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Endocrine changes (beyond diabetes) after bariatric surgery in adult life

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Abstract

Bariatric surgery is nowadays an effective therapeutic option for morbid obesity. Endocrinologists may thus have a growing opportunity to diagnose and treat obese patients eligible for surgery in pre- and post-operative phase. This requires a better understanding of endocrine changes caused by either obesity or weight loss surgery. Despite the large number of studies available in literature, only limited well-designed clinical trials have been performed so far to investigate changes of endocrine axes following bariatric procedures. There are still areas of unclear results such as female and male fertility, however, weight loss after bariatric surgery is considered to be associated with favorable effects on most endocrine axes. The aim of this clinical review is to overview the available literature on the effects of weight loss after bariatric surgery on the endocrine systems to suggest the most appropriate pre- and post-operative management of obese patients undergoing bariatric surgery in terms of “endocrine” health.

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References

  1. Park H, Ahima RS. Classical Hormones Linked to Obesity. In: Ahima RS (ed). Metabolic Basis of Obesity. New York: Springer Science & Business Media, LLC. 2011, 139–54.

    Google Scholar 

  2. Fierabracci P, Pinchera A, Martinelli S, et al. Prevalence of endocrine diseases in morbidly obese patients scheduled for bariatric surgery: beyond diabetes. Obes Surg 2011, 21: 54–60.

    PubMed  Google Scholar 

  3. Björntorp P, Rosmond R. Neuroendocrine abnormalities in visceral obesity. Int J Obes Relat Metab Disord 2000, 24 (Suppl): S80–5.

    PubMed  Google Scholar 

  4. Franco C, Bengtsson BA, Johannsson G. The GH/IGF-1 axis in obesity: physiological and pathological aspects. Metab Syndr Relat Disord 2006, 4: 51–6.

    PubMed  Google Scholar 

  5. Savastano S, Di Somma C, Belfiore A, et al. Growth hormone status in morbidly obese subjects and correlation with body composition. J Endocrinol Invest 2006, 29: 536–43.

    PubMed  Google Scholar 

  6. Buchwald H, Ikramuddin S, Dorman RB, Schone JL, Dixon JB. Management of the metabolic/bariatric surgery patient. Am J Med 2011, 124: 1099–105.

    PubMed  Google Scholar 

  7. Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev 2009, 2: CD003641.

    PubMed  Google Scholar 

  8. Angrisani L, Cutolo PP, Buchwald JN, et al. Laparoscopic reinforced sleeve gastrectomy: early results and complications. Obes Surg 2011, 21: 783–93.

    PubMed  Google Scholar 

  9. Papailiou J, Albanopoulos K, Toutouzas KG, Tsigris C, Nikiteas N, Zografos G. Morbid obesity and sleeve gastrectomy: how does it work? Obes Surg 2010, 20: 1448–55.

    PubMed  Google Scholar 

  10. Sjöström L, Gummesson A, Sjöström CD, et al; Swedish Obese Subjects Study. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 2009, 10: 653–62.

    PubMed  Google Scholar 

  11. Dorman RB, Serrot FJ, Miller CJ, et al. Case-matched outcomes in bariatric surgery for treatment of type 2 diabetes in the morbidly obese patient. Ann Surg 2012, 255: 287–93.

    PubMed  Google Scholar 

  12. Castagneto-Gissey L, Mingrone G. Insulin sensitivity and secretion modifications after bariatric surgery. J Endocrinol Invest 2012, 35: 692–8.

    PubMed  Google Scholar 

  13. Kreitschmann-Andermahr I, Suarez P, Jennings R, Evers N, Brabant G. GH/IGF-I regulation in obesity mechanisms and practical consequences in children and adults. Horm Res Paediatr 2010, 73: 153–60.

    PubMed  Google Scholar 

  14. Prodam F, Pagano L, Corneli G, et al. Update on epidemiology, etiology, and diagnosis of adult growth hormone deficiency. J Endocrinol Invest 2008, 31: 6–11.

    PubMed  Google Scholar 

  15. Hazem A, Elamin MB, Bancos I, et al. Body composition and quality of life in adults treated with GH therapy: a systematic review and meta-analysis. Eur J Endocrinol 2012, 166: 13–20.

    PubMed  Google Scholar 

  16. Cornford AS, Barkan AL, Horowitz JF. Rapid suppression of growth hormone concentration by overeating: potential mediation by hyperinsulinemia. J Clin Endocrinol Metab 2011, 96: 824–30.

    PubMed Central  PubMed  Google Scholar 

  17. Vijayakumar A, Yakar S, Leroith D. The intricate role of growth hormone in metabolism. Front Endocrinol (Lausanne) 2011, 2: 32–42.

    Google Scholar 

  18. Di Somma C, Savastano S, Rota F, et al. Appropriate use of stimulation tests and insulin-like growth factor-I in obesity. J Endocrinol Invest (Suppl) 2008, 31: 21–6.

    PubMed  Google Scholar 

  19. Bredella MA, Torriani M, Thomas BJ, et al. Peak growth hormone-releasing hormone-arginine-stimulated growth hormone is inversely associated with intramyocellular and intrahepatic lipid content in premenopausal women with obesity. J Clin Endocrinol Metab 2009, 94: 3995–4002.

    PubMed Central  PubMed  Google Scholar 

  20. Savastano S, Di Somma C, Pizza G, et al. Liver-spleen axis, insulinlike growth factor-(IGF)-I axis and fat mass in overweight/obese females. J Transl Med 2011, 9: 136–43.

    PubMed Central  PubMed  Google Scholar 

  21. Rasmussen MH. Obesity, growth hormone and weight loss. Mol Cell Endocrinol 2010, 316: 147–53.

    PubMed  Google Scholar 

  22. Di Somma C, Pivonello R, Pizza G, et al. Prevalence of the metabolic syndrome in moderately-severely obese subjects with and without growth hormone deficiency. J Endocrinol Invest 2010, 33: 171–7.

    PubMed  Google Scholar 

  23. Mekala KC, Tritos NA. Effects of recombinant human growth hormone therapy in obesity in adults: a meta analysis. J Clin Endocrinol Metab 2009, 94: 130–7.

    PubMed  Google Scholar 

  24. Valera Mora ME, Manco M, Capristo E, et al. Growth hormone and ghrelin secretion in severely obese women before and after bariatric surgery. Obesity (Silver Spring) 2007, 15: 2012–8.

    Google Scholar 

  25. Camastra S, Manco M, Frascerra S, Iaconelli A, Mingrone G, Ferrannini E. Daylong pituitary hormones in morbid obesity: effects of bariatric surgery. Int J Obes (Lond) 2009, 33: 166–72.

    Google Scholar 

  26. Mancini MC, Costa AP, de Melo ME, et al. Effect of gastric bypass on spontaneous growth hormone and ghrelin release profiles. Obesity (Silver Spring) 2006, 14: 383–7.

    Google Scholar 

  27. Mitterberger MC, Mattesich M, Klaver E, Piza-Katzer H, Zwerschke W. Reduced insulin-like growth factor-I serum levels in formerly obese women subjected to laparoscopic-adjustable gastric banding or diet-induced long-term caloric restriction. J Gerontol A Biol Sci Med Sci 2011, 66: 1169–77.

    PubMed  Google Scholar 

  28. De Marinis L, Bianchi A, Mancini A, et al. Growth hormone secretion and leptin in morbid obesity before and after biliopancreatic diversion: relationships with insulin and body composition. J Clin Endocrinol Metab 2004, 89: 174–80.

    PubMed  Google Scholar 

  29. Edén Engström B, Burman P, Holdstock C, Ohrvall M, Sundbom M, Karlsson FA. Effects of gastric bypass on the GH/IGF-I axis in severe obesity- and a comparison with GH deficiency. Eur J Endocrinol 2006, 154: 53–9.

    PubMed  Google Scholar 

  30. Di Somma C, Angrisani L, Rota F, et al. GH and IGF-I deficiency are associated with reduced loss of fat mass after laparoscopic-adjustable silicone gastric banding. Clin Endocrinol (Oxf) 2008, 69: 393–9.

    Google Scholar 

  31. Savastano S, Angrisani L, Di Somma C, et al. Relationship between growth hormone/insulin-like growth factor-1 axis integrity and voluntary weight loss after gastric banding surgery for severe obesity. Obes Surg 2010, 20: 211–20.

    PubMed  Google Scholar 

  32. Savastano S, Di Somma C, Angrisani L, et al. Growth hormone treatment prevents loss of lean mass after bariatric surgery in morbidly obese patients: results of a pilot, open, prospective, randomized, controlled study. J Clin Endocrinol Metab. 2009, 94: 817–26.

    PubMed  Google Scholar 

  33. Lecube A, Vilallonga R, Sturniolo G, Obiols G, Fort JM. Renaissance of acromegaly after bariatric surgery. Endocrine 2013, 43: 239–41.

    PubMed  Google Scholar 

  34. Pasquali R, Parenti M, Mattioli L, et al. Effect of dietary carbohydrates during hypocaloric treatment of obesity on peripheral thyroid hormone metabolism. J Endocrinol Invest 1982, 5: 47–52.

    PubMed  Google Scholar 

  35. Fox CS, Pencina MJ, D’Agostino RB, et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med 2008, 168: 587–92.

    PubMed  Google Scholar 

  36. Biondi B. Thyroid and obesity: an intriguing relationship. J Clin Endocrinol Metab 2010, 95: 3614–7.

    PubMed  Google Scholar 

  37. Rotondi M, Leporati P, La Manna A, et al. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism? Eur J Endocrinol 2009, 160: 403–8.

    PubMed  Google Scholar 

  38. De Pergola G, Ciampolillo A, Paolotti S, Trerotoli P, Giorgino R. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrinol (Oxf) 2007, 67: 265–9.

    Google Scholar 

  39. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol (Oxf) 2005, 62: 487–91.

    Google Scholar 

  40. Marzullo P, Minocci A, Tagliaferri MA, et al. Investigations of thyroid hormones and antibodies in obesity: leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants. J Clin Endocrinol Metab 2010, 95: 3965–72.

    PubMed  Google Scholar 

  41. Nannipieri M, Cecchetti F, Anselmino M, et al. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss. Int J Obes(Lond) 2009, 33: 1001–6.

    Google Scholar 

  42. Kok P, Roelfsema F, Langendonk JG, et al. High circulating thyrotropin levels in obese women are reduced after body weight loss induced by caloric restriction. J Clin Endocrinol Metab 2005, 90: 4659–63.

    PubMed  Google Scholar 

  43. Vettor R, Mingrone G, Manco M, et al. Reduced expression of uncoupling proteins-2 and -3 in adipose tissue in post-obese patients submitted to biliopancreatic diversion. Eur J Endocrinol 2003, 148: 543–50.

    PubMed  Google Scholar 

  44. Ravussin E, Lillioja S, Knowler WC, et al. Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med 1988, 318: 467–72.

    PubMed  Google Scholar 

  45. Dall’Asta C, Paganelli M, Morabito A, et al. Weight loss through gastric banding: effects on TSH and thyroid hormones in obese subjects with normal thyroid function. Obesity (Silver Spring) 2010, 18: 854–7.

    Google Scholar 

  46. Lechan RM, Fekete C Role of thyroid hormone deiodination in the hypothalamus. Thyroid 2005, 15: 883–97.

    PubMed  Google Scholar 

  47. Jankovic D, Wolf P, Anderwald CH, et al. Prevalence of endocrine disorders in morbidly obese patients and the effects of bariatric surgery on endocrine and metabolic parameters. Obes Surg 2012, 22: 62–9.

    PubMed  Google Scholar 

  48. Segal JB, Clark JM, Shore AD, et al. Prompt reduction in use of medications for comorbid conditions after bariatric surgery. Obes Surg 2009, 19: 1646–56.

    PubMed  Google Scholar 

  49. Santini F, Pinchera A, Marsili A, et al. Lean body mass is a major determinant of levothyroxine dosage in the treatment of thyroid diseases. J Clin Endocrinol Metab 2005, 90: 124–7.

    PubMed  Google Scholar 

  50. Andrew R, Gale CR, Walker BR, Seckl JR, Martyn CN. Glucocorticoid metabolism and the Metabolic Syndrome: associations in an elderly cohort. Exp Clin Endocrinol Diabetes 2002, 110: 284–90.

    PubMed  Google Scholar 

  51. Björntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obes Rev 2001, 2: 73–86.

    PubMed  Google Scholar 

  52. Classen JB. Review of evidence that epidemics of type 1 diabetes and type 2 diabetes/metabolic syndrome are polar opposite responses to iatrogenic inflammation. Curr Diabetes Rev 2012, 8: 413–8.

    PubMed  Google Scholar 

  53. Rask E, Simonyte K, Lönn L, Axelson M. Cortisol metabolism after weight loss-associations with 11 β-HSD type 1 and markers of obesity in women. Clin Endocrinol (Oxf) 2012, Jan 10 [Epub ahead of print]; doi: 10.1111/j.1365-2265.2012.04333.x.

  54. Mariniello B, Ronconi V, Rilli S, et al. Adipose tissue 11beta-hy-droxysteroid dehydrogenase type 1 expression in obesity and Cushing’s syndrome. Eur J Endocrinol 2006, 155: 435–41.

    PubMed  Google Scholar 

  55. Drapeau V, Therrien F, Richard D, Tremblay A. Is visceral obesity a physiological adaptation to stress? Panminerva Med 2003, 45: 189–95.

    PubMed  Google Scholar 

  56. Bujalska IJ, Kumar S, Stewart PM. Does central obesity reflect “Cushing’s disease of the omentum”? Lancet 1997, 349: 1210–3.

    PubMed  Google Scholar 

  57. Vogelzangs N, Beekman AT, Milaneschi Y, Bandinelli S, Ferrucci L, Penninx BW. Urinary cortisol and six-year risk of all-cause and cardiovascular mortality. J Clin Endocrinol Metab 2010, 95: 4959–64.

    PubMed Central  PubMed  Google Scholar 

  58. De Leo M, Cozzolino A, Colao A, Pivonello R. Subclinical Cushing’s syndrome. Best Pract Res Clin Endocrinol Metab 2012, 26: 497–505.

    PubMed  Google Scholar 

  59. De Pergola G, Zamboni M, Sciaraffia M, et al. Body fat accumulation is possibly responsible for lower dehydroepiandrosterone circulating levels in premenopausal obese women. Int J Obes Relat Metab Disord 1996, 20: 1105–10.

    PubMed  Google Scholar 

  60. Nestler JE. Regulation of human dehydroepiandrosterone metabolism by insulin. Ann NY Acad Sci 1995, 774: 73–81.

    PubMed  Google Scholar 

  61. Kalimi M, Shafagoj Y, Loria R, Padgett D, Regelson W. Anti-glucocorticoid effects of dehydroepiandrosterone (DHEA). Mol Cell Biochem 1994, 131: 99–104.

    PubMed  Google Scholar 

  62. Fontana L. Neuroendocrine factors in the regulation of inflammation: excessive adiposity and calorie restriction. Exp Gerontol 2009, 44: 41–5.

    PubMed Central  PubMed  Google Scholar 

  63. Tomlinson JW, Finney J, Hughes BA, Hughes SV, Stewart PM. Reduced glucocorticoid production rate, decreased 5alpha-reductase activity, and adipose tissue insulin sensitization after weight loss. Diabetes 2008, 57: 1536–43.

    PubMed  Google Scholar 

  64. Ram E, Vishne T, Diker D, et al. Impact of gastric banding on plasma ghrelin, growth hormone, cortisol, DHEA and DHEA-S levels. Obes Surg 2005, 15: 1118–23.

    PubMed  Google Scholar 

  65. Savastano S, Belfiore A, Guida B, et al. Role of dehydroepiandrosterone sulfate levels on body composition after laparoscopic adjustable gastric banding in pre-menopausal morbidly obese women. J Endocrinol Invest 2005, 28: 509–15.

    PubMed  Google Scholar 

  66. Manco M, Fernández-Real JM, Valera-Mora ME, et al. Massive weight loss decreases corticosteroid-binding globulin levels and increases free cortisol in healthy obese patients: an adaptive phenomenon? Diabetes Care 2007, 30: 1494–500.

    PubMed  Google Scholar 

  67. le Roux CW, Sivakumaran S, Alaghband-Zadeh J, Dhillo W, Kong WM, Wheeler MJ. Free cortisol index as a surrogate marker for serum free cortisol. Ann Clin Biochem 2002, 39: 406–8.

    PubMed  Google Scholar 

  68. Stephens JW, Boregowda K, Barry J, Price DE, Eyre N, Baxter JN. Adrenal insufficiency following bariatric surgery. Obes Rev 2012, 13: 560–2.

    PubMed  Google Scholar 

  69. Tiryakioglu O, Ugurlu S, Yalin S, et al. Screening for Cushing’s syndrome in obese patients. Clinics (Sao Paulo) 2010, 65: 9–13.

    Google Scholar 

  70. Newell-Price J, Bertagna X, Grossman AB, Nieman LK. Cushing’s syndrome. Lancet 2006, 367: 1605–17.

    PubMed  Google Scholar 

  71. Fleseriu M, Ludlam WH, Teh SH, Yedinak CG, Deveney C, Sheppard BC. Cushing’s syndrome might be underappreciated in patients seeking bariatric surgery: a plea for screening. Surg Obes Relat Dis 2009, 5: 116–9.

    PubMed  Google Scholar 

  72. Savastano S, Pivonello R, Colao A. Bariatric surgery for obesity and hidden Cushing syndrome. Surg Obes Relat Dis 2009, 5: 121–2.

    PubMed  Google Scholar 

  73. Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2008, 93: 1526–40.

    PubMed Central  PubMed  Google Scholar 

  74. Pasquali R, Patton L, Gambineri A. Obesity and infertility. Curr Opin Endocrinol Diabetes Obes 2007, 14: 482–7.

    PubMed  Google Scholar 

  75. Brewer CJ, Balen AH. The adverse effects of obesity on conception and implantation. Reproduction 2010, 140: 347–64.

    PubMed  Google Scholar 

  76. Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN; PCOS/Troglitazone Study Group. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006, 91: 48–53.

    PubMed  Google Scholar 

  77. Practice Committee of American Society for Reproductive Medicine. Obesity and reproduction: an educational bulletin. Fertil Steril 2008, 90: S21–9.

    Google Scholar 

  78. Guelinckx I, Devlieger R, Vansant G. Reproductive outcome after bariatric surgery: a critical review. Hum Reprod Update 2009, 15: 189–201.

    PubMed  Google Scholar 

  79. Tsoi E, Shaikh H, Robinson S, Teoh TG. Obesity in pregnancy: a major healthcare issue. Postgrad Med J 2010, 86: 617–23.

    PubMed  Google Scholar 

  80. Gosman GG, King WC, Schrope B, et al. Reproductive health of women electing bariatric surgery. Fertil Steril 2010, 94: 1426–31.

    PubMed Central  PubMed  Google Scholar 

  81. Bergholt T, Lim LK, Jørgensen JS, Robson MS. Maternal body mass index in the first trimester and risk of cesarean delivery in nulli-parous women in spontaneous labor. Am J Obstet Gynecol 2007, 196: 163.e1–5.

    Google Scholar 

  82. Crosignani PG, Vegetti W, Colombo M, Ragni G. Resumption of fertility with diet in overweight women. Reprod Biomed Online 2002, 5: 60–4.

    PubMed  Google Scholar 

  83. Magdaleno R jr, Pereira BG, Chaim EA, Turato ER. Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges. Arch Gynecol Obstet 2012, 285: 559–66.

    PubMed  Google Scholar 

  84. Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg 2006, 16: 1457–63.

    PubMed  Google Scholar 

  85. Musella M, Milone M, Bellini M, Sosa Fernandez LM, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surg Obes Relat Dis 2012, 8: 445–9.

    PubMed  Google Scholar 

  86. Dokras A, Baredziak L, Blaine J, Syrop C, VanVoorhis BJ, Sparks A. Obstetric outcomes after in vitro fertilization in obese and morbidly obese women. Obstet Gynecol 2006, 108: 61–9.

    PubMed  Google Scholar 

  87. Doblado MA, Lewkowksi BM, Odem RR, Jungheim ES. In vitro fertilization after bariatric surgery. Fertil Steril 2010, 94: 2812–14.

    PubMed Central  PubMed  Google Scholar 

  88. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA 2008, 300: 2286–96.

    PubMed  Google Scholar 

  89. Dalfrà MG, Busetto L, Chilelli NC, Lapolla A. Pregnancy and foetal outcome after bariatric surgery: a review of recent studies. J Matern Fetal Neonatal Med 2012, 25: 1537–43.

    PubMed  Google Scholar 

  90. Friedman D, Cuneo S, Valenzano M, et al. Pregnancies in an 18-year follow-up after biliopancreatic diversion Obes Surg 1995, 5: 308–13.

    PubMed  Google Scholar 

  91. Sheiner E, Levy A, Silverberg D, et al. Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. Am J Obstet Gynecol 2004, 190: 1335–40.

    PubMed  Google Scholar 

  92. Marceau P, Kaufman D, Biron S, et al. Outcome of pregnancies after biliopancreatic diversion. Obes Surg 2004, 14: 318–24.

    PubMed  Google Scholar 

  93. Patel JA, Patel NA, Thomas RL, Nelms JK, Colella JJ. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 2008, 4: 39–45.

    PubMed  Google Scholar 

  94. Dixon JB, Dixon ME, O’Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol 2005, 106: 965–72.

    PubMed  Google Scholar 

  95. Kral JG, Biron S, Simard S, et al. Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years. Pediatrics 2006, 118: 1644–9.

    Google Scholar 

  96. Ducarme G, Revaux A, Rodrigues A, Aissaoui F, Pharisien I, Uzan M. Obstetric outcome following laparoscopic adjustable gastric banding. Int J Gynaecol Obstet 2007, 98: 244–7.

    PubMed  Google Scholar 

  97. Bar-Zohar D, Azem F, Klausner J, Abu-Abeid S. Pregnancy after laparoscopic adjustable gastric banding: perinatal outcome is favorable also for women with relatively high gestational weight gain. Surg Endosc 2006, 20: 1580–3.

    PubMed  Google Scholar 

  98. Skull AJ, Slater GH, Duncombe JE, Fielding GA. Laparoscopic adjustable banding in pregnancy: safety, patient tolerance and effect on obesity-related pregnancy outcomes. Obes Surg 2004, 14: 230–5

    PubMed  Google Scholar 

  99. Wax JR, Heersink D, Pinette MG, Cartin A, Blackstone J. Symptomatic hypoglycemia complicating pregnancy following Roux-en-Y gastric bypass surgery. Obes Surg 2007, 17: 698–700.

    PubMed  Google Scholar 

  100. Beard JH, Bell RL, Duffy AJ. Reproductive considerations and pregnancy after bariatric surgery: current evidence and recommendations. Obes Surg 2008, 18: 1023–7.

    PubMed  Google Scholar 

  101. Dao T, Kuhn J, Ehmer D, Fisher T, McCarty T. Pregnancy outcomes after gastric-bypass surgery. Am J Surg 2006, 192: 762–6.

    PubMed  Google Scholar 

  102. Mody SK, Hacker MR, Dodge LE, Thornton K, Schneider B, Haider S. Contraceptive counseling for women who undergo bariatric surgery. J Womens Health (Larchmt) 2011, 20: 1785–8.

    Google Scholar 

  103. Paulen ME, Zapata LB, Cansino C, Curtis KM, Jamieson DJ. Contraceptive use among women with a history of bariatric surgery: a systematic review. Contraception 2010, 82: 86–94.

    PubMed  Google Scholar 

  104. Gerrits EG, Ceulemans R, van Hee R, Hendrickx L, Totté E. Contraceptive treatment after biliopancreatic diversion needs consensus. Obes Surg 2003, 13: 378–82.

    PubMed  Google Scholar 

  105. World Health Organization. Medical eligibility criteria for contraceptive use: 2008 update. http://www.who.int/reproductive-health/publications/mec/mecupdate2008.pdf.

  106. Bult MJ, van Dalen T, Muller AF. Surgical treatment of obesity. Eur J Endocrinol 2008, 158: 135–45.

    PubMed  Google Scholar 

  107. Escobar-Morreale HF. Surgical management of metabolic dysfunction in PCOS. Setroids 2012, 77: 312–6.

    Google Scholar 

  108. Motta AB. The role of obesity in the development of polycystic ovary syndrome. Curr Pharm Des 2012, 18: 2482–91.

    PubMed  Google Scholar 

  109. Fauser BC, Tarlatzis BC, Rebar RW, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012, 97: 28–38.

    PubMed  Google Scholar 

  110. Malik SM, Traub ML. Defining the role of bariatric surgery in polycystic ovarian syndrome patients. World J Diabetes 2012, 3: 71–9.

    PubMed Central  PubMed  Google Scholar 

  111. Gomez-Meade C, Lopez-Mitnik G, Arheart KL, et al. Effect of bariatric surgery on cardiometabolic disease risk factors among a multiethnic sample of women with polycystic ovary syndrome. 9th Annual Meeting of the Androgen Excess & PCOS Society, Orlando, FL, 2011, p. 73.

  112. Costello MF, Ledger WL. Evidence-based management of infertility in women with polycystic ovary syndrome using surgery or assisted reproductive technology. Womens Health (Lond Engl) 2012, 8: 291–300.

    Google Scholar 

  113. Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ. Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril 2009, 92: 1966–82.

    PubMed  Google Scholar 

  114. Heerwagen MJ, Miller MR, Barbour LA, Friedman JE. Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol 2010, 299: R711–22.

    PubMed Central  PubMed  Google Scholar 

  115. Allan CA, McLachlan RI. Androgens and obesity. Curr Opin Endocrinol Diabetes Obes. 2010, 17: 224–32.

    PubMed  Google Scholar 

  116. Pasquali R, Patton L, Gambineri A. Obesity and infertility. Curr Opin Endocrinol Diabetes Obes 2007, 14: 482–7.

    PubMed  Google Scholar 

  117. Sermondade N, Faure C, Fezeu L, Lévy R, Czernichow S; Obesity-Fertility Collaborative Group. Obesity and increased risk for oligozoospermia and azoospermia. Arch Intern Med 2012, 172: 440–2.

    PubMed  Google Scholar 

  118. Dandona P, Dhindsa S. Update: Hypogonadotropic hypogonadism in type 2 diabetes and obesity. J Clin Endocrinol Metab 2011, 96: 2643–51.

    PubMed Central  PubMed  Google Scholar 

  119. Dhindsa S, Miller MG, McWhirter CL, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care 2010, 33: 1186–92.

    PubMed Central  PubMed  Google Scholar 

  120. Hammoud AO, Gibson M, Peterson CM, Meikle AW, Carrell DT. Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril 2008, 90: 897–904.

    PubMed  Google Scholar 

  121. Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. J Clin Endocrinol Metab 2007, 92: 405–13.

    PubMed  Google Scholar 

  122. Shayeb AG, Bhattacharya S. Male obesity and reproductive potential. Br J Diabetes Vasc Dis 2009, 9: 7–12.

    Google Scholar 

  123. MacDonald AA, Herbison GP, Showell M, Farquhar CM. The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. Hum Reprod Update 2010, 16: 293–311.

    PubMed  Google Scholar 

  124. Hofny ER, Ali ME, Abdel-Hafez HZ, et al. Semen parameters and hormonal profile in obese fertile and infertile males. Fertil Steril 2010, 94: 581–4.

    PubMed  Google Scholar 

  125. Lotti F, Corona G, Colpi GM, et al. Elevated body mass index correlates with higher seminal plasma interleukin 8 levels and ultrasonographic abnormalities of the prostate in men attending an andrology clinic for infertility. J Endocrinol Invest 2011, 34: 336–42.

    Google Scholar 

  126. Håkonsen LB, Thulstrup AM, Aggerholm AS, et al. Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men. Reprod Health 2011, 8: 24–31.

    PubMed Central  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  128. Saad F, Aversa A, Isidori AM, Gooren LJ. Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review. Curr Diabetes Rev 2012, 8: 131–43.

    PubMed Central  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  130. 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: 1329–32.

    PubMed Central  PubMed  Google Scholar 

  131. Pellitero S, Olaizola I, Alastrue A, et al. Hypogonadotropic Hypogonadism in Morbidly Obese Males Is Reversed After Bariatric Surgery. Obes Surg 2012, Aug 25 [Epub ahead of print]; doi: 10.1007/s11695-012-0734-9.

  132. Botella-Carretero JI, Balsa JA, Gómez-Martin JM, et al. Circulating free testosterone in obese men after bariatric surgery increases in parallel with insulin sensitivity. J Endocrinol Invest 2012, Jun 25 [Epub ahead of print]; doi: 10.3275/8469.

  133. 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 2013, 23: 167–72.

    PubMed  Google Scholar 

  134. di Frega AS, Dale B, Di Matteo L, Wilding M. Secondary male factor infertility after Roux-en-Y gastric bypass for morbid obesity: case report. Hum Reprod 2005, 20: 997–8.

    PubMed  Google Scholar 

  135. Lazaros L, Hatzi E, Markoula S, Takenaka N, et al. Dramatic reduction in sperm parameters following bariatric surgery: report of two cases. Andrologia 2012, 44: 428–32.

    PubMed  Google Scholar 

  136. Sermondade N, Massin N, Boitrelle F, et al. Sperm parameters and male fertility after bariatric surgery: three case series. Reprod Biomed Online 2012, 24: 206–10.

    PubMed  Google Scholar 

  137. Reis LO, Zani EL, Saad RD, Chaim EA, de Oliveira LC, Fregonesi A. Bariatric surgery does not interfere with sperm quality-a preliminary long-term study. Reprod Sci 2012, 19: 1057–62.

    PubMed  Google Scholar 

  138. Sarwer DB, Lavery M, Spitzer JC. A review of the relationships between extreme obesity, quality of life, and sexual function. Obes Surg 2012, 22: 668–76.

    PubMed  Google Scholar 

  139. Lunenfeld B. The relationship between sex hormones and the metabolic syndrome. Acta Biomed 2010, 81 (Suppl): 79–84.

    PubMed  Google Scholar 

  140. Traish AM, Kypreos KE. Testosterone and cardiovascular disease: an old idea with modern clinical implications. Atherosclerosis 2011, 214: 244–8.

    PubMed  Google Scholar 

  141. Gastrointestinal surgery for severe obesity. National Institutes of Health Consensus Development Conference Draft Statement. Obes Surg 1991, 1: 257–66.

    Google Scholar 

  142. Pories WJ, Dohm LG, Mansfield CJ. Beyond the BMI: the search for better guidelines for bariatric surgery. Obesity (Silver Spring) 2010, 18: 865–71.

    Google Scholar 

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Authors and Affiliations

  1. Sezione di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Via S. Pansini 5, 80131, Napoli, Italy

    S. Savastano MD, R. Pivonello, V. Nedi & A. Colao

  2. IRCCS Fondazione SDN Napoli, Napoli, Italy

    C. Di Somma

  3. Sezione di Medicina Interna, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Napoli, Italy

    G. Tarantino

  4. Sezione di Endocrinologia, Università Parthenope di Napoli, Naples, Italy

    F. Orio

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  1. S. Savastano MD
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  2. C. Di Somma
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Correspondence to S. Savastano MD.

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Savastano, S., Di Somma, C., Pivonello, R. et al. Endocrine changes (beyond diabetes) after bariatric surgery in adult life. J Endocrinol Invest 36, 267–279 (2013). https://doi.org/10.3275/8880

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