Obesity-Related Hypogonadism in Women.

IF 22 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Pei Chia Eng, Maria Phylactou, Ambreen Qayum, Casper Woods, Hayoung Lee, Sara Aziz, Benedict Moore, Alexander D Miras, Alexander N Comninos, Tricia Tan, Steve Franks, Waljit S Dhillo, Ali Abbara
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Abstract

Obesity-related hypogonadotropic hypogonadism is a well-characterized condition in men (termed male obesity-related secondary hypogonadism; MOSH); however, an equivalent condition has not been as clearly described in women. The prevalence of polycystic ovary syndrome (PCOS) is known to increase with obesity, but PCOS is more typically characterized by increased gonadotropin-releasing hormone (GnRH) (and by proxy luteinizing hormone; LH) pulsatility, rather than by the reduced gonadotropin levels observed in MOSH. Notably, LH levels and LH pulse amplitude are reduced with obesity, both in women with and without PCOS, suggesting that an obesity-related secondary hypogonadism may also exist in women akin to MOSH in men. Herein, we examine the evidence for the existence of a putative non-PCOS "female obesity-related secondary hypogonadism" (FOSH). We précis possible underlying mechanisms for the occurrence of hypogonadism in this context and consider how such mechanisms differ from MOSH in men, and from PCOS in women without obesity. In this review, we consider relevant etiological factors that are altered in obesity and that could impact on GnRH pulsatility to ascertain whether they could contribute to obesity-related secondary hypogonadism including: anti-Müllerian hormone, androgen, insulin, fatty acid, adiponectin, and leptin. More precise phenotyping of hypogonadism in women with obesity could provide further validation for non-PCOS FOSH and preface the ability to define/investigate such a condition.

肥胖导致的女性性腺功能减退症。
肥胖相关性性腺功能减退症在男性中是一种特征明显的病症(称为男性肥胖相关性继发性性腺功能减退症;MOSH);但在女性中却没有明确的描述。众所周知,多囊卵巢综合征(PCOS)的发病率会随着肥胖而增加,但多囊卵巢综合征更典型的特征是促性腺激素释放激素(GnRH)(以及黄体生成素;LH)搏动性增加,而不是在 MOSH 中观察到的促性腺激素水平降低。值得注意的是,无论是否患有多囊卵巢综合症,肥胖都会导致 LH 水平和 LH 脉搏振幅降低,这表明与肥胖相关的继发性性腺功能减退症也可能存在于女性中,类似于男性中的 MOSH。在此,我们研究了非多囊卵巢综合症的 "女性肥胖相关继发性性腺功能减退症"(FOSH)的证据。我们简要介绍了在这种情况下发生性腺功能减退症的可能潜在机制,并考虑了这种机制与男性的 MOSH 和无肥胖女性的多囊卵巢综合症有何不同。在这篇综述中,我们考虑了在肥胖中发生改变并可能影响 GnRH 搏动性的相关病因,以确定它们是否会导致与肥胖相关的继发性性腺功能减退症,这些病因包括:抗穆勒氏激素、雄激素、胰岛素、脂肪酸、脂肪连通素和瘦素。对肥胖妇女的性腺功能减退症进行更精确的表型分析,可进一步验证非多囊卵巢综合征性腺功能减退症,并为确定/研究这种病症的能力作铺垫。
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来源期刊
Endocrine reviews
Endocrine reviews 医学-内分泌学与代谢
CiteScore
42.00
自引率
1.00%
发文量
29
期刊介绍: Endocrine Reviews, published bimonthly, features concise timely reviews updating key mechanistic and clinical concepts, alongside comprehensive, authoritative articles covering both experimental and clinical endocrinology themes. The journal considers topics informing clinical practice based on emerging and established evidence from clinical research. It also reviews advances in endocrine science stemming from studies in cell biology, immunology, pharmacology, genetics, molecular biology, neuroscience, reproductive medicine, and pediatric endocrinology.
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