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The discovery will be illustrated on 15 April in Lecce at the Mercure Hotel President, during the XVI medical conference on the theme of “Endocrine alterations in the obese subject: from infertility to osteoporosis”. The Paduan team: “The clinical consequences are infertility and hypogonadism in obese men and oncological risk in women”
According to the World Health Organization, the number of obese children and adolescents between the ages of 5 and 19 worldwide has increased tenfold in the last 40 years. Currently in Europe 59% of adults and almost 1 in 3 children are overweight or obese, and in Italy the situation is no better: 43% of adults are overweight, with peaks of 49% in Puglia. And it is certainly not better in the child population: on the basis of the OKKio alla Salute survey, among the children of Puglia, 4.8% are in conditions of severe obesity, 10.3% are obese, 21.6% overweight, so more than one in three children is not of normal weight.
Obesity increases the risk of many noncommunicable diseases, including cancers, cardiovascular disease, type 2 diabetes mellitus and chronic respiratory disease, and if obesity begins in childhood, the risk of disease in adulthood is even greater. The pathogenesis of many of these pathologies in the obese subject is shared with the reduction of vitamin D, a hormone essential for bone health and beyond, which is frequently found in the obese subject and which in turn can be a contributing cause of some associated pathologies to obesity such as male infertility and breast cancer.
The research group coordinated by prof. Carlo Forest and Dr. Andrea Di Nisio in collaboration with the Andrology and Reproductive Medicine Unit, directed by Prof. Alberto Ferlin of the Padua University Hospital, discovered that the adipose tissue in the obese patient captures the vitamin D circulating in the blood, which, accumulated in the fat, it is no longer released, thus leading to a pseudo-hypovitaminosis D which results in a hyper-vitaminosis in the adipose tissue.
It has in fact been calculated that the equivalent of vitamin D that is normally administered in 2000 days of recommended treatment is accumulated in the fat of the obese subject. For the first time, the results achieved by the team of prof. Foresta demonstrate that the accumulation of vitamin D in the adipose tissue of obese subjects alters the function of the adipocyte by inducing a greater expression and activity of the aromatase enzyme, which transforms testosterone into estrogen, and thus determining a condition of hyper-estrogenism.
In the obese male, the increase in estrogen induced by the consequences of the accumulation of vitamin D in the adipose cell participates in the typical clinical manifestations of obesity (gynaecomastia, reduced testosterone levels, infertility). In women, the Paduan researchers, coordinated by Dr. Maria Santa Rocca and in collaboration with the multidisciplinary day/week surgery directed by prof. Alberto Marchet, studying breast cancer, one of the most common forms of cancer in the female population, have shown that the increase in vitamin D in the peri-tumor adipose tissue is associated with a high expression of the aromatase enzyme in obese women, and therefore a greater concentration of estrogens, involved in tumor proliferation.
The research will be previewed on April 15th in Lecce at the Mercure Hotel President, on the sidelines of the XVI medical conference entitled “Endocrine alterations in the obese subject: from infertility to osteoporosis”.
“In conclusion, the studies presented by our team show in the obese a contradiction between reduced plasma levels of vitamin D and high concentrations of the same in adipose tissue, demonstrating that this phenomenon alters the functioning of adipose cells – concludes Professor Foresta – with consequences well-defined clinical features such as infertility and hypogonadism in obese men and oncological risk in women. Therefore, the treatment of hypovitaminosis D in obesity should primarily involve weight loss and physical activity, and not a specific pharmacological overload of vitamin D”.