Sex Steroid, Gonadotropin, Cortisol, and Prolactin Levels in Healthy, Massively Obese Women: Correlation with Abdominal Fat Cell Size and Effect of Weight Reduction*

Abstract

To examine hormonal status in obese, gynecologically normal women we studied 25 regularly menstruating, massively obese (mean weight, 120 kg) women participating in a weight reduction program and 25 age-matched normal weight (mean weight, 60 kg) women. Serum 17 beta-estradiol (E2), estrone (E1), androstenedione (A), dehydroepiandrosterone sulfate, testosterone, LH, FSH, PRL, and cortisol concentrations were measured during the follicular phase of the menstrual cycle. Waist to hip ratio and abdominal fat cell size were measured at the beginning of the study. The serum levels of E2 (P less than 0.04) as well as those of A, SHBG, and LH (P less than 0.002) were lower in the obese group. Consequently, the testosterone to SHBG ratio and the E1 to A ratio were higher and the LH to FSH ratio was lower in this group. Waist to hip ratio did not correlate with the levels of circulating hormones or SHBG, but an inverse correlation was found between abdominal fat cell size and A as well as the LH to FSH ratio in the nonhirsute women of the obese group. Subsequent to moderate weight reduction (13.2 kg), serum A and E1 levels (P less than 0.01) increased, and serum cortisol levels decreased (P less than 0.001). Thus, massive obesity is associated with abnormalities in hormonal balance in gynecologically symptomless women, there being an association between E1, E2, A, LH, cortisol, and relative weight and/or abdominal fat cell size.

Consumption of Lactobacillus acidophilus and Bifidobacterium longum do not alter urinary equol excretion and plasma reproductive hormones in premenopausal women

“…The inverse association between follicularphase E 2 and BMI is similar to previous reports from studies performed in massively obese women (Grenman et al, 1986), despite the fact that women in our study were within a normal range of BMI (18-31 kg/m 2 ). Also consistent with previous reports (Key et al, 2001), we found an inverse correlation between SHBG and BMI.…”

“…The inverse relationship found between SHBG and BMI is likely explained by the effect of BMI increasing insulin levels with subsequent inhibition of liver production of SHBG (Plymate et al, 1988;Franks et al, 1991). Although the inverse relationship between A and BMI in our cohort was only of borderline significance, it is consistent with other reports (Grenman et al, 1986), and may be explained by the increased metabolic clearance rate in obesity (Kirschner et al, 1983).…”

Impact of waist-hip-ratio and body-mass-index on hormonal and metabolic parameters in young, obese women

“…1,3,6,16 Obesity, especially android type obesity, is commonly associated with the insulin resistant state and secondary hyperinsulinaemia. 1,3,6,12,18,20,34,35 We also found signi®cantly higher insulin levels in women with android obesity. The insulin resistance was greater with increasing WHR.…”

“…23,24,34±36,39±41 Especially women with android obesity seem to be prone to develop menstrual disorders. 12,15,18,20,22,34 Even in lean women, an increasing WHR was associated with a reduced chance of conception. 24 The possible role of insulin as the mediating factor has aroused a great deal of interest in recent years.…”

“…13,45 However, they found increased free androgen and decreased SHBG levels, thus increased free androgenic activity in subjects with android obesity. 13,14,16,18,45 Other studies noted an inverse association between insulin and SHBG. Insulin itself could cause increased androgenic activity by decreasing SHBG levels.…”