Abstract
To evaluate the effect of weight loss and diet therapy on plasma sex hormone behavior in male obesity, 9 men with a BMI of 43.4 ± 6.3 participated in an 8-week semistarvation program [whose energy content ranged from 320 to 500 kcalorie/day (proteins 44 to 60 g and carbohydrates 54 to 81 g per day)] followed by a two-week hypocaloric (1000 kcalorie/day) refeeding. In basal conditions, obese patients presented higher estrogen and lower dehydroepiandrosterone sulphate, testosterone (total and free) and sex-hormone binding globulin concentrations with respect to a group of control normal-weight subjects. Cumulative weight loss was 23.9 ± 3.6 kg after semistarvation and 24.4 ± 4.8 kg after refeeding (p = NS). A significant increase in testosterone, free testosterone and dehydroepian-drosterone sulfate was observed throughout the study, irrespective of dietary intake. A transient increase occurred in estrone levels while 17B-estradiol did not change. Gonadotropins and sex-hormone binding globulin values remained unaltered. No relationship was found between sex hormones and dietary energy content or composition. Daily urine free cortisol, which was used as a parameter of adrenal function, fell approximately 50% during semistarvation but returned to baseline values after refeeding. These results show that in massively obese patients weight loss per se may partially reverse sex hormone abnormalities but not sex-hormone binding globulin concentrations. It remains to be determined whether the return to “normal weight” can normalize steroid metabolic derangements in the obese man.
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Glass A.R., Burman K.D., Dahms W.T., Boehm T.M. Endocrine function in human obesity. Metabolism 30: 89, 1981.
Kley H.K., Solbach H.G., MacKinnan J.C., Krüskemper H.L. Testosterone decrease and oestrogen increase in male patients with obesity. Acta Endocrinol. (Kbh.) 91: 553, 1979.
Strain G.W., Zumoff B., Kream J., Strain J.J., Deucher R., Rosenfeld R.S., Levin J., Fukushima D.K. Mild hypogonadotropic hypogonadism in obese men. Metabolism 31: 871, 1982.
Kley H.K., Deselaers T., Peerenboom H. Evidence for hypogonadism in massively obese males due to decreased free testosterone. Horm. Metab. Res. 13: 639, 1981.
Amatruda J.M., Harmann S.M., Pourmotabbed G., Lockwood D.H. Depressed plasma testosterone and fractional binding of testosterone in obese males. J. Clin. Endocrinol. Metab. 47: 268, 1978.
Glass A.R., Swerdloff R.S., Bray G.A., Dahm W.T., Actinson R.L. Low serum testosterone and sex-hormone-binding-globulin in massively obese men. J, Clin. Endocrinol. Metab. 45: 1211, 1977.
Schneider G., Kirschner M.A., Berkowitz R., Ertel N.H. Increased estrogen production in obese men. J. Clin. Endocrinol. Metab. 48: 633, 1979.
Hoffer L.J., Beitins I.Z., Kyung N., Bistrian B.R. Effects of severe dietary restriction on male reproductive hormones. J. Clin. Endocrinol. Metab. 62: 288, 1986.
Stanik S., Dornfeld L.P., Maxwell M.H., Viosca S.P., Koremann S.G. The effect of weight loss on reproductive hormones in obese men. J. Clin. Endocrinol. Metab: 53: 828, 1981.
Pasquali R., Baraldi G., Biso P., Piazzi S., Patrono D., Capelli M., Melchionda N. Effect of “physiological” doses of triiodothyronine replacement on the hormonal and metabolic adaptation to short-term semistarvation and to low-calorie diet in obese patients. Clin. Endocrinol. (Oxf.) 21: 357, 1984.
Pasquali R., Casimirri F., Melchionda N. Protein metabolism in obese subjects during very-low-calorie mixed diets containing different amounts of proteins and carbohydrates. Metabolism 36: 1141, 1987.
Mazzella G., Pasquali R., Aldini R., Sama C., Geminiani S., Monti F., Roda E., Melchionda N., Barbara L. Effects of caloric intake restriction and ursodeoxycholic acid administration on bile lipids in obese patients. In: Berchtold P., Cairella M., Jacobelli A., Silvano V. (Eds.), Regulators of intestinal absorption in obesity, diabetes and nutrition. Soc. Ed. Universo, Roma, 1981, p. 61.
Buster J.E., Abraham G.E. Radioimmunoassay for dehydroepiandrosterone sulfate. Anal. Lett. 5: 543, 1972.
Paradisi R., Lodi S., Bolelli G., Venturoli S. Radioimmunoassay of three oestrogens and three androgens in the same plasma sample after extraction and chromatographic separation. Acta Endocrinol. (Kbh.) 94: 229, 1980.
Cacciari E., Cicognani C., Tassoni P., Flamigni D., Bolelli G., Pirazzoli P., Salardi S. Plasma testosterone and estradiol concentration in prepubertal boys with cryptorchidism before and after dexamethasone and after human chorionic gonadotropin administration. Helv. Paediatr. Acta 29: 27, 1974.
Hammond G.L., Langley M.S., Robinson P.A. A liquid-phase IRMA for human sex hormone binding globulin (SHBG). J. Steroid Biochem. 23: 451, 1985.
Apter D., Bolton N.S., Hammond G.L., Vikho R. Serum SHBG during puberty in girls and in different types of adolescent menstrual cycle. Acta Endocrinol. (Kbh.) 107: 413, 1984.
Pasquali R., Fabbri. R., Venturoli S., Paradisi R., Antenucci D., Melchionda N. Effect of weight loss and antiandrogenic therapy on sex hormone blood levels and insulin resistance in obese patients with polycystic ovaries. Am. J. Obstet. Gynecol. 154: 139, 1986.
Elshami A.S. Measurement of free hormone levels in serum. Comm. Lab. Med. 1: 97, 1985.
Siegel S. Non parametric statistics for the behavioral sciences. McGraw Hill Book Co., New York, 1956.
Deslypere J.P., Verdonck L., Vermeulen A. Fat tissue: a steroid reservoir and site of steroid metabolism. J. Clin. Endocrinol. Metab. 61: 564, 1985.
Edman C.D., Aiman E.J., Porter J.C., MacDonald P.C. Identification of the estrogen product of extra-glandular aromatization of plasma androstenedione. Am. J. Obstet. Gynecol. 130: 439, 1978.
Grenman S., Ronnemaa T., Irjala K., Kaihola H.L., Grönroos M. Sex steroid, gonadotropin, cortisol and prolactin levels in healthy, massively obese women: correlation with abdominal fat cell size and effect of weight reduction. J. Clin. Endocrinol. Metab. 63: 1257, 1986
Siiteri P.K., Williams J.E., Takaki N.K. Steroid abnormalities in endometrial and breast carcinoma: a unifying hypothesis. J. Steroid Biochem. 7: 897, 1976.
O’Dea J.P.K., Meland R.G., Hallberg M.G., Llerena L.A., Zorn E.M., Genuth S.M. Effect of dietary weight loss on sex steroid binding, sex steroid binding, sex steroid, and gonadotropin in obese postmenopausal women. J. Clin. Lab. Med. 93: 1004, 1979.
Pasquali R., Antenucci D., Melchionda N., Fabbri R., Venturoli S., Patrono D., Capelli M., Barbara L. Sex hormones in obese premenopausal women and their relationship to body fat mass and distribution, B cell function and diet composition. J. Endocrinol. Invest 10: 345, 1987.
Streeten D.H.P., Stevenson C.T., Dalakos T.G., Nicholas J.J., Dennick LG., Fellerman H. The diagnosis of hypercortisolism. Biochemical criteria differentiating patients from lean to obese normal subjects and from females on oral contraceptives. J. Clin. Endocrinol. Metab. 29: 1191, 1969.
Galvao-Teles A., Graves L., Burke C.W., Fotherby K., Fraser R. Free Cortisol in obesity; effect of fasting. Acta Endocrinol. (Kbh.) 81: 321, 1976.
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Pasquali, R., Casimirri, F., Melchionda, N. et al. Weight loss and sex steroid metabolism in massively obese man. J Endocrinol Invest 11, 205–210 (1988). https://doi.org/10.1007/BF03350136
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DOI: https://doi.org/10.1007/BF03350136