Alagna, Sergio and Cossu, Maria Laura and Gallo, Paola and Tilocca, Pier L. and Pileri, Piera Veronica and Alagna, Giuliano and Maninchedda, Paola and Sini, Annalisa L. and Pilo, Luca and Rovasio, Pier Paolo and Noya, Giuseppe and Masala, Antonia (2006) Biliopancreatic diversion: long-term effects on gonadal function in severely obese men. Surgery for Obesity and Related Diseases, Vol. 2 (2), p. 82-86. eISSN 1878-7533. Article.
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This study investigated hormonal parameters of gonadal function in severely obese men before and 1 year after undergoing biliopancreatic diversion (BPD).
This observational 1-year postoperative study conducted at medical and surgical clinics at an academic medical center in Italy followed 20 severely obese men age 21 to 63 years, with a mean (± standard deviation) body mass index (BMI) of 47.3 ± 13.1. The following parameters were evaluated: body composition, using body impedance analysis (BIA), and serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, estradiol 17β, and leptin.
At a mean 12 ± 1 months after surgery, the patients showed a significant decrease in weight, from 132.1 ± 36.9 before surgery to 93.5 ± 20 kg (P < .0001), and BMI, from 47.3 ± 13.1 before surgery to 33.5 ± 7 (P < .0001). LH increased from 2.42 ± 1.59 to 4.97 ± 2.6 mIU/ml (P < .0001), FSH increased from 2.85 ± 1.85 to 4.9 ± 4.2 mIU/mL (P = .021), and total testosterone increased from subnormal presurgical values to within normal range (2.81 ± 1.08 to 9.12 ± 1.37 ng/mL; P < .0001), whereas estradiol 17β decreased from elevated basal levels of 44.0 ± 29 to 16.7 ± 6.9 pg/mL (P < .0001). The basal leptin level dropped from 33.0 ± 9.23 to 16.6 ± 5.12 ng/mL (P < .0001), reflecting the decrease in body fat. Subjective improvement in sexual performance was reported by 80% of patients.
Severe obesity is coupled with some significant alterations of the gonadotropin-testicular axis and estradiol 17β and leptin blood levels. These derangements were substantially corrected by 1 year after BPD.
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