Gonadal status and outcome of bariatric surgery in obese men

Aarts, Edo O.; Wageningen, Bas van; Loves, Sandra; Janssen, Ignace; Berends, Frits J.; Sweep, Fred C.G.J.; Boer, H. de

doi:10.1111/cen.12366

Cited by 23 publications

(11 citation statements)

References 23 publications

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“…An increase in serum androgen levels (for both total testosterone and the free testosterone index), which was even higher than the increase in SHBG levels in men has been reported (134, 191). Normalization of serum testosterone levels after BS is associated with improved fertility in severely obese men.…”

Section: Non-metabolic Bs-induced Endocrine Alterationscontrasting

confidence: 51%

“…It is thought that the differences between obese subjects with normal gonadal function and those with hypogonadism might be determined by aromatase expression levels: MOSH would be induced when aromatase gene expression is elevated. By contrast, testosterone levels would remain within the normal range when aromatase expression levels are low (134). Similar to PCOS in obese women, MOSH is not a generalized condition in male obesity and underlying mechanisms are largely unknown.…”

Section: Non-metabolic Bs-induced Endocrine Alterationsmentioning

confidence: 99%

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Metabolic and Endocrine Consequences of Bariatric Surgery

2019

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Obesity is one of the most serious worldwide epidemics of the twenty-first century according to the World Health Organization. Frequently associated with a number of comorbidities, obesity threatens and compromises individual health and quality of life. Bariatric surgery (BS) has been demonstrated to be an effective treatment to achieve not only sustained weight loss but also significant metabolic improvement that goes beyond mere weight loss. The beneficial effects of BS on metabolic traits are so widely recognized that some authors have proposed BS as metabolic surgery that could be prescribed even for moderate obesity. However, most of the BS procedures imply malabsorption and/or gastric acid reduction which lead to nutrient deficiency and, consequently, further complications could be developed in the long term. In fact, BS not only affects metabolic homeostasis but also has pronounced effects on endocrine systems other than those exclusively involved in metabolic function. The somatotropic, corticotropic, and gonadal axes as well as bone health have also been shown to be affected by the various BS procedures. Accordingly, further consequences and complications of BS in the long term in systems other than metabolic system need to be addressed in large cohorts, taking into account each bariatric procedure before making generalized recommendations for BS. In this review, current data regarding these issues are summarized, paying special attention to the somatotropic, corticotropic, gonadal axes, and bone post-operative health.

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Section: Non-metabolic Bs-induced Endocrine Alterationscontrasting

confidence: 51%

Section: Non-metabolic Bs-induced Endocrine Alterationsmentioning

confidence: 99%

Metabolic and Endocrine Consequences of Bariatric Surgery

2019

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“…In fact, low-calorie diet, with a weight loss of 9.8% induced an average T increase of less than 3 nmol/L, whereas results with bariatric surgery, with a weight loss of 32%, were three times higher (almost 9 nmol/L). In the last few years, four additional reports have evaluated the effect of surgery-induced weight loss on T production (Mora et al, 2013, Aarts et al, 2014, Calderón et al, 2014, Mihalca et al 2014). In addition, an update of a previous series was published (Samavat et al, 2014).…”

Section: B) Clinical Intervention Studiesmentioning

confidence: 99%

“…In addition, an update of a previous series was published (Samavat et al, 2014). Hence, so far, 15 observational studies (Bastounis et al 1998, Mingrone et al, 2002, Globerman et al 2005, Alagna et al 2006, Hammoud et al 2009, Omana et al 2009, Reis et al, 2010, Pellitero et al 2012 Mora et al, 2013;Aarts et al, 2014;Calderón et al, 2014, Mihalca et al 2014and Samavat et al, 2014 are available enrolling overall 398 patients, with a mean follow-up of 54.7 weeks, mean BMI of 48.6 kg/m 2 and mean age of 42.1 years (Table 1).…”

Section: B) Clinical Intervention Studiesmentioning

confidence: 99%

Obesity and late-onset hypogonadism

Corona

Vignozzi

Sforza

et al. 2015

Molecular and Cellular Endocrinology

127

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“…In fact, large population-based studies using liquid chromatography-tandem mass spectrometry (LC-MS/MS) have reported lower estradiol levels in hypogonadal men compared with eugonadal men. 15 16 Indeed, increased estradiol levels have only been reported in extremely obese men, 17 18 suggesting that increased estradiol contributes to the development of hypogonadism only in extremely obese men.…”

Section: Mechanisms Involved In the Relationship Between Male Hypogonmentioning

confidence: 99%

Secondary male hypogonadism: A prevalent but overlooked comorbidity of obesity

et al. 2018

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Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.

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Gonadal status and outcome of bariatric surgery in obese men

Abstract: Obesity-related hypogonadotrophic hypogonadism is a reversible condition in the majority of obese men. It does not reduce the efficacy of bariatric surgery. Preoperative weight-adjusted normal values are recommended to avoid an incorrect diagnosis of hypogonadism in obese men.

Cited by 23 publications

References 23 publications

Metabolic and Endocrine Consequences of Bariatric Surgery

Metabolic and Endocrine Consequences of Bariatric Surgery

Obesity and late-onset hypogonadism

Secondary male hypogonadism: A prevalent but overlooked comorbidity of obesity

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