Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No. 301 Middle Yanchang Road, Shanghai, 200072, China.
National Metabolic Management Center, Shanghai, 200072, China.
Obes Surg. 2019 Mar;29(3):869-877. doi: 10.1007/s11695-018-3611-3.
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 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.
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).
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).
观察腹腔镜袖状胃切除术(LSG)后中国肥胖男性患者性激素的变化及其与包括血清尿酸(SUA)在内的代谢参数的相关性。
选择 56 名 BMI 为 41.9±5.8 kg/m2 的肥胖男性进行 LSG。选择 31 名 BMI 正常的健康男性作为对照。比较 LSG 前后总睾酮(TT)、雌二醇(E2)、性激素结合球蛋白(SHBG)、卵泡刺激素(FSH)、黄体生成素(LH)、SUA 和其他代谢指标的水平。采用经验公式计算 TT 和 SHBG 得出游离睾酮(cFT)。
肥胖男性的 TT 降低和高尿酸血症(HUA)较为常见。LSG 后 12 个月,体重、BMI 和糖脂代谢指标显著降低。SUA 水平从 474.9±94.6 μmol/L 显著下降至 338.8±81.9 μmol/L,HUA 百分比从 76.8%下降至 54.1%(均 P<0.001)。此外,LSG 后 TT、SHBG 和 cFT 显著增加,低 TT 百分比降低(均 P<0.05),而 E2、FSH 和 LH 无明显变化。此外,TT 水平的变化比其他性激素更明显。校正年龄和 BMI 后,TT 水平升高与 SUA(β=-1.077,P<0.05)、BMI(β=-0.712,P<0.001)和 HOMA-IR(β=-0.652,P<0.05)降低以及 SHBG(β=0.759,P<0.001)升高显著相关。
LSG 可显著增加中国肥胖男性的 TT 水平,这可能是通过体重显著减轻、SUA 降低和胰岛素抵抗(IR)改善介导的。