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Hypogonadotropic Hypogonadism in Morbidly Obese Males Is Reversed After Bariatric Surgery

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Abstract

Background

The effect of weight loss by bariatric surgery on gonadal hormones in morbidly obese males is not entirely known. The main objective of the study was to analyze gonadal hormonal changes after weight loss.

Methods

An observational study was conducted before and after 12 months of weight loss at a clinical research center. Thirty-three men [age 40.5 ± 9.9, body mass index (BMI) 50.3 ± 6.1 kg/m2] undergoing bariatric surgery were included. The main outcome measures were as follows: changes in total (TT) and free testosterone (FT), estradiol (E2), sex hormone binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), inhibin B, and prolactin (PRL).

Results

Baseline prevalence of hypogonadism (defined by TT < 300 ng/dl or FT < 65 pg/ml) was 78.8 and 51.5 %, respectively. Hypogonadal patients were older and showed inhibin B and AMH significantly lower than those with normal TT. BMI correlated negatively with TT, LH, and SHBG. Regression analyses showed a significant and independent association of hypogonadism with age (OR = 1.2, p = 0.01), BMI (OR = 1.3, p = 0.03), and AMH (OR = 0.4, p = 0.03) after adjustments. After 1 year, percentage of weight loss (%WL) was 18.8 ± 5.2 %, and there was a significant increase of TT, FT, SHBG, and FSH and a decrease of E2 and PRL. Prevalence of persistent hypogonadism after surgery was 6 % (low TT) and 15 % (low FT). %WL was significantly associated with percent changes in SHBG (r = −0.4, p = 0.04), inhibin B (r = −0.4, p = 0.03), and AMH (r = −0.4, p = 0.01). Age and %WL were the only significant and independent parameters associated with %TT change.

Conclusions

Obesity-associated hypogonadism is very prevalent in males with morbid obesity and is mostly reversed after sustained weight loss by bariatric surgery.

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Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Endocrinology and Nutrition Service, Department of Internal Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital, Via Canyet, 08916, Badalona, Barcelona, Spain

    Silvia Pellitero, Izaskun Olaizola, Eva Martínez & Manel Puig-Domingo

  2. Clinical Biochemistry Service, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital, Via Canyet, Badalona, Barcelona, Spain

    María Luisa Granada

  3. Surgery Department, Universitat Autònoma de Barcelona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain

    Antoni Alastrue, Jose María Balibrea & Pau Moreno

  4. Nephrology Service, Department of Internal Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital, Via Canyet, Badalona, Barcelona, Spain

    Assumpta Serra, Maruja Navarro-Díaz & Ramon Romero

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  1. Silvia Pellitero
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Correspondence to Silvia Pellitero.

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Pellitero, S., Olaizola, I., Alastrue, A. et al. Hypogonadotropic Hypogonadism in Morbidly Obese Males Is Reversed After Bariatric Surgery. OBES SURG 22, 1835–1842 (2012). https://doi.org/10.1007/s11695-012-0734-9

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