The Metabolic Syndrome in Central Hypogonadotrophic Hypogonadism

The metabolic syndrome (MetS) is a term used to describe the constellation of cardiometabolic risk factors including central adiposity, dyslipidemia, insulin resistance, non-alcoholic fatty liver disease and arterial hypertension. Notably, a number of studies have shown high rates of testosterone (T) deficiency in men with MetS and type 2 diabetes mellitus (T2DM). Both hypogonadism and MetS confer increased health risk for morbidity and mortality as men with the MetS are at twice the risk for developing cardiovascular disease and at 5-fold higher risk for developing T2DM. Moreover, the inverse relationship between T and MetS is consistently observed across racial and ethnic groups. Thus, in the setting of growing obesity rates, this relationship between the reproductive endocrine axis and metabolism warrants renewed attention. This review specifically focuses on central hypogonadotrophic hypogonadism (CH) providing a concise overview of the metabolic implications of CH and identify the unanswered questions and future directions in this growing field.