الفهرس 
Obesity and Male ReproductionOnly 14 pages are availabe for public view
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Abstract
The prevalence of obesity has risen steadily for the past 35 years; it is considered one of the main risk factors of many health problems including cardiovascular diseases, hyperlipidemia, type 2 diabetes, osteoarthritis, hypertension and some cancers. Moreover, the obesity contributes to the male infertility by altering the hypothalamic–pituitary–gonadal axis both centrally and peripherally, resulting in hypogonadotropic hyperestrogenic hypogonadism and its effect on male reproductive system is aggravated by ageing and comorbidities.
Testosterone (T) declines with increasing age due to depletion of Leydig cells and an impaired testicular response to LH and changes in hypothalamic–pituitary function which are aggravated by changes due to aging-related chronic illnesses. T declines with aging/obesity (so-called late-onset hypogonadism or LOH). According to current practice guidelines, (LOH) can be recognized when low T is accompanied by cognate symptoms of androgen deficiency. One of the most specific and common symptoms of (LOH) is sexual dysfunction. There is also mounting evidence from recent randomized placebo-controlled trials that T replacement in older men with LOH can improve sexual function.
Leptin is an adipocyte-secreted hormone, circulates at levels proportional to the amount of adipose tissue and plays an important role in energy homeostasis and neuroendocrine functions mainly reproduction. Leptin level influences male reproduction centrally by both direct and indirect roles and peripherally by affecting spermatogenesis and testosterone production.
We aimed in the current study to measure serum leptin levels and assess its correlations in obese and non-obese aging males and to understand the effect of leptin and obesity on the physiology and pathophysiology of reproduction and fertility in males.
The study was carried out on 100 males who attended the Dermatology, Andrology and STDs, Outpatient Clinic at Menoufia University and Ganzour geriatric care center, Menoufia. The subjects were divided into 3 groups regarding the age and BMI to: 40 male subjects aging from 60 to 80 years old with (BMI > 30), 40 male subjects aging from 60 to 80 years old with (BMI < 30) and 20 male subjects aging from 30 to 45 years old with BMI < 30 as a control.
After taken their written consent, all subjects were subjected to complete history taking and clinical examination. Body mass index was calculated and blood samples were collected, leptin, both (total & free testosterone) and HbA1c. were measured for each subject.
Statistical analysis using student T test and Pearson correlation coefficient was done after calculation of the mean and standard deviation for each lab result.
Results revealed that, as regards age, there was high significant difference between both group (I& II) and control, while there was no significant difference between group I and group II. regarding BMI, there was no significant difference between group II and control, while there was high significant difference between group I and other two groups, regarding serum leptin, total and free testosterone, there was high significant difference between all groups.
As regards family history of obesity, there was a higher incidence of positive family history in (obese males) group I in comparison with other two groups (non-obese).
Regarding the incidence of some diseases as hypertension, cardiac vascular diseases (e.g. hyperlipidemia, ischemic heart disease, heart failure, heart surgery and/or catheterization) and cognitive problems, there was a significant difference and higher incidence of those diseases between aging groups (I& II) in comparison with control group. While in age matched groups with different BMI (I& II), there was no significant difference between them regarding cognitive problems, but there was significant differences between them regarding age related diseases and chronic obstructive pulmonary diseases.
Regarding sexual activity (desire, function, satisfaction and difficulties& emotional stress during act), there was high significant differences between aging obese males (group I) and control, between (aging non-obese (group II) and control group) and between group I and group II.
Pearson correlation coefficient test revealed that, there was a high significant positive correlation between serum leptin and BMI, while there is high significant negative correlations between both (serum leptin& BMI) and (total & free testosterone). There was a significant positive correlation between age and serum leptin, while there was high significant negative correlations between age and (total & free testosterone, Indicating the possible role of leptin in age/obesity associated hypogonadism and hyposexuality.