Human Reproduction Update Advance Access originally published online on June 14, 2006
Human Reproduction Update 2006 12(5):585-601; doi:10.1093/humupd/dml024
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Obesity and the role of gut and adipose hormones in female reproduction
1 Department of Obstetrics and Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA 2 Department of Nutritional Sciences, Pennsylvania State University, State College, PA, USA and 3 Department of Obstetrics and Gynecology, Pennsylvania State University College of Medicine, Hershey, PA, USA
4 To whom correspondence should be addressed at: Department of Obstetrics, Gynecology and Reproductive Science, Division of Reproductive Endocrinology and Infertility, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket Street, Room 2314, Pittsburgh, PA 15213, USA. E-mail: ggosman{at}mail.magee.edu
Reproductive function declines at both extremes of human energy balance. The relationship between obesity and reproductive function is complex and incompletely understood. The literature has established the negative impact of excess energy stores on ovulatory function and investigated the mechanisms whereby this occurs. Furthermore, weight loss in obese anovulatory women increases ovulation and conception. Obesity and anti-obesity therapy effects on the endometrium, implantation and early fetal development have received less attention. The discovery of adipokines and enterokines greatly expands the ability to investigate the relationship between obesity, therapies to produce weight loss and reproductive function. In this review, we discuss select adipose and enteric signals. We focus on in vitro, animal and human data that lend biological plausibility to adipokines and enterokines as mediators of obesity and reproduction. Very little published work exists that directly addresses adipocyte and enteric signals in this specific role; therefore, much of this review is on the basis of a synthesis of the literature in three areas: (i) in vitro and in vivo evidence regarding the reproductive effects of these signals; (ii) adipokine and enterokine changes that occur with weight-loss therapies, focusing on hypocaloric diets, bariatric surgery and drugs that target adipocyte or enteric signals and (iii) reproductive changes produced by these weight-loss therapies.
Key words: bowel / energy balance / gut / obesity / reproduction
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