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3 . 2021

Evaluation of the prevalence of excess estradiol and testosterone deficiency in men, taking into account the degree of obesity

Abstract

The bulk of estrogens in men is formed by the conversion of androgens to estrogens by the aromatase enzyme in adipose tissue. It is already known that in men with overdeveloped adipose tissue, the activity of this enzyme is increased, however, data on the relationship between testosterone and estradiol levels depending on the degree of obesity are limited.

The aim of the work was to assess the prevalence of testosterone deficiency and excess estradiol in men, depending on the degree of obesity.

Material and methods. 351 case histories were retrospectively analyzed and 301 were included in the final analysis after selection for exclusion criteria. The estradiol level > 41.2 pg/ml or >47 pg/ml was considered to be an excess of estradiol or hyperestrogenism, and a level of <12.1 nmol/l was considered as a testosterone deficiency.

Results. Depending on the upper limit of the estradiol norm, an excess of estradiol was detected in 107 people, i.e. in 36.14% of the entire sample. According to another variant, 64 people have an excess of estradiol, i.e. in 21.62% of the entire sample. At the same time, testosterone deficiency and hyperestrogenism were simultaneously present in 57 (18.9%) people. Thus, almost 19% of men did not have a true testosterone deficiency, but there was an excess aromatase activity, which led to a decrease in the level of circulating testosterone, with its initially normal synthesis. It has been demonstrated that an increase in the amount of adipose tissue is accompanied by a predictable increase in number of patients with testosterone deficiency from 31.6% in persons with normal weight to 88.9% in persons with grade 3 obesity.

Conclusion. Testosterone deficiency in obese men may not be due to a true decrease in levels due to dysfunction, but to a relative decrease due to increased conversion of testosterone to estradiol by the aromatase enzyme in overdeveloped adipose tissue.

Keywords:estradiol, testosterone, testosterone deficiency, obesity

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Golodnikov I.I., Pavlova Z.Sh. Evaluation of the prevalence of excess estradiol and testosterone deficiency in men, taking into account the degree of obesity. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2021; 10 (3): 96-9. DOI: https://doi.org/10.33029/2304-9529-2021-10-3-96-99 (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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