PS-05-003 The role of nutritional intervention in the treatment of male hypogonadism secondary to obesity

Abstract

The aim of the study was to evaluate the effects of nutritional intervention on body composition and hormonal profile in a group of obese patients after a weight loss of 10%. In particular, the study focused on the evaluation of aromatase activity, calculated as the ratio between total testosterone and estradiol. 28 patients aged between 18 and 65 were enrolled, fat percentage was > 30% and it was estimated with total body densitometry. Body composition (anthropometry, circumferences, DEXA), hormonal profile, cardiovascular risk indices and the HOMA index were evaluated. The patients underwent two tests: Yale Food Addiction Scale (YFAS) and Aging Male Symptoms (AMS), respectively for the assessment of carbohydrate dependence and symptoms related to hypogonadism. The nutritional treatment was based on hypocaloric, high-protein diet (1.5 g/kg ideal body weight/day). Diet energy gap was between 170–250 kcal/day. After a mean time of 6 months and a mean weight loss of 10% from baseline, a significant increase in serum total testosterone levels (405.3 ± 124.8 vs 298.2 ± 81.4 ng / dl, p = 0.002) and a significant reduction of estradiol (37.8 ± 16.2 vs 46.4 ± 12.1 pg / ml, p = 0.049) were observed. There was also a significant reduction in the percentage of total (36.1 ± 4.7 vs 39.8 ± 6.9, p = 0.0001) and segmental fat mass (android fat mass 46.3 ± 6.5% vs 52.1 ± 6.3% P = 0.0012; gynoid fat mass 36.4 ± 5.9 % vs 39.1 ± 6.1% p = 0.0001). The lean mass remained unchanged. The reduction in aromatase activity (expressed as the total testosterone / estradiol ratio) was statistically significant (110.9 ± 52.8 vs 69.1 ± 34.1, p = 0.003). Food addiction has not improved after the nutritional intervention and probiotic supplementation.