have higher levels of free testosterone, total testosterone, FSH, and inhibin B and exhibit lower levels of estradiol than their obese counterparts [ 115 ]. Thus, an obesity–hypogonadism relationship has been demonstrated and may be driven by increased estradiol levels and a reduced testosterone/estradiol ratio [ 115 ].…”

“…It has been shown that normal-weight adolescents have higher levels of free testosterone, total testosterone, FSH, and inhibin B and exhibit lower levels of estradiol than their obese counterparts [ 115 ]. Thus, an obesity–hypogonadism relationship has been demonstrated and may be driven by increased estradiol levels and a reduced testosterone/estradiol ratio [ 115 ].…”