Men with low testosterone, women after menopause and both men and women with growth hormone deficiency without involvement of HPA axis perturbations tend to have abdominal obesity (49). These hormones prevent accumulation of body fat in intra-abdominal depots, and deficiency would then be expected to be followed by enlargement of these depots. The mechanisms whereby this occurs have been largely elucidated, and substitution with the deficient hormone is followed by a specific decrease of visceral fat as well as improvement of the factors included in the metabolic syndrome (6). The prevalence of such conditions seem to be in the order of 10% in the middle-aged male population (56).
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