Visceral adipose tissue (VAT) should be considered an endocrine organ that can influence gonadal steroidal hormones through the enzyme aromatase, which plays a key role in converting androgens to estrogens and may lead to secondary hypogonadism by suppressing the reproductive axis, reducing total testosterone (TT), and sex hormone-binding globulin (SHBG) serum concentrations [41,42]. Here, SHBG is linked to hypogonadism.