Obesity and androgens: facts and perspectives
Obesity and androgens: facts and perspectives
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DOI：
10.1016/j.fertnstert.2005.10.054
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发表时间：
2006-05-01
影响因子：
6.7
通讯作者：
Pasquali, Renato
中科院分区：
文献类型：
--
作者：
Pasquali, Renato
目的：根据男性和女性肥胖的特殊表型，讨论其雄激素状态及其主要机制。设计：最近20年发表的文献数据代表了纳入综述的大多数数据和概念的基础。结果(S)：肥胖与雄激素的分泌、运输、代谢和行为的深刻变化有关，这是一种取决于石油性别的二分法行为。肥胖男性的特征是随着体重的增加，睾酮水平逐渐下降，而肥胖女性，特别是具有腹部表型的女性，往往会发展为功能性高雄激素血症。性激素结合球蛋白合成减少和血液循环水平下降是唯一的共同机制，这在两性中都有责任。在其他部分仍未确定的因素中，可能导致雄激素水平性别差异的机制包括促性腺激素分泌、雌激素、下丘脑-垂体-肾上腺轴、瘦素、雄激素受体、外周组织中特定的类固醇生成酶的特定变化。可能还有Ghrelin。在两性中，雄激素在决定身体脂肪分布的性别依赖模式中发挥着重要作用。此外，从理论上讲，男性体内的睾丸素水平较低，女性体内的游离睾酮水平较高，可能在代谢综合征的发展过程中起到一定作用。在患有多囊卵巢综合征的女性和性腺功能低下的男性中，肥胖与代谢综合征的其他特征之间的明确关联就是例证。雄激素和抗雄激素在肥胖男性和女性中的作用也代表了支持这种联系的论点。结论：鉴于性激素在人体成分、燃料动态平衡和生殖调节中的基础作用，雄激素失调在不同肥胖表型和代谢综合征的病理生理中的潜在作用应受到更多的重视。
Objective: This review discusses androgen status in male and female obesity, according to their specific phenotype, and the main mechanisms responsible.Design: Published data in the literature of the last 20 years represented the basis of most of the data and concepts incorporated in the review.Result(s): Obesity is associated with profound alterations in androgen secretion, transport, metabolism, and action, according to a dichotomous behavior depending oil sex. Obese men are characterized by a progressive decrease of testosterone levels with increasing body weight, whereas obese women, particularly those with the abdominal phenotype, tend to develop a condition of functional hyperandrogenism. Reduced sex hormone-binding globulin synthesis and circulating blood levels represent the sole common mechanism which is responsible in both sexes. Among other still partially undefined factors, mechanisms potentially responsible for the sex dichotomy in androgen levels involve specific alterations of gonadotropin secretion, estrogens, the hypothalamic-pituitary-adrenal axis, leptin, androgen receptors, specific steroidogenic enzymes in the peripheral tissues. and, possibly, ghrelin. In both sexes, androgens play an important role in determining the sex-dependent pattern of body fat distribution. Moreover there are theoretical possibilities that low testosterone in men and high free testosterone fraction in women may play a role in the development of the metabolic syndrome. This is exemplified by the well defined association between obesity and other features of the metabolic syndrome in women with polycystic ovary syndrome and in hypogonadal men. The effects of androgen and antiandrogens in obese men and women also represent arguments in favor of this association.Conclusion(s): Given the fundamental role of sex hormones in the regulation of body composition, fuel homeostasis, and reproduction in humans, more emphasis should be placed on the potential role of androgen dysregulation in the pathophysiology of different obesity phenotypes and the metabolic syndrome.