Dilemma of obesity in both sexes

In the gluteo-femoral obesity, the metabolic consequences are comparative scarce and the endocrine effects are directly linked to the excess of adipose tissue. In abdominal obesity the endocrine effects are very important: insulin resistance and hyperinsulinemia, increase of IGF-I activity, increase of active androgen production by ovarian estroma, important reduction of sex-hormone-binding-globulin (SHBG) and increasing 'bioavailable' estradiol (E2), testosterone (T) and dihidrotestosterone (DHT). In short, obesity and abnormal endocrinology appear to be associated with the development of endometrium and breast cancer in women. Growth hormone (GH) secretion is markedly reduced in obesity, and hypothalamic, pituitary and peripheral factors may contribute to the abnormal GH secretion. GH plays a critical rol in the regulation of body composition and energy balance. The circulating leptin is a product of specific adipocyte ob-gene that exerts stimulating effect on GH release. Furthermore, selected series of obese patients have shown that high free insulin like growth factor (IGF-I) and low IGF-binding proteins generally increased in overweight subjects. Obesity is also characterized by fasting hyperinsulinemia and exaggerated insulin release after a glucose load. Recently it has also demonstrated that leptine plays an important role in the reproductive system at all levels of the hypothalamus-pituitary-gonadal axis.