In obese men, LH pulse frequency after naloxone increased by 51% from baseline.
These results suggested a role for endogenous opioids in
the pathophysiology of hypogonadotropic hypoandrogenism
in extremely obese men (41). It has been suggested that patients
with insulin-dependent diabetes have suppressed pituitary
function after a GnRH stimulation test and have higher
sperm ultrastructural defects and DNA fragmentation than
control subjects (42–44). The effect of type 2 diabetes, which
isfrequently associated with obesity, on the hypothalamic-pituitary-
gonadal axis and sperm function is poorly understood.