The role of overweight and glucose tolerance in the impaired pituitary-gonadal axis of obese males.

In a group of 30 obese male patients (160.2% of ideal body weight), an impaired function of the pituitary-gonadal axis has been demonstrated. Decreased testosterone and increased estradiol basal levels, increased LH and FHS responsiveness to gonadotropin-releasing hormone, and increased basal prolactin (PRL) levels are the most significant findings. The overweight factor seems to account for the documented decreased testosterone and increased estrogen levels through a modulation of peripheral steroid metabolism. These peripheral steroid patterns might affect gonadotropin and PRL secretions as well; nevertheless an interference with the metabolism of cerebral neurotransmitters, perhaps related to a nutritional component (impaired glucose tolerance), cannot be completely excluded.