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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypogonadism, erectile dysfunction (ED), visceral adiposity, insulin resistance and metabolic syndrome (MetS) often coexist in the same subjects. This cluster of abnormalities is associated with an increased risk of diabetes and cardiovascular diseases (CVD), affecting not only quality of life but also life expectancy. Longitudinal studies have also demonstrated that ED and male hypogonadism could be considered surrogate markers of incident CVD and MetS. However, how androgens signal fat depots and lessen them is still a matter of active research and whether or not low testosterone could play a pathogenetic role in CVD is still under debate. Hence, pathogenetic mechanisms linking hypogonadism with obesity and insulin resistance appear to be complex and often multi-directional. Visceral obesity can probably be considered a relevant cause of hypogonadism but at the same time, hypogonadism could be a cause of obesity and insulin resistance, consequently establishing a vicious cycle. To provide a critical analysis of these issues, a comprehensive literary search was carried out to discuss the relationship between insulin resistance ED, visceral adiposity, MetS and hypogonadism focusing on their possible involvement in the development of CVD.
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PMID:Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases. 1922 7

Many risk factors have been implicated in the pathogenesis of erectile dysfunction (ED), but it is not clearly evident which of these factors are more relevant among the young population. The aim of this project was to find the most significant risk factors for this disease in young patients. We included 434 patients with organic ED younger than 40 years and 272 age-matched controls. All participants had their complete history taken (including the International Index of Erectile Function-5 [IIEF-5]) and underwent physical examination and some laboratory investigations. Univariate analysis was then applied to study the significance of the following factors in the predisposition of ED: smoking, use of recreational drugs, obesity, dyslipidemia, diabetes mellitus, hypertension, coronary heart disease, and chronic pelvic pain syndrome. This analysis showed that smoking, use of recreational drugs, dyslipidemia, hypertension, and obesity were the significant factors (P < .05 for each factor). When these significant factors were studied in the multivariate model, the only factors that sustained the statistical significance were smoking (P < .05; odds ratio [OR], 1.78; 95% confidence interval [95% CI], 1.16-2.72) and use of recreational drugs (P < .05; OR, 3.18; 95% CI, 1.15-8.82). In addition, a negative correlation was detected between the smoking index of the impotent patients and their IIEF-5 score (r(2) = 0.67; P < .05). In conclusion, smoking and the use of recreational drugs are the most significant risk factors for organic ED in patients younger than 40 years.
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PMID:Analysis of risk factors for organic erectile dysfunction in Egyptian patients under the age of 40 years. 1923 10

The aim of this study was to assess the relationship between body fat mass (BFM) and erectile dysfunction (ED) in Korean men. This study was a cross-sectional study using data on 208 men (the mean age=67.4+/-8.2). ED was diagnosed by the International Index of Erectile Function (IIEF)-5 and body fat percentage (BF%) was quantified with bioelectrical impedance. BF% was divided into quintiles (quintile 1: < or =20.5%, quintile 2: 20.6-23.2%, quintile 3: 23.3-25.8%, quintile 4: 25.9-28.8%, quintile 5: > or =28.9%). Using subjects with quintile 3 of BF% as reference, the adjusted odds ratios of subjects with the lowest quintile of BF% and with the highest quintile were 9.29 (95% CI: 2.29-37.72) and 4.99 (95% CI: 1.37-18.09), respectively. This study showed that BFM and ED had a U-shaped relationship in Korean men. These findings suggest that not only obesity but also a low BFM may be a risk factor of ED in Asians.
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PMID:The relationship between body fat mass and erectile dysfunction in Korean men: Hallym Aging Study. 1924 81

Obese melanocortin-4-receptor-deficient (MC4R-/-) male mice are reported to have erectile dysfunction, while homozygous MC4R-/- female mice are apparently fertile. A recently established obese mouse strain, carrying an inactivating mutation in the MC4R gene, revealed difficulties in breeding for the homozygous female mice. This prompted us to determine the presence of follicles and corpora lutea (CL) in ovaries of MC4R-/- mice aged 3-6 months in comparison to wild type (MC4R+/+) littermates. Serial sections of formaldehyde-fixed ovaries of mice with vaginal signs of estrus and metestrus were assessed for the number of healthy and regressing follicles and CL. The number of CL, as an estimate for the ovulation rate, decreased to zero during aging in MC4R-/- mice. The number of small- (diameter 100-200 micrometer) and large-sized follicles namely antral follicles (diameter >200 micrometer) were slightly increased in MC4R-/- compared to MC4R+/+ mice. Greater differences were found in very large to cystic follicles, which were more numerous in MC4R-/- mice. The number of regressing antral follicles was higher in the MC4R-/- group compared to the MC4R+/+ group. This was associated with a wide range in the number of collapsed zonae pellucidae as the last remnants of regressed follicles. A conspicuous hypertrophy of the interstitial cells was noted in 6-month-old MC4R-/- mice. In conclusion, cystic follicles and the reduction in CL number point to a decreased ovulation rate in obese MC4R-/- mice.
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PMID:Reduction in corpora lutea number in obese melanocortin-4-receptor-deficient mice. 1930 31

It is becoming increasingly evident that the low serum levels of testosterone experienced by aging men are associated with increased all-cause mortality from CHD and other vascular disorders. Achieving a normal physiological testosterone concentration through the administration of testosterone therapy has been shown to provide beneficial effects on the pathophysiological markers and clinical symptoms of CHD. Many of the factors involved in the atherosclerotic process are interlinked with other, increasingly prevalent pathological conditions such as obesity, the metabolic syndrome (MetS), type 2 diabetes and erectile dysfunction, suggesting that testosterone therapy has potentially wide-ranging health benefits. As the number and scope of testosterone substitution and androgen deprivation studies increases and evidence accumulates, it is timely to assess available data and this review summarises the current understanding of the effects of testosterone on cardiovascular risk factors with particular emphasis on the relevance of testosterone treatment.
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PMID:The effects of testosterone on risk factors for, and the mediators of, the atherosclerotic process. 1946 9

The purpose of this study was to determine the relationship between erectile dysfunction (ED), coronary artery disease (CAD), and T(-786)C and intron 4 a/b endothelial nitric oxide synthase (eNOS) polymorphisms in 419 patients with suspected or known CAD referred for coronary angiography. The patients had a high prevalence of risk factors for both CAD and ED: hypercholesterolemia (64%), hypertension (74%), diabetes mellitus (25%), obesity (30%), and smoking (63%). Three hundred and twenty-one patients had significant coronary atherosclerosis (luminal diameter narrowing of 50% or more of at least 1 coronary artery), 41 had insignificant coronary stenoses, and 57 patients were found to have coronary arteries without the evidence of atherosclerosis. The prevalence of ED in these groups was 79%, 76%, and 67% (P = NS), respectively. As compared to patients without ED, those with ED exhibited significantly higher probability of having significant coronary atherosclerosis (69% vs 79%, P = 0.04), higher number of significant coronary stenoses (median, 1 vs 2, P = 0.004), and a higher prevalence of a triple-vessel disease (12% vs 25%, P = 0.004). We did not find any relationship between T(-786)C and intron 4 a/b polymorphisms and the manifestation of coronary atherosclerosis or the presence of ED. In conclusion, in patients with numerous cardiovascular risk factors referred for coronary angiography, there was a high prevalence of ED in patients with both the presence and the absence of coronary atherosclerosis. The coincidence of CAD and ED identified patients at increased risk of severe forms of CAD.
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PMID:Association of coronary artery disease, erectile dysfunction, and endothelial nitric oxide synthase polymorphisms. 1946 14

It has recently been demonstrated that > or = one-third of men with type 2 diabetes mellitus have low testosterone concentrations associated with inappropriately low luteinizing hormone and follicle-stimulating hormone concentrations. Hypogonadotropic hypogonadism in men with type 2 diabetes is associated with obesity but not duration of diabetes, elevated glycosylated hemoglobin, or the presence of microvascular complications of diabetes. Recent data show that hypogonadotropic hypogonadism is also observed frequently in nondiabetics with the metabolic syndrome or obesity, but it is not associated with type 1 diabetes. Low testosterone concentrations in men with type 2 diabetes have also been related to a higher C-reactive protein concentrations, lower hematocrit, increased total and regional adiposity, lower bone mineral density, and erectile dysfunction. This article discusses the pathophysiology of hypogonadotropic hypogonadism in men with type 2 diabetes and its signs and symptoms. Clinical trials are required to determine whether testosterone replacement therapy alleviates insulin resistance, inflammation, and symptoms related to sexual dysfunction care.
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PMID:Hypogonadotropic hypogonadism in men with type 2 diabetes. 1949 39

Testosterone determination in an old men population has demonstrated its about the as general health marker, not only sexual, prompting a greater in to arrest for this analytic determination and the potential relations of testosterone with other markers of cardiovascular health, obesity, hypertension, erectile dysfunction, sarcopenia, metabolic syndrome, ageing, and other conditions. We specifically review the relationship between cardiovascular health, erectile dysfunction, and androgen deficiency, processes easily recognizable, prevented and treated. Current information gives such a prominence to testosterone as a health reference that its determination seems to be inexcusable in the ageing male consult.
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PMID:[Testosterone, endothelial function, cardiovascular health and androgen deficiency in the old man]. 1954 88

Obesity is associated with increased risk of erectile dysfunction (ED); however, the underlying causes of ED in obese individuals remain poorly defined. The aim of this review is to discuss the evidence available on the relationship between obesity and ED. A search of published studies in PubMed from 1970 through 2009 was conducted, and relevant articles were evaluated and discussed. Visceral obesity is a public health threat, and is associated with increased risk of diabetes, vascular disease, endothelial dysfunction, and ED. Plasma testosterone levels are reduced in obesity, further contributing to an increased risk of vascular pathology in obesity. The recognition of the relationship between obesity, reduced testosterone levels, and ED has paved the way for new approaches to manage and treat obese, hypogonadal patients with ED. Obesity profoundly and adversely impacts overall health and, in particular, vascular health, by increasing proinflammatory factors, altering endothelial function and the androgen endocrine milieu, thus increasing the risk of ED.
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PMID:Obesity and erectile dysfunction: is androgen deficiency the common link? 1964 6

This study focuses on the role of sex steroids on the libido, sexual life, emotional and physiological heart of men of all ages. Sex steroids play a significant role throughout a man's life, with a gradual decline in old age. The foetal testis secretes testosterone and dehydroepiandrosterone at about nine weeks gestation. At puberty, testosterone increases dramatically in boys. Changes in weight and height of boys across this period are associated with increasing testosterone concentration and sex hormone binding globulin (SHBG). Romantic thoughts, fantasy, and sexual pleasure-seeking behaviour in adolescents are associated with exposure to high androgens secretion. Thus, the libido and sexual life of a man is initiated and maintained by testosterone and SHBG. Lower testosterone levels are associated with erectile dysfunction among other risk factors: diabetes, hypertension, heart disease, psychological stress and obesity. Men with proven coronary atherosclerosis have lower levels of testosterone and SHBG, which have negative correlation with very low-density lipoprotein, triglycerides, body mass index and body fat mass. These are some of the risk factors for cardiovascular diseases. Thus, in men, endogenous sex steroids impart beneficial effects on the heart. How exactly endogenous sex steroids act on the heart is not clear. Further study is needed to understand the interaction between endogenous sex steroids, higher centers in the brain and the heart of a man.
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PMID:Hormonal profiles behind the heart of a man. 1965 70


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