ArticleEndocrine2021
The ketogenic diet corrects metabolic hypogonadism and preserves pancreatic ß-cell function in overweight/obese men: a single-arm uncontrolled study.
Article in Endocrine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Pooled it
- Mediterranean Diet versus Very Low-Calorie Ketogenic Diet: Effects of Reaching 5% Body Weight Loss on Body Composition in Subjects with Overweight and with Obesity-A Cohort Study.International journal of environmental research and public health · 2022Trial
- Ketogenic Diet in Obesity and Diabetes: A Narrative Review.Nutrients · 2026Review
- Advancing Obesity Management: the Very Low-Energy Ketogenic therapy (VLEKT) as an Evolution of the "Traditional" Ketogenic Diet.Current obesity reports · 2025Review
- Obesity in Prediabetic Patients: Management of Metabolic Complications and Strategies for Prevention of Overt Diabetes.Endocrine, metabolic & immune disorders drug targets · 2025Review
- Genetics and diet shape the relationship between islet function and whole body metabolism.American journal of physiology. Endocrinology and metabolism · 2024Article
- New perspectives in functional hypogonadotropic hypogonadism: beyond late onset hypogonadism.Frontiers in endocrinology · 2023Review
- Caloric restriction improves glycaemic control without reducing plasma branched-chain amino acids or keto-acids in obese men.Scientific reports · 2022Article
- Review
- Reply to the letter by Onfiani G. "VLCD versus VLCKD for obese male patients with hypogonadism. Considerations about the recent systematic review and consensus statement published by Italian Society of Endocrinology (SIE)".Eating and weight disorders : EWD · 2022Article
- Adipose Tissue Dysfunction and Obesity-Related Male Hypogonadism.International journal of molecular sciences · 2022Review
- Beneficial Effects of the Very-Low-Calorie Ketogenic Diet on the Symptoms of Male Accessory Gland Inflammation.Nutrients · 2022Article
- Obesity and Male Reproduction: Do Sirtuins Play a Role?International journal of molecular sciences · 2022Review
- Diet and exercise interventions reduce serum asprosin and the corresponding hypothalamic- pituitary-gonad-axis dysfunction in obese men.Frontiers in physiology · 2022Article
- Molecular Mechanisms Underlying the Relationship between Obesity and Male Infertility.Metabolites · 2021Review
- The forgotten confounding variable of the very-low-caloric intervention in the ketogenic diet.Endocrine · 2021Article
- Treatment of Men with Central Hypogonadism: Alternatives for Testosterone Replacement Therapy.International journal of molecular sciences · 2020Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOverweight and obesity are increasingly spread in our society. Low testosterone levels are often present in these patients, the so-called metabolic hypogonadism, that further alters the metabolic balance in a sort of vicious cycle. Very low-calorie ketogenic diet (VLCKD) has been reported to efficiently reduce body weight, glycaemia, and the serum levels of insulin, glycated hemoglobin, but its effects on β-cell function and total testosterone (TT) levels are less clear.
aimTo evaluate the effects of VLCKD on markers suggested to be predictive of β-cell dysfunction development, such as proinsulin or proinsulin/insulin ratio, and on TT values in a cohort of overweight or obese nondiabetic male patients with metabolic hypogonadism.
methodsPatients with overweight or obesity and metabolic hypogonadism underwent to VLCKD for 12 weeks. Anthropometric parameters, blood testing for the measurement of glycaemia, insulin, C-peptide, proinsulin, TT, calculation of body-mass index (BMI), and HOMA index were performed before VLCKD and after 12 weeks.
resultsTwenty patients (mean age 49.3 ± 5.2 years) were enrolled. At enrollement all patients presented increased insulin, HOMA index, C-peptide, and proinsulin levels, whereas the proinsulin/insulin ratio was within the normal values. After VLCKD treatment, body weight and BMI significantly decreased, and 14.9 ± 3.9% loss of the initial body weight was achieved. Glycaemia, insulin, HOMA index, C-peptide, and proinsulin significantly decreased compared to pre-VLCKD levels. Serum glycaemia, insulin, C-peptide, and proinsulin levels returned within the normal range in all patients. No difference in the proinsulin/insulin ratio was observed after VLCKD treatment. A mean increase of 218.1 ± 53.9% in serum TT levels was achieved and none of the patients showed TT values falling in the hypogonadal range at the end of the VLCKD treatment.
conclusionsThis is the first study that evaluated the effects of VLCKD on proinsulin, proinsulin/insulin ratio, and TT levels. VLCKD could be safely used to improve β-cell secretory function and insulin-sensitivity, and to rescue overweight and obese patients from β-cell failure and metabolic hypogonadism.
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