Functional hypogonadism among patients with obesity, diabetes, and metabolic syndrome.
Marne M LoutersMichelle PearlmanEmily SolsrudAmy Marcia PearlmanPublished in: International journal of impotence research (2021)
Testosterone deficiency, defined as low total testosterone combined with physical, cognitive, and sexual signs and/or symptoms, is a common finding in adult men. Functional hypogonadism (FH) is defined as borderline low testosterone (T) secondary to aging and/or comorbid conditions such as diabetes, obesity, and/or metabolic syndrome. The relationship between FH and metabolic disorders is multifactorial and bidirectional, and associated with a disruption of the hypothalamic-pituitary-gonadal axis. Resolution of FH requires the correct diagnosis and treatment of the underlying condition(s) with lifestyle modifications considered first-line therapy. Normalization of T levels through dietary modifications such as caloric restriction and restructuring of macronutrients have recently been explored. Exercise and sleep quality have been associated with T levels, and patients should be encouraged to practice resistance training and sleep seven to nine hours per night. Supplementation with vitamin D and Trigonella foenum-graecum may also be considered when optimizing T levels. Ultimately, treatment of FH requires a multidisciplinary approach and personalized patient care.
Keyphrases
- metabolic syndrome
- replacement therapy
- sleep quality
- resistance training
- physical activity
- insulin resistance
- type diabetes
- smoking cessation
- cardiovascular disease
- high intensity
- end stage renal disease
- weight loss
- depressive symptoms
- uric acid
- body composition
- cardiovascular risk factors
- ejection fraction
- glycemic control
- chronic kidney disease
- high fat diet induced
- quality improvement
- peritoneal dialysis
- newly diagnosed
- healthcare
- young adults
- weight gain
- stem cells
- patient reported outcomes
- body mass index
- middle aged
- mesenchymal stem cells