Department of Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul.
Department of Surgery, Faculty of Medicine, Near East University, Nicosia, Turkey.
Surg Laparosc Endosc Percutan Tech. 2022 Jan 17;32(2):188-196. doi: 10.1097/SLE.0000000000001039.
Metabolic/bariatric surgery has been shown to increase testosterone in males with obesity. This study investigated the effect of the novel metabolic/bariatric surgery procedure, sleeve gastrectomy with transit bipartition (SG-TB), on serum total testosterone and metabolic variable changes in men with obesity and type 2 diabetes.
In a prospective single-center cohort study, laboratory samples were analyzed preoperatively and at 6 months following SG-TB in patients with a body mass index (BMI) ≥30 kg/m2. Changes in metabolic parameters and testosterone were evaluated.
Between July 2018 and March 2019, 166 patients with a mean baseline BMI of 34.9±3.8 kg/m2 (mean age 51.5±9.3 y), glycosylated hemoglobin 9.5±1.3%, and testosterone 3.1±1.3 underwent SG-TB. At 6-month follow-up, mean excess BMI loss was 70.2±24.3%; glycosylated hemoglobin, 6.6±1.1% (P<0.001); and testosterone, 4.5±1.5 (P<0.001).
In the early term following SG-TB, more than any other factor assessed, BMI loss was found to be a significant driver of improvement in testosterone levels. Regardless of preoperative obesity classification, patients with initially low testosterone attained significantly increased testosterone levels at 6-month follow-up.
代谢/减重手术已被证明可增加肥胖男性的睾丸酮水平。本研究旨在探究新型代谢/减重手术程序——胃旁路术联合转流分区（SG-TB）对肥胖合并 2 型糖尿病男性的总睾酮和代谢变量变化的影响。
在一项前瞻性单中心队列研究中，对 BMI≥30kg/m2 的患者在接受 SG-TB 术前和术后 6 个月进行实验室样本分析。评估代谢参数和睾丸酮的变化。
2018 年 7 月至 2019 年 3 月，166 例基线 BMI 平均为 34.9±3.8kg/m2（平均年龄 51.5±9.3 岁）、糖化血红蛋白 9.5±1.3%、睾丸酮 3.1±1.3ng/ml 的患者接受了 SG-TB。6 个月随访时，平均超重 BMI 损失为 70.2±24.3%；糖化血红蛋白为 6.6±1.1%（P<0.001）；睾丸酮为 4.5±1.5ng/ml（P<0.001）。
在 SG-TB 后的早期，除了评估的其他任何因素外，BMI 损失被发现是改善睾丸酮水平的重要驱动因素。无论术前肥胖症的分类如何，最初睾丸酮水平较低的患者在 6 个月随访时睾丸酮水平显著升高。
