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Biliopancreatic diversion: long-term effects on gonadal function in severely obese men

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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DOI: 10.1016/j.soard.2006.01.005

Abstract

Background
This study investigated hormonal parameters of gonadal function in severely obese men before and 1 year after undergoing biliopancreatic diversion (BPD).

Methods
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.

Results
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.

Conclusions
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.

Item Type:Article
ID Code:4141
Status:Published
Refereed:Yes
Uncontrolled Keywords:Biliopancreatic diversion, gonadotropins, testosterone, estradiol 17β, leptin
Subjects:Area 06 - Scienze mediche > MED/09 Medicina interna
Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 03 Istituti > Clinica chirurgica generale e terapia chirurgica
001 Università di Sassari > 03 Istituti > Patologia speciale medica e metodologia clinica
Publisher:Elsevier
eISSN:1878-7533
Copyright Holders:© 2006 American Society for Bariatric Surgery
Deposited On:12 Jul 2010 09:41

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