Changes in Sex Hormones After Laparoscopic Sleeve Gastrectomy in Chinese Obese Men: a 12-Month Follow-Up

• Published in: Obesity surgery Vol. 29; no. 3; pp. 869 - 877
• Main Authors: Zhu, Cuiling, Zhang, Yi, Zhang, Ling, Gao, Jingyang, Mei, Fangyun, Zhu, Bing, Lu, Liesheng, Zhou, Donglei, Qu, Shen
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2019; Springer Nature B.V
• Subjects: Bariatric Surgery; Body mass index; China; Follow-Up Studies; Gastrectomy - statistics & numerical data; Gonadal Steroid Hormones - blood; Hormones; Humans; Laparoscopy; Laparoscopy - statistics & numerical data; Male; Medicine; Medicine & Public Health; Metabolism; Obesity - blood; Obesity - surgery; Original Contributions; Surgery; Uric Acid - blood; China; Obesity; Sex hormone-binding globulin; Uric acid; Total testosterone; Laparoscopic sleeve gastrectomy
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-018-3611-3

Background To examine changes in sex hormones after laparoscopic sleeve gastrectomy (LSG) in Chinese obese male patients and their correlation with metabolic parameters including serum uric acid (SUA) Methods A total of 56 obese men with body mass index (BMI) 41.9 ± 5.8 kg/m 2 undergoing LSG were selected. Thirty-one healthy men with normal BMI were included as controls. Levels of total testosterone (TT), estradiol (E2), sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), SUA, and other metabolic indices were compared pre- and 12 months post-LSG. Calculated free testosterone (cFT) was calculated from TT and SHBG using an empirical equation. Results At baseline, low TT and hyperuricemia (HUA) were common in obese men. Twelve months after LSG, statistically significant reduction in weight, BMI, and glucolipid metabolism indices was noted. SUA levels declined remarkably from 474.9 ± 94.6 to 338.8 ± 81.9 μmol/L and the percentage of HUA decreased from 76.8 to 54.1% (all P  < 0.001). Additionally, significant increases in TT, SHBG, and cFT as well as a decrease in percentage of low TT were observed after LSG (all P  < 0.05), while E2, FSH, and LH did not change significantly. Moreover, changes in TT levels were more pronounced than those of other sex hormones. After age and BMI were adjusted, increased TT levels were correlated significantly with decreased SUA ( β =  − 1.077, P  < 0.05), BMI ( β =  − 0.712, P  < 0.001), and HOMA-IR ( β =  − 0.652, P  < 0.05), as well as increased SHBG ( β =  0.759, P  < 0.001). Conclusions LSG promotes a significant increase in TT levels in Chinese obese men, which may be mediated by substantial weight loss, SUA reduction, and improved insulin resistance (IR).