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Volume 20, Issue 6 (November 2018) 20, 531–538; 10.4103/aja.aja_44_18

Secondary male hypogonadism: A prevalent but overlooked comorbidity of obesity

María Molina-Vega1, Araceli Muñoz-Garach1,2, Miguel Damas-Fuentes1, José Carlos Fernández-García1,2,3, Francisco J Tinahones1,2,3

1 Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
2 Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
3 CIBER Pathophysiology of Obesity and Nutrition (CB06/003), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain

Correspondence: Dr. JC Fernández‑García (josecarlosfdezgarcia@hotmail.com)

Date of Submission 09-Jan-2018 Date of Acceptance 03-May-2018 Date of Web Publication 03-Jul-2018


Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.

Keywords: adipose tissue; male hypogonadism; obesity; testosterone

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