Minerva Endocrinology 2021 Mar 16

DOI: 10.23736/S2724-6507.21.03224-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Obesity in childhood: how to improve male adolescence incoming

Paola GUALTIERI ¹ ✉, Maria Grazia TARSITANO ², Gemma L. DE SANTIS ³, Lorenzo ROMANO ³, Ernesto ESPOSITO ⁴, Antonino DE LORENZO ¹

¹ Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; ² Department of Experimental Medicine, University of Rome Sapienza, Rome, Italy; ³ School of Specialization in Food Science, University of Rome Tor Vergata, Rome, Italy; ⁴ Direzione Generale Dipartimento Politiche della Persona, Regione Basilicata, Potenza, Italy

INTRODUCTION: Earlier or delayed puberty can be determined by numerous causes, but the exact mechanisms are not fully known. Anyway, those may be independent from the hypothalamicpituitary-gonadal axis involvement. Certainly, obesity is one of the main factors. In fact, obesity and infertility are strongly linked. For this reason, we want to analyse the relationship between puberty and obesity and give an updated state-of-the-art starting by discussing a 14-year-old obese boy’s clinical case.
EVIDENCE ACQUISITION: Literature data are conflicting. Main criticisms are related to study design and evaluation criteria. Indeed, examined populations are not homogeneous by age, Tanner stage and BMI classification. The obesity epidemic is involved in earlier puberty, and puberty seems to be anticipated in all BMI groups. Very few studies evaluate the level of adiposity in the diagnosis of obesity. However, the role of the adipose tissue is crucial for hormone synthesis and regulation. Therefore, fat mass age-related and not simply BMI has to be considered by clinicians for appropriate diagnosis.
EVIDENCE SYNTHESIS: Regarding the clinical case, in three months our patient recovered delayed pubertal development following an anti-inflammatory and antioxidant Mediterranean Diet. Loss of weight, as in decrease of fat mass but saving of lean mass, increased testicular volume and testosterone levels occurred.
CONCLUSIONS: Puberty depends on several factors, including obesity. Further studies are needed to evaluate age groups, Tanner stage, diet and lifestyle, ethnicity and above all the fat/lean mass ratio. Lack of adequate tools could hinder a clinician's ability to recognize when or if therapeutic intervention is needed.

KEY WORDS: Testicular function; Supplements; Fat mass; Testicular volume; Obesity; Male secondary hypogonadism