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

Elevated androgens in PCOS promote visceral and abdominal fat accumulation, which further worsens insulin resistance and creates a cycle that perpetuates weight gain.

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

Low SHBG means less sex hormone is protein-bound, increasing the free bioavailable fraction of testosterone and estrogen, which can amplify androgenic or estrogenic effects in tissues.

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

Aromatase in adipose tissue converts androgens (such as androstenedione) to estrogens, so obese postmenopausal women have higher peripheral estrogen levels than lean postmenopausal women despite absent ovarian production.

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

Testosterone is essential for maintaining muscle mass; deficiency causes sarcopenia (muscle loss), which reduces the major site of glucose disposal, leading to insulin resistance and preferential fat accumulation.

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

Metformin reduces insulin resistance, which lowers insulin-driven stimulation of ovarian androgen production, addressing both hyperinsulinemia and hyperandrogenism simultaneously in PCOS.

Endocrine Weight Loss Practice Test

Endocrine Weight Loss Practice Test

Endocrine Weight Loss Sex Hormones and Body Composition 2