Hospital das Clinicas, São Paulo, São Paulo, Brazil.
Surg Obes Relat Dis. 2013 Sep-Oct;9(5):636-40. doi: 10.1016/j.soard.2012.06.010. Epub 2012 Jul 5.
The long-term effect of bariatric intervention on androgenic hormones and erectile function is not well known. In a prospective comparative study, the profile of sexual function was ascertained. The setting was a large public academic hospital.
A total of 51 patients were included in the present study. Of these, 23 were in the bariatric surgery cohort (with 6-14 yr of follow-up), 14 were obese controls, and 14 were lean controls, aged 30-65 years. The groups were matched for age and, in the case of obese controls, the current body mass index. The measurements included orchidometry, an assessment of gynecomastia, the International Index of Erectile Function, the Aging Males Symptoms questionnaire, the measurement of 12 hormones, and general biochemical measurements.
Bariatric patients lost substantial weight (59.8 ± 12.1 versus 35.1 ± 7.7 kg/m(2)), albeit residual obesity was the rule, with varying degrees of sleep apnea, hypertension, and glucose/lipid aberrations. The total and free testosterone and sex hormone-binding globulin levels were greater in the gastric bypass patients than in the obese controls and comparable to those of lean individuals. The International Index of Erectile Function final score revealed no differences; however, the domains of erectile dysfunction (P = .015) and overall satisfaction (P = .028) were better than those in the obese controls, although still lower than those in the lean group. The correlation between the body mass index and the International Index of Erectile Function score in the entire population (n = 51) was negative, as expected, with, however, low r and r(2) indexes (.354 and .125, respectively).
The findings are consistent with long-term normalization of androgenic hormones but less than complete normalization of erectile function. This seeming contradiction might be explained by the remaining or relapsing obesity or its co-morbidities.
减重干预对雄激素和勃起功能的长期影响尚不清楚。在一项前瞻性的对照研究中，我们确定了性功能的状况。研究地点是一家大型公立学术医院。
本研究共纳入 51 例患者，其中 23 例患者接受了减重手术（随访 6-14 年），14 例肥胖对照组，14 例瘦对照组，年龄 30-65 岁。这些组在年龄上相匹配，在肥胖对照组中，还与当前的体重指数匹配。测量包括阴茎测量、乳房女性化评估、国际勃起功能指数、男性衰老症状问卷、12 种激素的测量以及一般生化测量。
减重患者体重明显减轻（59.8 ± 12.1 与 35.1 ± 7.7 kg/m2），尽管仍然存在肥胖，但伴有不同程度的睡眠呼吸暂停、高血压和血糖/脂质异常。胃旁路患者的总睾酮和游离睾酮以及性激素结合球蛋白水平高于肥胖对照组，与瘦对照组相当。国际勃起功能指数最终评分无差异；然而，勃起功能障碍（P =.015）和总体满意度（P =.028）评分领域优于肥胖对照组，尽管仍低于瘦对照组。整个研究人群（n = 51）的体重指数与国际勃起功能指数评分之间的相关性呈负相关，这与预期的一致，但 r 和 r2 指数较低（分别为.354 和.125）。
这些发现与雄激素的长期正常化一致，但勃起功能的正常化不完全。这种看似矛盾的现象可能是由于残留或复发的肥胖或其合并症所致。
