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Circulating free testosterone in obese men after bariatric surgery increases in parallel with insulin sensitivity

Journal of Endocrinological Investigation volume 36, pages 227–232 (2013)Cite this article

Abstract

Background and aim: Male hypogonadism has been linked to obesity and diabetes. We aimed to study the association of changes in insulin sensitivity and testosterone levels in severe obese patients submitted to bariatric surgery. Subjects and methods: Prospective intervention study with twenty consecutive patients who underwent bariatric surgery studied before and after significant weight loss. Serum testosterone, SHBG, fasting glucose, and insulin were measured among others. Free testosterone was calculated with the Vermeulen formula and insulin sensitivity with the homeostatic model assessment (HOMA). Results: At baseline, thirteen patients had low total testosterone levels, whereas eight of these patients also had free testosterone levels below the reference range obtained from the control group. After bariatric surgery total testosterone, SHBG, and free testosterone significantly increased and achieved normal values in all evaluated patients. Insulin sensitivity improved in all of them. Multivariate linear regression showed that changes in fasting glucose (β=−1.868, p= 0.001), insulin (β=−3.782, p= 0.001), weight (β=−0.622, p= 0.002), and SHBG (β=−0.635, p= 0.022) were associated with changes in free testosterone (adjusted R2 =0.936, F=26.613, p= 0.001). When insulin resistance calculated by HOMA was in the model instead of insulin and glucose, it also was associated (β=−3.488, p= 0.008) with free testosterone (adjusted R2 =0.821, F=11.111, p= 0.005). Conclusion: Circulating testosterone in obese men increases after bariatric surgery in parallel with an improvement in insulin sensitivity.

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Authors and Affiliations

  1. Unit of Clinical Nutrition and Obesity, Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain

    J. I. Botella-Carretero MD, PhD, J. A. Balsa, J. M. Gómez-Martin, M. Carrasco, F. Arrieta, I. Zamarron & C. Vazquez

  2. Centro de Investigación Biomédica en Red de Fisiopatología de Obesidad y Nutrición (CIBERobn), Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain

    J. I. Botella-Carretero MD, PhD, J. A. Balsa, L. Huerta, F. Arrieta, I. Zamarron, A. Martin-Hidalgo & C. Vazquez

  3. Department of General Surgery, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain

    R. Peromingo

  4. Department of Biochemistry-Investigation, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain

    L. Huerta & A. Martin-Hidalgo

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  1. J. I. Botella-Carretero MD, PhD
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Correspondence to J. I. Botella-Carretero MD, PhD.

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Botella-Carretero, J.I., Balsa, J.A., Gómez-Martin, J.M. et al. Circulating free testosterone in obese men after bariatric surgery increases in parallel with insulin sensitivity. J Endocrinol Invest 36, 227–232 (2013). https://doi.org/10.3275/8469

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