Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases

Authors

  • G. Corona,

    1. Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
    2. Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
    Search for more papers by this author
    • 1

      These authors contributed equally to this study.

  • E. Mannucci,

    1. Diabetes Section Geriatric Unit, Department of Critical Care, University of Florence, Florence, Italy
    Search for more papers by this author
    • 1

      These authors contributed equally to this study.

  • G. Forti,

    1. Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
    Search for more papers by this author
  • M. Maggi

    1. Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
    Search for more papers by this author

  • This is a review for the 5th European Congress of Andrology, Rome, Italy, 2008.

Prof. Mario Maggi, Andrology Unit, Department of Clinical Physiopathology, Viale Pieraccini 6, 50139 Florence, Italy. E-mail: m.maggi@dfc.unifi.it

Summary

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.

Ancillary