Late-onset hypogonadism: metabolic impact.
M Grossmann1,2, M Ng Tang Fui1,2, A S Cheung1,2
1Department of Medicine Austin Health, University of Melbourne, Melbourne, Vic., Australia.
Obesity and type 2 diabetes (diabesity) are linked to low testosterone and hypogonadism. Reversible hypogonadism can improve with weight loss, while testosterone therapy aids body composition and insulin resistance.
Area of Science:
- Endocrinology
- Metabolic Health
- Men's Health
Background:
- Obesity and dysglycemia, termed diabesity, are linked to reduced testosterone levels.
- This association can manifest as clinical symptoms of androgen deficiency in some men.
Purpose of the Study:
- To review the metabolic impact of late-onset hypogonadism (LOH).
Main Methods:
- A comprehensive literature search was conducted, focusing on recent publications.
Main Results:
- Obesity is a significant risk factor for LOH; diabetes exacerbates hypothalamic-pituitary-testicular axis suppression.
- This suppression is functional, potentially reversible, and linked to hypothalamic inflammation and dysregulated signaling.
- Estradiol's role is debated, with potential deficiency contributing to metabolic issues in diabesity.
Conclusions:
- The relationship between diabesity and LOH is bidirectional.
- Lifestyle changes and testosterone therapy may offer additive benefits in select men.
- Further large-scale trials are needed to optimize clinical management.
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