Early weight loss may protect fertility for boys with obesity
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Short-term weight loss may improve Leydig cell function and help protect future fertility for boys with obesity, according to data presented at the European Society for Pediatric Endocrinology virtual meeting.
Boys with obesity aged 10 to 18 who participated in a 12-week therapeutic educational program had an increase in testosterone at 12 weeks compared with baseline, with the increase correlating to a reduction in fat mass. Changes were observed in markers of Leydig cell function and not in Sertoli cell function markers.
“Obesity may impact gonadic function in adolescent boys, and therefore alter their future fertility in adulthood,” Solène Rérat, MD, a pediatrician in the pediatric endocrinology unit at Angers University Hospital in France, told Healio. “Weight reduction seems to restore some, but not all, of these gonadic alterations. Screening of these potential alterations should be performed during the follow-up of boys with obesity.
Rérat and colleagues analyzed data from 34 boys aged 10 to 18 years with obesity who participated in a 12-week therapeutic program between 2012 and 2020. The program included a balanced diet, at least 1 hour of physical activity per day and weekly sessions with a dietitian. A physical examination and DXA scan were conducted at baseline and at the end of the program. Measurements of follicle-stimulating hormone, luteinizing hormone, anti-Müllerian hormone, inhibin B, testosterone, estradiol, fasting insulin and glucose were collected at baseline and 12 weeks.
At 12 weeks, participants had significant decreases in body weight, BMI, fat mass percentage, fasting insulin and homeostasis model assessment of insulin resistance, along with a significant increase in testosterone levels, indicating changes in Leydig cell function. However, there were no differences in markers of Sertoli cell function at 12 weeks compared with baseline.
“This was the first pediatric study to study both Leydig and Sertoli cell functions after weight reduction,” Rérat said. “We have found in our previous study that the alteration of Sertoli cell function occurs earlier in puberty in boys with obesity than in Leydig cell function. Therefore, our hypothesis is that a more prolonged altered function might need more time to recover after weight loss.”
Median testosterone levels increased significantly at 12 weeks. The increase in testosterone correlated with a loss in fat mass (r = 0.39; P < .05).
Rérat noted the small study population and short study period. She said more research is needed to confirm the findings.
“Gonadic function in boys with obesity should be monitored regularly, alongside the follow-up of other metabolic consequences of obesity, to confirm our data and give us the possibility to make a longitudinal study,” Rérat said. “This would help us to find explanations for these alterations.”
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Rérat S, et al. P2-200. Presented at: European Society for Pediatric Endocrinology Annual Meeting; Sept. 22-26, 2021 (virtual meeting).
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