The male patient with obesity undergoing metabolic and bariatric surgery: changes in testosterone levels correlate with weight loss after one-anastomosis gastric bypass and Roux-en-Y gastric bypass |
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| Institution: | 1. Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria;2. Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Section for Medical Statistics, Medical University of Vienna, Vienna, Austria;3. Division of Endocrinology, Department of Internal Medicine, Medical University of Vienna, Vienna, Austria;1. Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;3. Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran;4. Student Research Committee, Dnipro Medical Institute of Conventional and Traditional Medicine, Dnipro, Ukraine;5. Temecula Valley Hospital, Temecula, California;6. Department of Epidemiology and Biostatistics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran;7. Isfahan Cardiovascular Research Center, Chamran University Hospital, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;8. Department of Surgery, Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran;1. Obesity and Metabolism Research Laboratory, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain;2. Department of General and Digestive System Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain;3. Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Hospital, Murcia, Spain;4. Department of Medical Oncology, Virgen de la Victoria and Regional University Hospitals-IBIMA, UMA-CIMES, Málaga, Spain;5. Department of Surgical Specialties, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, Málaga, Spain;6. Department of Biochemistry, Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, Murcia, Spain;1. Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;2. Department of Surgery, Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;3. New England Research Institutes, Watertown, Massachusetts;4. Neuropsychiatric Research Institute, and the University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota;5. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;6. Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania;1. Assia Medical Group, Assuta Medical Center, Tel-Aviv, Israel;2. Faculty of Health Sciences, Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheba, Israel;3. Department of Nutrition, Assuta Medical Center, Tel-Aviv, Israel;4. Department of Nutrition, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;5. Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel;6. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;7. Department of Surgery A, Emek Medical Center, Afula, Israel;8. Rappaport, Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel |
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| Abstract: | BackgroundMale obesity secondary hypogonadism (MOSH) is a common disease among men with obesity and can be associated with metabolic syndrome and a variety of metabolic problems ultimately leading to androgen deficiency. Metabolic and bariatric surgery is a well-established treatment option associated with significant weight loss and reduction in metabolic co-morbidities.ObjectivesTo evaluate the impact of surgery on plasma levels of sexual hormones and their effect on weight loss comparing 2 surgical methods (one-anastomosis gastric bypass OAGB] and Roux-en-Y gastric bypass RYGB]) in male patients with obesity.SettingUniversity hospital, Austria.MethodsPatients undergoing OAGB and RYGB between 2012 and 2017 were analyzed retrospectively. Follow-up in this study was up to 24 months. Systemic levels of sexual hormones (luteinizing hormone LH]), follicle stimulating hormone FSH], total testosterone TT], sexual hormone binding globin SHBG], 17 beta-estradiol 17bE], androstenedione AS]) were retrieved at each visit. A linear mixed model was used to assess the correlation between changes in testosterone levels and percent excess weight loss (%EWL).ResultsIn 30.8% of all patients, MOSH was present preoperatively. A significant increase of TT was observed postoperatively that led to a complete resolution of hypogonadism within the period observed. Bioavailable testosterone (bTT) and FSH levels significantly increased each month of follow-up after surgery (all P < .01). Levels of 17bE did not change significantly after surgery. The overall change of TT, comparing preoperative and 1-year postoperative TT levels (ΔTT), significantly correlated with %EWL. Changes in TT levels were not affected by the choice of surgical method.ConclusionsSerum plasma testosterone levels rise significantly after metabolic and bariatric surgery in male patients. The change of testosterone levels seems to play a role in continued weight loss after surgery. This is true irrespective of the surgical method used. |
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| Keywords: | Obesity Male Bariatric surgery Sexual hormones Testosterone Weight loss One-anastomosis gastric bypass Roux-en-Y gastric bypass |
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