Endocrine Abstracts

Introduction: Bariatric surgery has become an essential option for long-term weight loss in morbidly obese population.

Objective: This study was aimed at investigating the effects of bariatric surgery on sex hormone levels and potential hormonal changes associated with significant weight loss in a cohort of 49 patients with obesity.

Methodology: Forty-nine patients with obesity, scheduled for bariatric surgery in Colombo South Teaching Hospital, Sri Lanka were enrolled in this prospective study. Preoperative assessments included demographic information and anthropometric measurements. The baseline sex hormones, including follicular stimulating hormone (FSH), luteinizing hormone (LH, testosterone), Sex Hormone Binding Globulin (SHBG), and symptomatology related to hypogonadism, were collected. Postoperative follow-ups were conducted at regular intervals to evaluate weight changes and hormonal profiles.

Results: Thirty-one females and 19 males were analysed. The mean weight before surgery among females were 124 kg (SD = 16.7), and males were 129.1 kg (SD = 19.6). The prevalence of Polycystic Ovary Syndrome (PCOS) in females was 64.5% (n=20). The prevalence of obesityrelated hypogonadism was 64% (n=11) among males. The average weight loss by 12 months after surgery was 40.2 kg (95% CI 36.7–43.63, P<0.05) in females, and males had an average weight reduction of 39.2 kg (95% CI 33.00–45.54, P<0.05). The Sex hormone binding globulin (SHBG) level was significantly increased in males 63.9% from baseline (95CI; 40.9-86.5: P<0.05) and females in 50.5% from the baseline (95%; 61.75-121.3; P<0.05) at the end of 12 months after surgery. It was positively correlated with weight loss, percentage of total fat loss and waist circumference reduction in both males and females. Total testosterone increased significantly in men at the end of 12 months 6.4 nmol/l (95%C; I4.2-7.6: P<0.05. Total testosterone levels showed a significant positive correlation with weight loss parameters in males. There was no significant correlation found in gonadotrophin levels or oestrogen levels in males or females. The free androgen index improved in females at the end of 12 months, but no significant change was seen in males. These changes led to the resolution of PCOS in 72.4% of the female population. And obesityrelated male hypogonadism led to a resolution of 84.3%.

Conclusions: There was significant improvement in SHBG following bariatric surgery in males and females. The remarkable rate of resolution of PCOS and male obesity-related hypogonadism after bariatric surgery provides strong evidence supporting a causal role of obesity and adipose tissue dysfunction in the development of gonadal dysfunction in severely obese subjects.