Endocrine Weight Loss Sex Hormones and Body Composition 2

Question 1

In polycystic ovary syndrome (PCOS), elevated androgens contribute to weight gain primarily by promoting:

Accepted Answer

Visceral and abdominal fat accumulation

Answer

Subcutaneous gluteal fat accumulation

Answer

Reduced appetite and caloric intake

Answer

Increased thyroid hormone production

Question 2

Sex hormone-binding globulin (SHBG) levels are typically reduced in obesity. What is the clinical consequence of low SHBG?

Accepted Answer

More free (bioavailable) sex hormones are available to tissues

Answer

More testosterone and estrogen are protein-bound and inactive

Answer

Androgen deficiency symptoms occur despite normal total testosterone

Answer

SHBG reduction has no clinical significance

Question 3

Adipose tissue expresses aromatase enzyme. What does this mean for obese postmenopausal women?

Accepted Answer

Peripheral conversion of androgens to estrogen increases with greater fat mass

Answer

They produce less estrogen than lean postmenopausal women

Answer

Adipose aromatase converts estrogen to androgens

Answer

Aromatase activity in fat tissue is clinically irrelevant

Question 4

Which mechanism best explains why men with hypogonadism often develop insulin resistance and central obesity?

Accepted Answer

Testosterone deficiency reduces muscle mass, lowering glucose uptake and metabolic rate

Answer

Low testosterone increases SHBG, sequestering insulin

Answer

Low testosterone stimulates cortisol production, causing hyperglycemia

Answer

Hypogonadism directly inhibits pancreatic beta cell function

Question 5

A woman with PCOS is found to have elevated free testosterone and insulin resistance. Which treatment approach addresses both problems simultaneously?

Accepted Answer

Metformin, which reduces insulin resistance and thereby lowers androgen production

Answer

Testosterone replacement therapy

Answer

High-dose estrogen therapy

Answer

Thyroid hormone supplementation

Question 6

Estradiol (E2) is the predominant estrogen in premenopausal women, while estrone (E1) predominates postmenopausally. How does this shift affect weight?

Accepted Answer

Estrone is a weaker estrogen, providing less protection against visceral fat accumulation

Answer

Estrone is more potent than estradiol, promoting greater fat loss

Answer

Estrone preferentially promotes subcutaneous fat storage like estradiol

Answer

The shift between estrogen types has no effect on body weight

Question 7

In men, excess adipose tissue (obesity) can lead to decreased testosterone levels through which primary mechanism?

Accepted Answer

Adipose aromatase converts testosterone to estradiol, reducing circulating testosterone

Answer

Fat cells secrete testosterone antagonists that block androgen receptors

Answer

Obesity stimulates SHBG production, which binds all available testosterone

Answer

Excess fat increases LH pulsatility, suppressing testicular function