title: Age as a predictive factor of testosterone improvement in male patients after bariatric surgery: preliminary results of a monocentric prospective study.
abstract: BACKGROUND
  Male obesity can be associated with symptomatic alterations in sex hormones resulting in hypogonadism and impaired fertility. Surgical-induced weight loss can improve the sex hormone profile in men. The aim of the present study is to evaluate the levels of sex hormones in obese males before and after 6 months from bariatric surgery. Possible mechanisms and clinical implications are also discussed.
  
  
  METHODS
  We evaluated levels of serum total testosterone (TT), sex hormone-binding globulin (SHBG), calculated free testosterone (cFT), follicular-stimulating hormone (FSH), luteinizing hormone (LH), and total estradiol (E2) in 20 male patients at the baseline and 6 months after bariatric surgery.
  
  
  RESULTS
  Median [interquartile range] age at the time of surgery was 40.5 [27.2-46.7] years with a median [interquartile range] BMI of 43.6 [40.9-48.7] kg/m(2). The median baseline levels of TT, SHBG, cFT, LH, and FSH were reduced; levels of E2 were elevated. At 6 months from surgery, the median BMI dropped to 34.8 [31.7-40.5] kg/m(2), TT, SHBG, cFT, LH, and FSH increased, while levels of E2 decreased. The improvement in the sex hormone profile was more evident in younger patients, with a statistically significant difference in cFT following surgery and in the raise of TT and cFT between the groups of patients below and above 35 years. At multivariate analysis, the age was the best predictive factor of the postoperative variations of TT.
  
  
  CONCLUSIONS
  These preliminary results confirm the general improvement in sex hormone profile in obese men after bariatric surgery and introduce the age as a possible contributing factor to this improvement.
authors.affiliation: Bariatric and Metabolic Surgery Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy. enricofacchiano@yahoo.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Facchiano
authors.forename: Stefano
authors.initials: S
authors.lastname: Scaringi
authors.forename: Marco
authors.initials: M
authors.lastname: Veltri
authors.forename: Jinous
authors.initials: J
authors.lastname: Samavat
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Michaela
authors.initials: M
authors.lastname: Luconi
authors.forename: Marcello
authors.initials: M
authors.lastname: Lucchese
mesh_terms: D000328:Adult; D000367:Age Factors; D005640:Follicle Stimulating Hormone / Q000097:blood; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D007006:Hypogonadism / Q000097:blood* / Q000209:etiology / Q000601:surgery; D007248:Infertility, Male / Q000097:blood* / Q000209:etiology / Q000601:surgery*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone