Experience with the management of patients with extreme obesity – Part 2

Czech version

Authors: Adela Penesová ^1,2,3
Published in: Diab Obez 2025; 25(1): 8-15
Category: Reviews

Overview

The most common obesity-associated endocrinopathy in women is hyperandrogenism, often associated with polycystic ovary syndrome (PCOS), while hypogonadism is often found in men. In women, obesity is implicated in the pathogenesis of PCOS, and approximately 40–70% of patients with PCOS are overweight or obese. According to a systematic review and meta-analysis by Calderón et al (2016), the cumulative prevalence of hypogonadism in obese men is as high as 45.0–57.5%. Most commonly, this is secondary to male obesity-associated hypogonadism (MOSH). While the prevalence of subclinical hypothyroidism is about 14.0%, hypercortisolism is found in only 0.9% of cases. In both sexes, androgens play an important role in the distribution of body fat. Low testosterone in men and high free testosterone in women contribute to the development of metabolic complications. Overweight and obesity before pregnancy are key modifiable risk factors for the development of Adverse Pregnancy Outcomes (APO). Nearly 39 million pregnancies complicated by obesity occur annually worldwide. Pre-pregnancy overweight and obesity are key modifiable risk factors for the development of adverse pregnancy outcomes and for the baby.

Keywords:

Polycystic ovary syndrome – gravidity – hypogonadism – extreme obesity – Cushing´s syndrome – hyperandrogenism – hypothyreosis

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