Endocrine Abstracts

Introduction: Obesity is known to be associated with hypogonadotropic hypogonadism. Hypogonadism is an established risk factor for cardio vascular disease and type 2 diabetes mellitus (T2DM). However there is little evidence on improvement in testosterone with bariatric surgery.

Aim and methods: To asses changes in testosterone levels after bariatric surgery. Retrospective study on men undergoing bariatric surgery, and data collected pre and post surgery. Data was analysed for normality followed by paired Wilcoxon signed rank tests. State version ten was used for analysis.

Results:: 22 patients underwent bariatric surgery and were followed up over a median interval of 11 months. The mean (S.D.) age was 49.49 (8.55) years. Mean pre operative weight (kg) was 151.09 (23.88). Mean weight loss was 35.5 (12.1–74). There was significant rise in total testosterone levels, mean Pre op and post op testosterone (nmol/l) being 9.02 (3.66) and 14.5 (9.04) respectively (P=0.009). 50% of patients in study group showed improvement in their testosterone level. FSH and LH levels improve after surgery though these were not significant. Linear regression models showed that the rise in testosterone was not determined by weight loss.

Discussion: Testosterone levels are inversely proportional to the BMI. There are several mechanisms by which obesity can cause hypogonadism.In the above study, as only half of them showed improvement in testosterone and not that all the patients came off testosterone after surgery. This indicates that there may be uncertain mechanisms apart from weight loss that improves the level.

Conclusion: This is one of the studies on improvement in testosterone level after weight loss. Further large scale data is needed to look into the long term effect of weight loss in sex hormones and also to identify other uncertain mechanisms which improves the testosterone.