Assessing the Prevalence of Male Obesity-Associated Gonadal Dysfunction in Severe Obesity: A Focus on the Impact of Bariatric Surgery and Surgical Approaches.

Autor: Bombardieri A; Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Siena, Italy., Bufano A; Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Siena, Italy., Fralassi N; Department of Biochemical, Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy., Ciuoli C; Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Siena, Italy., Benenati N; Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Siena, Italy., Dalmiglio C; Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Siena, Italy., Voglino C; Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Siena, Italy., Tirone A; Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Siena, Italy., Vuolo G; Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Siena, Italy., Castagna MG; Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Siena, Italy. mariagrazia.castagna@unisi.it.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2024 Sep; Vol. 34 (9), pp. 3434-3444. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1007/s11695-024-07426-8
Abstrakt: Purpose: Obesity is an important risk factor for secondary hypogonadism in men. Several studies evaluated the impact of bariatric surgery on gonadal function in men, proving an improvement in testosterone levels, without yet a global consensus on the impact of different surgical approaches. Objectives of the study are: to estimate the prevalence of obesity-associated gonadal dysfunction among men with severe obesity; to evaluate the response to bariatric surgery in terms of resolution of this condition, distinguishing between restrictive and restrictive-malabsorptive surgery.
Methods: We conducted a retrospective evaluation of 413 males with severe obesity (BMI 44.7 ± 8.3 kg/m2). A subgroup of them (61.7%) underwent bariatric surgery. Anthropometric assessment (weight, BMI, waist and hip circumference), metabolic (glyco-lipidic asset and urate) and hormonal (morning gonadotropin and total testosterone) assessments were carried out at baseline and 3-6 months post-surgery.
Results: Using a TT threshold of 2.64 ng/ml, 256 out of 413 (62%) patients were categorized as having biochemical hypogonadism. At multivariate analysis, the only parameter significantly associated with biochemical hypogonadism, was BMI value (p = 0.001). At 3-6 months after surgery, during the acute weight loss phase, only 20.1% of patients still had biochemical hypogonadism. At multivariate analysis, which included age, presurgical BMI, pre-surgical TT, surgical approach and %EWL, presurgical TT levels (p = 0.0004), %EWL (p = 0.04), and mixed restrictive-malabsorptive surgery (p = 0.01), were independently associated with the recovery of gonadal function.
Conclusions: The results of this study underscore the potential reversibility of obesity-associated gonadal dysfunction through bariatric surgery, highlighting the importance of considering surgical approach.
(© 2024. The Author(s).)
Databáze: MEDLINE
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