Endocrine Weight Loss Sex Hormones and Body Composition 1 — Questions and Answers
Question 1: Estrogen primarily promotes fat storage in which body region in premenopausal women?
- Visceral (abdominal) region
- Subcutaneous gluteal-femoral region (Correct answer)
- Intramuscular depots
- Hepatic tissue
Correct answer: Subcutaneous gluteal-femoral region
Estrogen directs fat storage to subcutaneous gluteal-femoral (hip and thigh) depots, creating a gynoid fat distribution pattern in premenopausal women.
Question 2: Which effect does testosterone have on body composition in both men and women?
- Increases total body fat percentage
- Promotes visceral fat accumulation
- Stimulates muscle protein synthesis and lean mass (Correct answer)
- Reduces basal metabolic rate
Correct answer: Stimulates muscle protein synthesis and lean mass
Testosterone is an anabolic hormone that stimulates muscle protein synthesis, increasing lean body mass and contributing to higher resting metabolic rate.
Question 3: During menopause, the decline in estrogen most commonly leads to a shift toward which type of fat distribution?
- Gynoid (pear-shaped) fat distribution
- Increased subcutaneous thigh fat
- Androgenic (apple-shaped) visceral fat distribution (Correct answer)
- Decreased overall adiposity
Correct answer: Androgenic (apple-shaped) visceral fat distribution
The decline in estrogen at menopause removes its protective effect against visceral fat accumulation, shifting distribution toward the androgenic (apple-shaped) central pattern.
Question 4: DHEA (dehydroepiandrosterone) levels in the body peak around what age and then progressively decline?
- Age 10–15
- Age 20–30 (Correct answer)
- Age 40–50
- Age 60–70
Correct answer: Age 20–30
DHEA and DHEAS levels peak in the mid-twenties (roughly age 20–30) and then decline steadily by approximately 2% per year, contributing to age-related changes in body composition.
Question 5: How does estrogen influence insulin sensitivity in premenopausal women?
- Estrogen worsens insulin sensitivity by promoting glucose uptake
- Estrogen has no effect on insulin sensitivity
- Estrogen enhances insulin sensitivity, protecting against type 2 diabetes (Correct answer)
- Estrogen causes hyperinsulinemia
Correct answer: Estrogen enhances insulin sensitivity, protecting against type 2 diabetes
Estrogen enhances insulin sensitivity through multiple mechanisms including upregulating GLUT4 transporters and reducing hepatic glucose production, offering metabolic protection in premenopausal women.
Question 6: A 45-year-old man presents with decreased libido, fatigue, increased body fat, and reduced muscle mass. Lab work shows low total testosterone. This cluster of symptoms is most consistent with:
- Primary hypothyroidism
- Hypogonadism (testosterone deficiency) (Correct answer)
- Cushing's syndrome
- Hyperprolactinemia
Correct answer: Hypogonadism (testosterone deficiency)
Hypogonadism (testosterone deficiency) classically presents with decreased libido, fatigue, increased adiposity, and loss of lean muscle mass in men, confirmed by low serum testosterone.
Question 7: Progesterone's effect on weight is most commonly related to:
- Directly increasing fat cell size through lipolysis inhibition
- Promoting fluid retention and appetite stimulation (Correct answer)
- Reducing cortisol levels and decreasing stress eating
- Increasing metabolic rate and fat oxidation
Correct answer: Promoting fluid retention and appetite stimulation
Progesterone can promote fluid retention (through its interaction with aldosterone receptors) and may stimulate appetite, contributing to the weight gain some women notice in the luteal phase of their cycle.
Endocrine Weight Loss Sex Hormones and Body Composition 1
Estrogen primarily promotes fat storage in which body region in premenopausal women?