Skip to main content

Advertisement

SpringerLink
Log in

Reduced Circulating Androgen Levels After Gastric Bypass Surgery in Severely Obese Women

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

Abstract

Background

Previous studies have shown a reduction of elevated androgen levels in premenopausal women after marked weight loss induced by bariatric surgery. In this study, we aimed to assess whether circulating androgen levels also decline after bariatric surgery in women displaying normal values preoperatively as well as in postmenopausal women.

Methods

In 36 severely obese women (six postmenopausal), levels of total testosterone, dehydroepiandresterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) were assessed before and at ~1 year after gastric bypass. Free and bioavailable testosterone levels as well as the free androgen index were calculated by established formulas.

Results

After the surgery, women had lost on average 43.1 ± 1.8 kg. Independently of the pre/postmenopausal state, women showed a marked reduction in all testosterone-related androgen markers and DHEA-S levels, while SHBG levels markedly increased (all P < 0.001). Respective changes were found in both women with and without preoperatively elevated levels. Changes after the surgery in testosterone-related markers as well as in SHBG levels but not in DHEA-S levels were correlated with changes in insulin levels independently of body weight changes.

Conclusions

Data show a marked reduction of androgen levels in severely obese women after a surgically induced weight loss, which is independent from the menopausal state and preoperative levels. The mechanisms and consequences of these hormonal changes induced by bariatric surgery should be addressed in further studies.

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

Similar content being viewed by others

References

  1. Norman RJ, Dewailly D, Legro RS, et al. Polycystic ovary syndrome. Lancet. 2007;370:685–97.

    Article  PubMed  CAS  Google Scholar 

  2. Samojlik E, Kirschner MA, Silber D, et al. Elevated production and metabolic clearance rates of androgens in morbidly obese women. J Clin Endocrinol Metab. 1984;59:949–54.

    Article  PubMed  CAS  Google Scholar 

  3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–7.

    Article  Google Scholar 

  4. Gambineri A, Pelusi C, Vicennati V, et al. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord. 2002;26:883–96.

    Article  PubMed  CAS  Google Scholar 

  5. Wild RA. Obesity, lipids, cardiovascular risk, and androgen excess. Am J Med. 1995;98:27S–32S.

    Article  PubMed  CAS  Google Scholar 

  6. Goodman-Gruen D, Barrett-Connor E. Sex hormone-binding globulin and glucose tolerance in postmenopausal women. The Rancho Bernardo Study. Diabetes Care. 1997;20:645–9.

    Article  PubMed  CAS  Google Scholar 

  7. Haffner SM, Katz MS, Stern MP, et al. The relationship of sex hormones to hyperinsulinemia and hyperglycemia. Metabolism. 1988;37:683–8.

    Article  PubMed  CAS  Google Scholar 

  8. Pasquali R, Casimirri F, Plate L, et al. Characterization of obese women with reduced sex hormone-binding globulin concentrations. Horm Metab Res. 1990;22:303–6.

    Article  PubMed  CAS  Google Scholar 

  9. Preziosi P, Barrett-Connor E, Papoz L, et al. Interrelation between plasma sex hormone-binding globulin and plasma insulin in healthy adult women: the telecom study. J Clin Endocrinol Metab. 1993;76:283–7.

    Article  PubMed  CAS  Google Scholar 

  10. Soler JT, Folsom AR, Kaye SA, et al. Associations of abdominal adiposity, fasting insulin, sex hormone binding globulin, and estrone with lipids and lipoproteins in post-menopausal women. Atherosclerosis. 1989;79:21–7.

    Article  PubMed  CAS  Google Scholar 

  11. Tchernof A, Toth MJ, Poehlman ET. Sex hormone-binding globulin levels in middle-aged premenopausal women. Associations with visceral obesity and metabolic profile. Diabetes Care. 1999;22:1875–81.

    Article  PubMed  CAS  Google Scholar 

  12. Brolin RE. Bariatric surgery and long-term control of morbid obesity. JAMA. 2002;288:2793–6.

    Article  PubMed  Google Scholar 

  13. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  14. Buchwald H. Bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. J Am Coll Surg. 2005;200:593–604.

    Article  PubMed  Google Scholar 

  15. Fisher BL, Schauer P. Medical and surgical options in the treatment of severe obesity. Am J Surg. 2002;184:9S–16S.

    Article  PubMed  Google Scholar 

  16. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.

    PubMed  Google Scholar 

  17. Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F, et al. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90:6364–9.

    Article  PubMed  CAS  Google Scholar 

  18. Kopp HP, Krzyzanowska K, Schernthaner GH, et al. Relationship of androgens to insulin resistance and chronic inflammation in morbidly obese premenopausal women: studies before and after vertical banded gastroplasty. Obes Surg. 2006;16:1214–20.

    Article  PubMed  Google Scholar 

  19. Dixon JB, O'Brien PE. Neck circumference a good predictor of raised insulin and free androgen index in obese premenopausal women: changes with weight loss. Clin Endocrinol. 2002;57:769–78.

    Article  CAS  Google Scholar 

  20. Barba M, Schunemann HJ, Sperati F, et al. The effects of metformin on endogenous androgens and SHBG in women: a systematic review and meta-analysis. Clin Endocrinol (Oxf). 2009;70:661–70.

    Article  CAS  Google Scholar 

  21. 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;84:3666–72.

    Article  PubMed  CAS  Google Scholar 

  22. Carter GD, Holland SM, Alaghband-Zadeh J, et al. Investigation of hirsutism: testosterone is not enough. Ann Clin Biochem. 1983;20:262–3.

    PubMed  Google Scholar 

  23. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  PubMed  CAS  Google Scholar 

  24. Kupelian V, Page ST, Araujo AB, et al. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab. 2006;91:843–50.

    Article  PubMed  CAS  Google Scholar 

  25. Ding EL, Song Y, Manson JE, et al. Sex hormone-binding globulin and risk of type 2 diabetes in women and men. N Engl J Med. 2009;361:1152–63.

    Article  PubMed  CAS  Google Scholar 

  26. Pasquali R, Vicennati V, Gambineri A, et al. Sex-dependent role of glucocorticoids and androgens in the pathophysiology of human obesity. Int J Obes (Lond). 2008;32:1764–79.

    Article  CAS  Google Scholar 

  27. Davis SR, Shah SM, McKenzie DP, et al. Dehydroepiandrosterone sulfate levels are associated with more favorable cognitive function in women. J Clin Endocrinol Metab. 2008;93:801–8.

    Article  PubMed  CAS  Google Scholar 

  28. Stewart PM. Aging and fountain-of-youth hormones. N Engl J Med. 2006;355:1724–6.

    Article  PubMed  CAS  Google Scholar 

  29. Voznesensky M, Walsh S, Dauser D, et al. The association between dehydroepiandosterone and frailty in older men and women. Age Ageing. 2009;38:401–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

No conflicts of interest were declared by any of the authors: BE, BW, MT, and BS.

Author information

Authors and Affiliations

  1. Interdisciplinary Obesity Center, Kantonsspital St. Gallen, Heidener Strasse 11, 9400, Rorschach, Switzerland

    Barbara Ernst, Britta Wilms, Martin Thurnheer & Bernd Schultes

Authors
  1. Barbara Ernst
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Britta Wilms
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Thurnheer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernd Schultes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bernd Schultes.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ernst, B., Wilms, B., Thurnheer, M. et al. Reduced Circulating Androgen Levels After Gastric Bypass Surgery in Severely Obese Women. OBES SURG 23, 602–607 (2013). https://doi.org/10.1007/s11695-012-0823-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-012-0823-9

Keywords

Search

Navigation