Biliopancreatic diversion: long-term effects on gonadal function in severely obese men

Cossu, Maria Laura; Gallo, Paola; Tilocca, Pier Luigi; Pileri, Piera Veronica; Alagna, Giuliano; Maninchedda, Paola; Sini, Annalisa; Pilo, Luca; Rovasio, P. P.; Noya, Giuseppe; Masala, A.

doi:10.1016/j.soard.2006.01.005

Cited by 34 publications

(32 citation statements)

References 46 publications

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“…There was a significant decrease in BMI at 3 months following Bariatric surgery in our study group with mean BMI at the end of 1 month and 3 months being 42.68 kg/m 2 and 35.69 kg/m 2 as compared to the pre-op values of 46.31 kg/m 2 . Similar results were found by Alagna et al [9] at mean 12±1 months after surgery, the patients showed a significant decrease in weight, from 132.1±36.9 before surgery to 93.5±20 kg (P<.0001), and BMI, from 47.3±13.1 before surgery to 33.5±7 (P <.0001).…”

Section: Discussionsupporting

confidence: 89%

To Study the Effect of Laparoscopic Bariatric Surgery on Serum Insulin Levels in Morbidly Obese Patients

Singh¹,

Ahuja²,

Bhagtana³

2017

jemds

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Section: Discussionsupporting

confidence: 89%

To Study the Effect of Laparoscopic Bariatric Surgery on Serum Insulin Levels in Morbidly Obese Patients

Singh¹,

Ahuja²,

Bhagtana³

2017

jemds

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“…Bariatric surgery has been extensively described to ameliorate sex hormone and SHBG levels in morbidly obese patients (9,14,15,16,17,18,19), with an effect that may exceed what is predictable on the basis of weight loss (17). In this study, we demonstrate that the increase in androgens (cFT and TT) occurs only in hypogonadal patients (TT!8 nmol/l).…”

Section: Discussionmentioning

confidence: 53%

Hypogonadism as an additional indication for bariatric surgery in male morbid obesity?

Samavat

Facchiano

Lucchese

et al. 2014

European Journal of Endocrinology

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Objective: Male obesity is often associated with reduced levels of circulating total (TT) and calculated free testosterone (cFT), with normal/reduced gonadotropins. Bariatric surgery often improves sex steroid and sex hormone-binding globulin (SHBG) levels. The aim of this study was to assess the effects of bariatric surgery on waist circumference (WC) and BMI, and on TT levels, in morbidly obese men, stratified, according to the gonadal state, in eugonadal and hypogonadal (TT!8 nmol/l) subjects. Design: A cohort of morbidly obese patients (29 with hypogonadism (HG) and 26 without) undergoing bariatric surgery (37, 10, 6, and 2, with Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, biliopancreatic diversion and gastric sleeve, respectively) was studied at 6 and 12 months from the operation. Methods: Anthropometric parameters (weight, BMI, WC) and sex hormones (gonadotropins, TT, cFT, estradiol (E 2 ), SHBG) were assessed. Results: WC was the only parameter significantly correlated with androgens, but not with E 2 , SHBG, and gonadotropins, at baseline. After surgery, a significant increase in TT, cFT, and SHBG, accompanied by a decrease in E 2 , was evident in the two groups. However, both TT and cFT, but not E 2 , SHBG, and gonadotropin variations, were significantly higher in the hypogonadal group at follow-up, with an overall 93% complete recovery from HG. Reduction in WC, but not BMI, was significantly greater in hypogonadal men (DWCZK29.4G21.6 vs K14.4G17.4 at 12 months, PZ0.047). Conclusions: Recovery from obesity-associated HG is one of the beneficial effects of bariatric surgery in morbidly obese men. The present findings suggest that the gonadal state is a predictor of WC decrease after bariatric surgery.

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“…2A). In particular, malabsorptive surgery (including studies which performed biliopancreatic diversion, see references (35,43,44,46,50)) determined a more consistent increase in TT when compared with non-malabsorptive surgery (including studies which performed gastroplasty approach, see references (41, 42)) (11.58 (7.12-16.03) vs 6.08 (2.38-9.78) nmol/l, respectively; both P!0.0001). However, the latter was not confirmed after adjusting for percent weight loss of BMI (D-BMI).…”

Section: Effect Of Diet or Bariatric Surgery On Hormonal Modificationsmentioning

confidence: 94%

“…The results of these studies are essentially conflicting: some of them showed an increase of testosterone (26,27,28,29,30,31,32,33,34), others showed no change (35,36,37,38,39), and one small study has shown even a decrease in testosterone levels (40). Similarly, in the last 10 years, several trials have evaluated the impact of bariatric surgery on testosterone levels in men generally, showing an increase in testosterone levels (41,42,43,44,45,46,47,48).…”

Section: Introductionmentioning

confidence: 99%

Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis

Corona

Rastrelli

Monami

et al. 2013

European Journal of Endocrinology

341

290

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Objective: Few randomized clinical studies have evaluated the impact of diet and physical activity on testosterone levels in obese men with conflicting results. Conversely, studies on bariatric surgery in men generally have shown an increase in testosterone levels. The aim of this study is to perform a systematic review and meta-analysis of available trials on the effect of body weight loss on sex hormones levels. Design: Meta-analysis. Methods: An extensive Medline search was performed including the following words: 'testosterone', 'diet', 'weight loss', 'bariatric surgery', and 'males'. The search was restricted to data from January 1, 1969 up to August 31, 2012. Results: Out of 266 retrieved articles, 24 were included in the study. Of the latter, 22 evaluated the effect of diet or bariatric surgery, whereas two compared diet and bariatric surgery. Overall, both a lowcalorie diet and bariatric surgery are associated with a significant (P!0.0001) increase in plasma sex hormone-binding globulin-bound and -unbound testosterone levels (total testosterone (TT)), with bariatric surgery being more effective in comparison with the low-calorie diet (TT increase: 8.73 (6.51-10.95) vs 2.87 (1.68-4.07) for bariatric surgery and the low-calorie diet, respectively; both P!0.0001 vs baseline). Androgen rise is greater in those patients who lose more weight as well as in younger, non-diabetic subjects with a greater degree of obesity. Body weight loss is also associated with a decrease in estradiol and an increase in gonadotropins levels. Multiple regression analysis shows that the degree of body weight loss is the best determinant of TT rise (BZ2.50G0.98, PZ0.029). Conclusions: These data show that weight loss is associated with an increase in both bound and unbound testosterone levels. The normalization of sex hormones induced by body weight loss is a possible mechanism contributing to the beneficial effects of surgery in morbid obesity.

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Biliopancreatic diversion: long-term effects on gonadal function in severely obese men

Cited by 34 publications

References 46 publications

To Study the Effect of Laparoscopic Bariatric Surgery on Serum Insulin Levels in Morbidly Obese Patients

To Study the Effect of Laparoscopic Bariatric Surgery on Serum Insulin Levels in Morbidly Obese Patients

Hypogonadism as an additional indication for bariatric surgery in male morbid obesity?

Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis

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