Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Journal of Endocrinological Investigation
Published in: Journal of Endocrinological Investigation 12/2014

01-12-2014 | Review

The gonadal function in obese adolescents: review

Authors: Rosita A. Condorelli, Aldo E. Calogero, Enzo Vicari, Laura Mongioi’, Vincenzo Favilla, Giuseppe Morgia, Sebastiano Cimino, Giorgio Russo, Sandro La Vignera

Published in: Journal of Endocrinological Investigation | Issue 12/2014

Login to get access

Abstract

This review deals with the relationship between obesity in male adolescents and gonadal function. The article is structured in two main paragraphs; the first one is about population studies that have assessed puberty timing and its mode of onset in relation with body weight to evaluate if and how the latter can influence the gonadal function in this phase of life. These studies analyze issues such as increased BMI and early onset of male puberty, gender differences, secular trend toward early onset of puberty in males, effects of a different body composition on male puberty and consequences of a different stage of childhood obesity on the onset of male puberty. The second paragraph examines the possible mechanisms through which, obesity may alter the timing of puberty in young males, including the role of SHBG, leptin, insulin resistance, ghrelin, GH-IGF-1 axis, AR polymorphisms, primary testicular dysfunction, retinol binding protein 4 (RBP-4) and liver function abnormalities. However, despite the numerous studies in the literature, the etiology of gonadal disfunction in obese adolescents on puberty remains uncertain.
Literature
1.
2.
Parent AS, Teilmann G, Juul A et al (2003) The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev 24:668–693PubMedCrossRef
3.
Prader A (1966) Testicular size: assessment and clinical importance. Triangle 7:240–243PubMed
4.
Tinggaard J, Mieritz MG, Sørensen K, Mouritsen A, Hagen CP, Aksglaede L, Wohlfahrt-Veje C, Juul A (2012) The physiology and timing of male puberty. Curr Opin Endocrinol Diabetes Obes 19:197–203PubMedCrossRef
5.
Sorensen K, Aksglaede L, Petersen JH, Juul A (2010) Recent changes in pubertal timing in healthy Danish boys: associations with body mass index. J Clin Endocrinol Metab 95:263–270PubMedCrossRef
6.
Parrino C, Rossetti P, Baratta R, La Spina N, La Delfa L, Squatrito S, Vigneri R, Frittitta L (2012) Secular trends in the prevalence of overweight and obesity in Sicilian schoolchildren aged 11–13 years during the last decade. PLoS ONE 7(4):e34551PubMedCentralPubMedCrossRef
7.
Karpati AM, Rubin CH, Kieszak SM, Marcus M, Troiano RP (2002) Stature and pubertal stage assessment in American boys: the 1988–1994 Third National Health and Nutrition Examination Survey. J Adolesc Health 30:205–212PubMedCrossRef
8.
Juul A, Magnusdottir S, Scheike T et al (2007) Age at voice break in Danish boys: effects of prepubertal body mass index and secular trend. Int J Androl 30:537–542PubMedCrossRef
9.
Lee JM, Kaciroti N, Appugliese D et al (2010) Body mass index and timing of pubertal initiation in boys. Arch Pediatr Adolesc Med 164:139–144PubMedCentralPubMed
10.
Silventoinen K, Haukka J, Dunkel L, Tynelius P, Rasmussen F (2008) Genetics of pubertal timing and its associations with relative weight in childhood and adult height: the Swedish Young Male Twins Study. Pediatrics 121:e885–e891PubMedCrossRef
11.
Hammar SL, Campbell MM, Campbell VA, Moores NL, Sareen C, Gareis FJ, Lucas B (1972) An interdisciplinary study of adolescent obesity. J Pediatr 80:373–383PubMedCrossRef
12.
Wang Y (2002) Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics 110:903–910PubMedCrossRef
13.
Biro FM, Khoury P, Morrison JA (2006) Influence of obesity on timing of puberty. Int J Androl 29:272–277PubMedCrossRef
14.
Ji CY, Chen TJ (2008) Secular changes in stature and body mass index for Chinese youth in sixteen majorcities, 1950s–2005. Am J Hum Biol 20:530–537PubMedCrossRef
15.
Buyken AE, Karaolis-Danckert N, Remer T (2009) Association of prepubertal body composition in healthy girls and boys with the timing of early and late pubertal markers. Am J Clin Nutr 89:221–230PubMedCrossRef
16.
Sandhu J, Ben-Shlomo Y, Cole TJ et al (2006) The impact of childhood body mass index on timing of puberty, adult stature and obesity: a follow-up study based on adolescent anthropometry recorded at Christ’s Hospital (1936–1964). Int J Obes (Lond). 30:14–22CrossRef
17.
Vizmanos B, Martí-Henneberg C (2000) Puberty begins with a characteristic subcutaneous body fat mass in each sex. Eur J Clin Nutr 54:203–208PubMedCrossRef
18.
Boyne MS, Thame M, Osmond C et al (2010) Growth, body composition, and the onset of puberty: longitudinal observations in Afro-Caribbean children. J Clin Endocrinol Metab 95:3194–3200PubMedCrossRef
19.
20.
Hui LL, Wong MY, Lam TH et al (2012) Infant growth and onset of puberty: prospective observations from Hong Kong’s ‘Children of 1997’ birth cohort. Ann Epidemiol 22:43–50PubMedCrossRef
21.
Buyken AE, Bolzenius K, Karaolis-Danckert N et al (2011) Body composition trajectories into adolescence according to age at pubertal growth spurt. Am J Hum Biol. 23:216–224PubMedCrossRef
22.
He Q, Karlberg J (2001) BMI in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res 49:244–251PubMedCrossRef
23.
Kleber M, Schwarz A, Reinehr T (2011) Obesity in children and adolescents: relationship to growth, pubarche, menarche, and voice break. J Pediatr Endocrinol Metab 24:125–130PubMedCrossRef
24.
Maggi M, Buvat J (2013) Standard operating procedures: pubertas tarda/delayed puberty–male. J Sex Med. 10:285–293PubMedCrossRef
25.
Andersson AM, Toppari J, Haavisto AM et al (1998) Longitudinal reproductive hormone profiles in infants: peak of inhibin B levels in infant boys exceeds levels in adult men. J Clin Endocrinol Metab 83:675–681PubMed
26.
Seminara SB, Messager S, Chatzidaki EE et al (2003) The GPR54 gene as a regulator of puberty. N Engl J Med 349:1614–1627PubMedCrossRef
27.
Morelli A, Marini M, Mancina R, Luconi M, Vignozzi L, Fibbi B, Filippi S, Pezzatini A, Forti G, Vannelli GB, Maggi M (2008) Sex steroids and leptin regulate the “first Kiss” (KiSS 1/G-protein-coupled receptor 54 system) in human gonadotropin-releasing-hormone-secreting neuroblasts. J Sex Med 5:1097–1113PubMedCrossRef
28.
Morelli A, Comeglio P, Sarchielli E, Cellai I, Vignozzi L, Vannelli GB, Maggi M (2013) Negative effects of high glucose exposure in human gonadotropin-releasing hormone neurons. Int J Endocrinol 2013:684659PubMedCentralPubMed
29.
Morelli A, Sarchielli E, Comeglio P, Filippi S, Vignozzi L, Marini M, Rastrelli G, Maneschi E, Cellai I, Persani L, Adorini L, Vannelli GB, Maggi M (2014) Metabolic syndrome induces inflammation and impairs gonadotropin-releasing hormone neurons in the preoptic area of the hypothalamus in rabbits. Mol Cell Endocrinol 382:107–119PubMedCrossRef
30.
Ferlin A, Garolla A, Rigon F, Caldogno LR, Lenzi A, Foresta C (2006) Changes in seruminsulin like 3 during normal male puberty. J Clin Endocrinol Metab 91:3426–3431PubMedCrossRef
31.
Foresta C, Bettella A, Vinanzi C, Dabrilli P, Meriggiola MC et al (2004) Insulin like factor 3: a novel circulating hormone of testis origin in humans. J Clin Endocrinol Metab 89:5952–5958PubMedCrossRef
32.
Sadeghian H, Anand-Ivell R, Balvers M, Relan V, Ivell R (2005) Constitutive regulation of the Insl3 gene in rat Leydig cells. Mol Cell Endocrinol 241:10–20PubMedCrossRef
33.
Bay K, Matthiesson KL, McLachlan RI, Andersson AM (2006) The effects of gonadotropin suppression and selective replacement on insulin-like factor 3 secretion in normal adult men. J Clin Endocrinol Metab 91:1108–1111PubMedCrossRef
34.
Ferlin A, Pepe A, Gianesello L, Garolla A, Feng S et al (2008) Mutations in the insulin-like factor 3 receptor are associated with osteoporosis. J Bone Miner Res 23:683–693PubMedCentralPubMedCrossRef
35.
Ferlin A, Pepe A, Gianesello L, Garolla A, Feng S et al (2009) New roles for INSL3 in adults. Ann N Y Acad Sci 1160:215–218PubMedCrossRef
36.
Andersson AM, Juul A, Petersen JH et al (1997) Serum inhibin B in healthy pubertal and adolescent boys: relation to age, stage of puberty, and follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol levels. J Clin Endocrinol Metab 82:3976–3981PubMed
37.
Jensen TK, Andersson AM, Hjollund NH et al (1997) Inhibin B as a serum marker of spermatogenesis: correlation to differences in sperm concentration and follicle-stimulating hormone levels. A study of 349 Danish men. J Clin Endocrinol Metab 82:4059–4063PubMed
38.
Jorgensen N, Liu F, Andersson AM et al (2010) Serum inhibin-b in fertile men is strongly correlated with low but not high sperm counts: a coordinated study of 1,797 European and US men. Fertil Steril 94:2128–2134PubMedCrossRef
39.
Rajpert-De ME, Jorgensen N, Graem N et al (1999) Expression of anti-Mullerian hormone during normal and pathological gonadal development: association with differentiation of Sertoli and granulosa cells. J Clin Endocrinol Metab 84:3836–3844
40.
Aksglaede L, Skakkebaek NE, Almstrup K, Juul A (2011) Clinical and biological parameters in 166 boys, adolescents and adults with non-mosaic Klinefelter syndrome: a Copenhagen experience. Acta Paediatr 100:793–806PubMedCrossRef
41.
42.
Derkacz M, Chmiel-Perzynska I, Nowakowski A (2011) Gynecomastia: a difficult diagnostic problem. Endokrynol Pol. 62:190–202PubMed
43.
Dundar B, Dundar N, Erci T et al (2005) Leptin levels in boys with pubertal gynecomastia. J Pediatr Endocrinol Metab 18:929–934PubMed
44.
Williams G (2012) Aromatase up-regulation, insulin and raised intracellular oestrogens in men, induce adiposity, metabolic syndrome and prostate disease, via aberrant ER-alpha and GPER signalling. Mol Cell Endocrinol 351:269–278PubMedCrossRef
45.
Ilyés I, Kirilina S (1992) Sex hormone binding globulin (SHBG) in children with obesity. Acta Paediatr Hung. 32:149–157PubMed
46.
47.
48.
Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372:425–432PubMedCrossRef
49.
Hassink SG, Sheslow DV, deLancey E, Opentanova I, Considine RV, Caro JF (1996) Serum leptin in children with obesity: relationship to gender and development. Pediatrics 98:201–203PubMed
50.
Sudi KM, Gallistl S, Borkenstein MH, Payerl D, Aigner R, Möller R, Tafeit E (2001) Effects of Weight Loss on Leptin, Sex Hormones, and Measures of Adiposity in Obese Children. Endocrine 14:429–435PubMedCrossRef
51.
Jin L, Burguera BG, Couce ME, Scheithauer BW, Lamsan J, Eberhardt NL, Kulig E, Lloyd RV (1999) Leptin and leptin receptor expression in normal and neoplastic human pituitary: evidence of a regulatory role for leptine on pituitary cell proliferation. J Clin Endocrinol Metab 84:2903–2911PubMed
52.
Caprio M, Isidori AM, Carta AR, Moretti C, Dufau ML, Fabbri A (1999) Expression of functional leptin receptors in rodent Leydig cells. Endocrinology 140:4939–4947PubMed
53.
El Majdoubi M, Sahu A, Ramaswamy S, Plant TM (2000) Neuropeptide Y: a hypothalamic break restraining the onset of puberty in primates. Proc Natl Acad Sci USA 97:6179–6184PubMedCentralPubMedCrossRef
54.
Morelli A, Fibbi B, Marini M, Silvestrini E, De Vita G, Chavalmane AK, Vignozzi L, Filippi S, Forti G, Vannelli GB, Maggi M (2009) Dihydrotestosterone and leptin regulate gonadotropin-releasing hormone (GnRH) expression and secretion in human GnRH-secreting neuroblasts. J Sex Med 6:397–407PubMedCrossRef
55.
Shalitin S, Phillip M (2003) Role of obesity and leptin in the pubertal process and pubertal growth – a review. International Journal of obesity. 27:869–874PubMedCrossRef
56.
Wabitsch M, Blum W, Muche R, Braun M, Huber F, Rascher W et al (1997) Contribution of androgens to the gender difference in leptin production in obese children and adolescents. Journal of Clinical Investigation. 100:808–813PubMedCentralPubMedCrossRef
57.
Glasow A, Haidan A, Hilbers U, Breidert M, Gillespie J, Scherbaum WA et al (1998) Expression of Ob receptor in normal human adrenals: differential regulation of adrenocortical and adrenomedullary function by leptin. J Clin Endocrinol Metab 83:4459–4466PubMed
58.
Moriarty-Kelsey M, Harwood JEF, Travers SH, Zeitler PS, Nadeau KJ (2010) Testosterone, obesity and insuline resistance in young males: evidence for an association between gonadal dysfunction and insuline resistance during puberty. J Pediatr Endocrinol Metab 23:1281–1287PubMedCrossRef
59.
Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K (1999) Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 402:656–660PubMedCrossRef
60.
Tena-Sempere M (2005) Ghrelin: novel regulator of gonadal function. J Endocrinol Invest 28:26–29PubMed
61.
Hataya Y, Akamizu T, Takaya K, Kanamoto N, Ariyasu H, Saijo M, Moriyama K, Shimatsu A, Kojima M, Kangawa K, Nakao K (2001) A low dose of ghrelin stimulates growth hormone (GH) release synergistically with GHreleasing hormone in humans. J Clin Endocrinol Metab 86:4552PubMedCrossRef
62.
63.
Lebrethon MC, Aganina A, Fournier M, Gerard A, Parent AS, Bourguignon JP (2007) Effects of in vivo and in vitro administration of ghrelin, leptin and neuropeptide mediators on pulsatile gonadotrophin-releasing hormone secretion from male rat hypothalamus before and after puberty. J Neuroendocrinol 19:181–188PubMedCrossRef
64.
El-Eshmawy MM (2010) Abdel Aal AI, El hawary AK. Association of ghrelin and leptin with reproductive hormones in constitutional delay of growth and puberty. Reproductive Biology and Endocrinology. 8:153PubMedCentralPubMedCrossRef
65.
L’Allemand D, Schmidt S, Rousson V, Brabant G, Gasser T, Grüters A (2002) Associations between body mass, leptin, IGF-I and circulating adrenal androgens in children with obesity and premature adrenarche. Eur J Endocrinol 146:537–543PubMedCrossRef
66.
Suter KJ, Pohl CR, Wilson ME (2000) Circulating concentrations of nocturnal leptin, growth hormone, and insulin-like growth factor-I increase before the onset of puberty in agonadal male monkeys: potential signals for the initiation of puberty. J Clin Endocrinol Metab 85:808–814PubMed
67.
Balducci R, Toscano V, Larizza D, Mangiantini A, Galasso C, Municchi G et al (1998) Effects of long-term growth hormone therapy on adrenal steroidogenesis in Turner syndrome. Horm Res 49:210–215PubMedCrossRef
68.
Guercio G, Rivarola MA, Chaler E, Maceiras M, Belgorosky A (2002) Relationship between the GH/IGF-I axis, insulin sensitivity, and adrenal androgens in normal prepubertal and pubertal boys. J Clin Endocrinol Metab 87(3):1162–1169PubMedCrossRef
69.
Pausova Z, Abrahamowicz M, Mahboubi A, Syme C, Leonard GT, Perron M, Richer L, Veillette S, Gaudet D, Paus T (2010) Functional Variation in the Androgen-Receptor Gene Is Associated With Visceral Adiposity and Blood Pressure in Male Adolescents. Hypertension 55:706–714PubMedCrossRef
70.
Weise M, Eisenhofer G, Merke DP (2002) Pubertal and gender-related changes in the sympathoadrenal system in healthy children. J Clin Endocrinol Metab 87:5038–5043PubMedCrossRef
71.
Taneli F, Ersoy B, Özhan B, Çalkan M, Yılmaz O, Dinç G, Genç A, Taneli C (2010) The effect of obesity on testicular function by insulin-like factor 3, inhibin B, and leptin concentrations in obese adolescents according to pubertal stages. Clin Biochem 43:1236–1240PubMedCrossRef
72.
Radicioni AF, Anzuini A, De Marco E, Nofroni I, Castracane VD, Lenzi A (2005) Changes in serum inhibin B during normal male puberty. Eur J Endocrinol 152:403–409PubMedCrossRef
73.
Aggerholm AS, Thulstrup AM, Toft G, Ramlau-Hansen CH, Bonde JP (2008) Is overweight a risk factor for reduced semen quality and altered serum sex hormone profile? Fertil Steril 90:619–626PubMedCrossRef
74.
Winters SJ, Wang C, Abdelrahaman E, Hadeed V, Dyky MA, Brufsky A (2006) Inhibin B levels in healthy young adult men and prepubertal boys: is obesity the cause for the contemporary decline in sperm count because of fewer Sertoli cells? J Androl 27:560–564PubMedCrossRef
75.
Wikström AM, Bay K, Hero M, Andersson AM, Dunkel L (2006) Serum insulin-like factor 3 levels during puberty in healthy boys and boys with klinefelter syndrome. J Clin Endocrinol Metab 91:4705–4708PubMedCrossRef
76.
77.
Foresta C, Di Mambro A, Pagano C, Garolla A, Vettor R, Ferlin A (2009) Insulin-like factor 3 as a marker of testicular function in obese men. Clin Endocrinol (Oxf). 71:722–726PubMedCrossRef
78.
Ishikawa T, Fujioka H, Ishimura T, Takenaka A, Fujisawa M (2007) Expression of leptin and leptin receptor in the testis of fertile and infertile patients. Andrologia. 39:22–27PubMedCrossRef
79.
Zhang LD, Li HC, Gao M, Wang L, Deng Q, Shi T, He JL, Chong T, Wang ZM (2013) Sexual development characteristics and sex hormone levels in obese male adolescents. Zhonghua Nan Ke Xue. 19:434–438PubMed
80.
Esteve E, Ricart W, Fernández-Real JM (2009) Adipocytokines and insulin resistance: the possible role of lipocalin-2, retinol binding protein-4, and adiponectin. Diabetes Care 32:S362–S367PubMedCentralPubMedCrossRef
81.
Wolf G (2007) Serum retinol-binding protein: a link between obesity, insulin resistance, and type 2 diabetes. Nutr Rev 65:251–256PubMedCrossRef
82.
Graham TE, Yang Q, Blüher M et al (2006) Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. The New England Journal of Medicine. 354:2552–2563PubMedCrossRef
83.
Yang Q, Graham TE, Mody N et al (2005) Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature 436:356–362PubMedCrossRef
84.
Lin C-J, Chu NF, Hung Y-J, Chang J-B, He C-T, Hsiao F-C, Hsieh C-H (2013) The association of retinol-binding protein 4 with metabolic syndrome and obesity in adolescents: the effects of gender and sex hormones. Clin Pediatr 52:16–23CrossRef
85.
Denzer C, Thiere D, Muche R, Koenig W, Mayer H, Kratzer W, Wabitsch M (2009) Gender-Specific Prevalences of Fatty Liver in Obese Children and Adolescents: roles of Body Fat Distribution, Sex Steroids, and Insulin Resistance. J Clin Endocrinol Metab 94:3872–3881PubMedCrossRef
86.
Li Y, Liu L, Wang B, Xiong J, Li Q, Wang J, Chen D (2013) Impairment of reproductive function in a male rat model of non-alcoholic fatty liver disease and beneficial effect of N-3 fatty acid supplementation. Toxicol Lett 222:224–232PubMedCrossRef
87.
Birkebaek NH, Lange A, Holland-Fischer P, Kristensen K, Rittig S, Vilstrup H, Handberg A, Gronbaek H (2010) Effect of weight reduction on insulin sensitivity, sex hormone-binding globulin, sex hormones and gonadotrophins in obese children. Eur J Endocrinol 163:895–900PubMedCrossRef
88.
Tartarin P, Moison D, Guibert E, Dupont J, Habert R, Rouiller-Fabre V, Frydman N, Pozzi S, Frydman R, Lecureuil C, Froment P (2012) Metformin exposure affects human and mouse fetal testicular cells. Hum Reprod 27:3304–3314PubMedCrossRef
89.
Fang X, Xu QY, Jia C, Peng YF (2012) Metformin improves epididymal sperm quality and antioxidant function of the testis in diet-induced obesity rats. Zhonghua Nan Ke Xue. 18:146–149PubMed
90.
Bertelloni S, Baroncelli GI, Garofalo P, Cianfarani S (2010) Androgen therapy in hypogonadal adolescent males. Horm Res Paediatr 74:292–296PubMedCrossRef
Metadata
Title
The gonadal function in obese adolescents: review
Authors
Rosita A. Condorelli
Aldo E. Calogero
Enzo Vicari
Laura Mongioi’
Vincenzo Favilla
Giuseppe Morgia
Sebastiano Cimino
Giorgio Russo
Sandro La Vignera
Publication date
01-12-2014
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 12/2014
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-014-0107-4

Other articles of this Issue 12/2014

Journal of Endocrinological Investigation 12/2014 Go to the issue

Original Article

Bone mineral density in women with polycystic ovary syndrome

Original Article

Vitamin D levels and bone mineral density: are LH levels involved in the pathogenesis of bone impairment in hypogonadal men?

Review

Childhood obesity: prevention and strategies of intervention. A systematic review of school-based interventions in primary schools

Original Article

Factors related to mortality in patients with papillary and follicular thyroid cancer in long-term follow-up

Opinion

Graves’-like orbitopathy: do not forget IgG4-related disease

Endocrinology and Art

“Adoration of the shepherds”—Simone Peterzano (1540–1596)
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits