Skip to main content

Advertisement

SpringerLink
Log in

Age as a Predictive Factor of Testosterone Improvement in Male Patients After Bariatric Surgery: Preliminary Results of a Monocentric Prospective Study

  • Clinical Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Male obesity can be associated with symptomatic alterations in sex hormones resulting in hypogonadism and impaired fertility. Surgical-induced weight loss can improve the sex hormone profile in men. The aim of the present study is to evaluate the levels of sex hormones in obese males before and after 6 months from bariatric surgery. Possible mechanisms and clinical implications are also discussed.

Methods

We evaluated levels of serum total testosterone (TT), sex hormone-binding globulin (SHBG), calculated free testosterone (cFT), follicular-stimulating hormone (FSH), luteinizing hormone (LH), and total estradiol (E2) in 20 male patients at the baseline and 6 months after bariatric surgery.

Results

Median [interquartile range] age at the time of surgery was 40.5 [27.2–46.7] years with a median [interquartile range] BMI of 43.6 [40.9–48.7] kg/m2. The median baseline levels of TT, SHBG, cFT, LH, and FSH were reduced; levels of E2 were elevated. At 6 months from surgery, the median BMI dropped to 34.8 [31.7–40.5] kg/m2, TT, SHBG, cFT, LH, and FSH increased, while levels of E2 decreased. The improvement in the sex hormone profile was more evident in younger patients, with a statistically significant difference in cFT following surgery and in the raise of TT and cFT between the groups of patients below and above 35 years. At multivariate analysis, the age was the best predictive factor of the postoperative variations of TT.

Conclusions

These preliminary results confirm the general improvement in sex hormone profile in obese men after bariatric surgery and introduce the age as a possible contributing factor to this improvement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Flegal KM. Epidemiologic aspects of overweight and obesity in the United States. Physiol Behav. 2005;86(5):599–602.

    Article  PubMed  CAS  Google Scholar 

  2. Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295(13):1549–55.

    Article  PubMed  CAS  Google Scholar 

  3. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  4. Alagna S, Cossu ML, Gallo P, et al. Biliopancreatic diversion: long-term effects on gonadal function in severely obese men. Surg Obes Relat Dis. 2006;2(2):82–6.

    Article  PubMed  Google Scholar 

  5. Facchiano E, Iannelli A, Santulli P, et al. Pregnancy after laparoscopic bariatric surgery: comparative study of adjustable gastric banding and Roux-en-Y gastric bypass. Surg Obes Relat, Dis. 2011;8(4):429–33.

    Article  Google Scholar 

  6. Cabler S, Agarwal A, Flint M, et al. Obesity: modern man's fertility nemesis. Asian J Androl. 2010;12(4):480–9.

    Article  PubMed  Google Scholar 

  7. Hammoud AO, Gibson M, Peterson CM, et al. Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril. 2008;90(4):897–904.

    Article  PubMed  Google Scholar 

  8. Rao SR, Kini S, Tamler R. Sex hormones and bariatric surgery in men. Gend Med. 2011;8(5):300–11.

    Article  PubMed  Google Scholar 

  9. Kaukua J, Pekkarinen T, Sane T, et al. Sex hormones and sexual function in obese men losing weight. Obes Res. 2003;11(6):689–94.

    Article  PubMed  CAS  Google Scholar 

  10. Stanik S, Dornfeld LP, Maxwell MH, et al. The effect of weight loss on reproductive hormones in obese men. J Clin Endocrinol Metab. 1981;53(4):828–32.

    Article  PubMed  CAS  Google Scholar 

  11. Hammoud A, Gibson M, Hunt SC, et al. Effect of Roux-en-Y gastric bypass surgery on the sex steroids and quality of life in obese men. J Clin Endocrinol Metab. 2009;94(4):1329–32.

    Article  PubMed  CAS  Google Scholar 

  12. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84(10):3666–72.

    Article  PubMed  CAS  Google Scholar 

  13. Iannelli A, Facchiano E, Gugenheim J. Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2006;16(10):1265–71.

    Article  PubMed  Google Scholar 

  14. Scopinaro N, Gianetta E, Civalleri D, et al. Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg. 1979;66(9):618–20.

    Article  PubMed  CAS  Google Scholar 

  15. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg. 1998;22(9):936–46.

    Article  PubMed  CAS  Google Scholar 

  16. Reis LO, Favaro WJ, Barreiro GC, et al. Erectile dysfunction and hormonal imbalance in morbidly obese male is reversed after gastric bypass surgery: a prospective randomized controlled trial. Int J Androl. 2010;33(5):736–44.

    Article  PubMed  CAS  Google Scholar 

  17. Bastounis EA, Karayiannakis AJ, Syrigos K, et al. Sex hormone changes in morbidly obese patients after vertical banded gastroplasty. Eur Surg Res. 1998;30(1):43–7.

    Article  PubMed  CAS  Google Scholar 

  18. Globerman H, Shen-Orr Z, Karnieli E, et al. Inhibin B in men with severe obesity and after weight reduction following gastroplasty. Endocr Res. 2005;31(1):17–26.

    Article  PubMed  CAS  Google Scholar 

  19. Pasquali R, Pelusi C, Genghini S, et al. Obesity and reproductive disorders in women. Hum Reprod Update. 2003;9(4):359–72.

    Article  PubMed  Google Scholar 

  20. Roth MY, Amory JK, Page ST. Treatment of male infertility secondary to morbid obesity. Nat Clin Pract Endocrinol Metab. 2008;4(7):415–9.

    Article  PubMed  Google Scholar 

  21. Akingbemi BT. Estrogen regulation of testicular function. Reprod Biol Endocrinol. 2005;3:51.

    Article  PubMed  Google Scholar 

  22. Giagulli VA, Kaufman JM, Vermeulen A. Pathogenesis of the decreased androgen levels in obese men. J Clin Endocrinol Metab. 1994;79(4):997–1000.

    Article  PubMed  CAS  Google Scholar 

  23. Tsai EC, Matsumoto AM, Fujimoto WY, et al. Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat. Diabetes Care. 2004;27(4):861–8.

    Article  PubMed  CAS  Google Scholar 

  24. Gautier JF, Choukem SP, Girard J. Physiology of incretins (GIP and GLP-1) and abnormalities in type 2 diabetes. Diabetes Metab. 2008;34 Suppl 2:S65–72.

    Article  PubMed  CAS  Google Scholar 

  25. Haffner SM, Karhapaa P, Mykkanen L, et al. Insulin resistance, body fat distribution, and sex hormones in men. Diabetes. 1994;43(2):212–9.

    Article  PubMed  CAS  Google Scholar 

  26. Stellato RK, Feldman HA, Hamdy O, et al. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care. 2000;23(4):490–4.

    Article  PubMed  CAS  Google Scholar 

  27. Patriti A, Facchiano E, Sanna A, et al. The enteroinsular axis and the recovery from type 2 diabetes after bariatric surgery. Obes Surg. 2004;14(6):840–8.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no proprietary, financial, professional, or other personal interest of any nature or kind in any product or service that may influence the position presented.

Author information

Authors and Affiliations

  1. Bariatric and Metabolic Surgery Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy

    Enrico Facchiano, Stefano Scaringi, Marco Veltri & Marcello Lucchese

  2. Department of Clinical Physiopathology, Endocrinology Unit, University of Florence, Florence, Italy

    Jinous Samavat, Gianni Forti & Michaela Luconi

  3. Department of Clinical Physiopathology, Sexual Medicine and Andrology Unit, University of Florence, Florence, Italy

    Mario Maggi

Authors
  1. Enrico Facchiano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefano Scaringi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marco Veltri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jinous Samavat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mario Maggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gianni Forti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michaela Luconi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marcello Lucchese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Enrico Facchiano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Facchiano, E., Scaringi, S., Veltri, M. et al. Age as a Predictive Factor of Testosterone Improvement in Male Patients After Bariatric Surgery: Preliminary Results of a Monocentric Prospective Study. OBES SURG 23, 167–172 (2013). https://doi.org/10.1007/s11695-012-0753-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-012-0753-6

Keywords

Search

Navigation