IMPROVEMENT OF MALE HYPOGONADISM IN SEVERE OBESITY DURING WEIGHT LOSS AFTER BARIATRIC SURGERY
M Monteiro1, H Cardoso1, G Vargas1, P Mendes1, A Sergio2, M Santos3, C Santos3 & H Ramos1
Objectives: To evaluate changes in gonadotrophins, total (TT) and free (FT) testosterone, SHBG, insulin and c-peptide levels during weight lost after bariatric surgery.
Material and methods: Seven (n=7) patients submitted to bariatric surgery for treatment of severe obesity were followed-up over time. Before surgery mean age was 32,857 (19-56) years old, mean weight was 170,571 kg (± 37,362) and mean BMI was 58,824 kg per m2(± 14,211).
Results: After a mean follow-up of 13 months (min 6, max 25), mean weight and BMI decreased respectively to 126 kg (min 97, max 196; ± 33,872) and 43,767 Kg per m2 (± -13,845).
The mean analytical values before (B) and after (A) surgery were: FSH (mUI per ml) B:3,245 ± 1,380 A:2,330 ± 0,948; LH (mUI per ml) B:3,142 ± 0,780 A:2,700 ± 1,009; TT (ng per ml) B:2,050 ± 0,825 A:3,653 ± 1,452; FT (pg per ml) B:6,028 ± 2,377 A:13,400 ± 5,702; SHBG (nmol per l) B:21,237 ± 15,329 A:26,666 ± 10,366; Insulin (microunits per ml) B:44,528 ± 39,321 A:17,716 ± 12,1598; C-Pep (ng per ml) B:6,833 ± 2,320 A:4,116 ± 1,621.
After surgery all patients improved their weight and BMI in a significant way (p=0,001). Weight loss attained with bariatric surgery resulted in significant increase of TT and FT (p=0,019 and p=0,026), and decrease of c-peptide (p=0,034). Gonadotrophins and SHBG increased and insulin decreased, with weight loss, but not significantly.
Weight loss in men with severe obesity and hypogonadism, attained by bariatric surgery, improved hypogonadism with increase of TT and FT levels.