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Increased Estrogen Production in Obese Men^*

East Orange Veterans Administration Hospital, East Orange 07019; and the Newark Beth Israel Medical Center and the New Jersey Medical School, Newark, New Jersey 07112

Serum estrone (E,) and 17β-estradiol (E₂) were noted to be 2-fold elevated in a group of morbidly obese men. Urinary E₁ and E₂ production rates were elevated in proportion to the degree of obesity, with values as high as 127 and 157 µg/day, respectively.

Although serum testosterone (T) concentrations were reduced in obese men, averaging 348 ± 35 vs. 519 ± 42 ng/dl in lean controls, the dialyzable T fractions were elevated and, hence, the calculated free T concentrations were normal in obese men. Further, the obese men exhibited normal serum LH, FSH, and T responses to clomiphene citrate, indicating intact hypothalamic-pituitary-Leydig cell axes.

MCRs of T and peripheral conversion of T to E₂ and androstenedione () to E₁ were all increased in obese men in proportion to the percentage above ideal weight.

Although the obese men exhibited increased blood levels and production rates of estrogens, there were no signs of feminization, increased T-estrogen-binding globulin levels, or suppressed basal gonadotropin levels, suggesting a lack of biological effect. We postulate that obese men exhibit defective estrogen receptors, leading to decreased T-estrogen-binding globulin, increased clearance of androgenic hormones, and elevated estrogen production rates. (J Clin Endocrinol Metab 48: 633, 1979)

^* This work was presented in part at the 59th Meeting of The Endocrine Society, Chicago, IL, 1977.

Received May 17, 1978.

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