Sex steroids influence the storing of fat, and differences in the distribution of fat are a typical secondary sexual characteristic. Androgens act on fatty tissues in males either directly through stimulation of the androgen receptor or indirectly through aromatization of the estrogen receptor. Androgens can be classified as aromatizable or non-aromatizable. Testosterone (T) is the main aromatizable androgen, while its metabolite dihydrotestosterone (DHT) is a non-aromatizable androgen that acts only through the androgen receptor. It is precisely this difference in having activity only through the androgen receptor that has given rise to the hypothesis concerning the differing effects of DHT and T on body composition, with DHT possibly being responsible for male-type fat distribution. As part of my post-graduate studies we analyzed the dependence serum levels of T and DHT on age, as well as changes in their ratio with age. Further, we sought relationships between aromatizable and non-aromatizable androgens and metabolic and anthropometric parameters. We also focused on following any changes in steroidogenesis in obese males. We showed that before puberty the dominant androgen is rather DHT than T, that the fDHT/fT ratio during the life of adult males is constant, and that there is no evidence of a reversal...

Sex steroids influence the storing of fat, and differences in the distribution of fat are a typical secondary sexual characteristic. Androgens act on fatty tissues in males either directly through stimulation of the androgen receptor or indirectly through aromatization of the estrogen receptor. Androgens can be classified as aromatizable or non-aromatizable. Testosterone (T) is the main aromatizable androgen, while its metabolite dihydrotestosterone (DHT) is a non-aromatizable androgen that acts only through the androgen receptor. It is precisely this difference in having activity only through the androgen receptor that has given rise to the hypothesis concerning the differing effects of DHT and T on body composition, with DHT possibly being responsible for male-type fat distribution. As part of my post-graduate studies we analyzed the dependence serum levels of T and DHT on age, as well as changes in their ratio with age. Further, we sought relationships between aromatizable and non-aromatizable androgens and metabolic and anthropometric parameters. We also focused on following any changes in steroidogenesis in obese males. We showed that before puberty the dominant androgen is rather DHT than T, that the fDHT/fT ratio during the life of adult males is constant, and that there is no evidence of a reversal...

A obesidade é uma doença crônica que vêm alcançando proporções epidêmicas em todo o mundo. É um fator de risco para inúmeras desordens médicas, morbidade e mortalidade, além de estar também associada a um aumento dos custos socioeconômicos e com saúde. O tratamento a longo prazo, incluindo a farmacoterapia, mostra-se necessário para muitos pacientes obesos. Neste contexto, este trabalho teve a finalidade de avaliar a tolerabilidade e eficácia clínica da Fluoxetina, adjunta a uma dieta de 1.500 Kcal/dia, na redução de parâmetros antropométricos e metabólicos em mulheres obesas. Cloridrato de Fluoxetina (60 mg/dia), foi comparado ao placebo em 19 mulheres obesas, durante 90 dias de tratamento. O grupo Fluoxetina (n=9) apresentou uma redução estatisticamente significativa do peso (-9,24 vs -1,05 kg), IMC (-3,64 vs -0,45 Kg/m²) e circunferência abdominal (-12,3 vs -2,9 cm), em relação ao placebo (n=10). Observou-se ainda uma elevação estatisticamente significativa dos níveis séricos de HDL-colesterol (p< 0,01) no grupo tratado com o fármaco, e uma redução significativa dos níveis plasmáticos de triglicérides (-39,5 vs +18,7 mg/dL) quando comparado ao grupo placebo. As reações adversas mais comumente reportadas pelos pacientes foram insônia, náuseas e sonolência. Concluímos que a Fluoxetina demonstrou ser um fármaco bem tolerado e eficaz na redução de parâmetros antropométricos e metabólicos, prevenindo o desenvolvimento de fatores de risco cardiovasculares e diminuindo morbidade em mulheres obesas. / Obesity is a chronic condition that has been reaching epidemic proportions worldwide. It is a risk factor for numerous medical disorders and excessive mortality. Long-term treatment, including pharmacotherapy, may be necessary for many obese patients. This study aimed to assess the tolerability and clinical effectiveness of Fluoxetine, as an adjunct therapy to a 1.500 Kcal/day diet, in reducing anthropometric and metabolic parameters in obese women. Fluoxetine (60 mg/day), was compared to placebo in 19 obese females in a 90-day trial. Fluoxetine therapy (n=9) resulted in a statistically significant greater mean reduction in weight (-9,24 vs -1,05 kg), BMI (-3,64 vs -0,45 Kg/m²) and waist circumference (-12,3 vs -2,9 cm), than placebo group (n=10). There was also an elevation of HDL-cholesterol (p< 0,01) in Fluoxetine group and mean triglycerides levels was reduced (-39,5 vs +18,7 mg/dL) when compared to placebo. Side effects most commonly reported by the patients were insomnia, nausea and somnolence. We concluded that Fluoxetine may provide an effective and well tolerated possibility in reducing anthropometric and metabolic parameters, preventing the development of cardiovascular risk factors and reducing morbidity in obese women.

A obesidade é uma doença crônica que vêm alcançando proporções epidêmicas em todo o mundo. É um fator de risco para inúmeras desordens médicas, morbidade e mortalidade, além de estar também associada a um aumento dos custos socioeconômicos e com saúde. O tratamento a longo prazo, incluindo a farmacoterapia, mostra-se necessário para muitos pacientes obesos. Neste contexto, este trabalho teve a finalidade de avaliar a tolerabilidade e eficácia clínica da Fluoxetina, adjunta a uma dieta de 1.500 Kcal/dia, na redução de parâmetros antropométricos e metabólicos em mulheres obesas. Cloridrato de Fluoxetina (60 mg/dia), foi comparado ao placebo em 19 mulheres obesas, durante 90 dias de tratamento. O grupo Fluoxetina (n=9) apresentou uma redução estatisticamente significativa do peso (-9,24 vs -1,05 kg), IMC (-3,64 vs -0,45 Kg/m²) e circunferência abdominal (-12,3 vs -2,9 cm), em relação ao placebo (n=10). Observou-se ainda uma elevação estatisticamente significativa dos níveis séricos de HDL-colesterol (p< 0,01) no grupo tratado com o fármaco, e uma redução significativa dos níveis plasmáticos de triglicérides (-39,5 vs +18,7 mg/dL) quando comparado ao grupo placebo. As reações adversas mais comumente reportadas pelos pacientes foram insônia, náuseas e sonolência. Concluímos que a Fluoxetina demonstrou ser um fármaco bem tolerado e eficaz na redução de parâmetros antropométricos e metabólicos, prevenindo o desenvolvimento de fatores de risco cardiovasculares e diminuindo morbidade em mulheres obesas. / Obesity is a chronic condition that has been reaching epidemic proportions worldwide. It is a risk factor for numerous medical disorders and excessive mortality. Long-term treatment, including pharmacotherapy, may be necessary for many obese patients. This study aimed to assess the tolerability and clinical effectiveness of Fluoxetine, as an adjunct therapy to a 1.500 Kcal/day diet, in reducing anthropometric and metabolic parameters in obese women. Fluoxetine (60 mg/day), was compared to placebo in 19 obese females in a 90-day trial. Fluoxetine therapy (n=9) resulted in a statistically significant greater mean reduction in weight (-9,24 vs -1,05 kg), BMI (-3,64 vs -0,45 Kg/m²) and waist circumference (-12,3 vs -2,9 cm), than placebo group (n=10). There was also an elevation of HDL-cholesterol (p< 0,01) in Fluoxetine group and mean triglycerides levels was reduced (-39,5 vs +18,7 mg/dL) when compared to placebo. Side effects most commonly reported by the patients were insomnia, nausea and somnolence. We concluded that Fluoxetine may provide an effective and well tolerated possibility in reducing anthropometric and metabolic parameters, preventing the development of cardiovascular risk factors and reducing morbidity in obese women.