Pre-operative Obesity-Associated Hyperandrogenemia in Women and Hypogonadism in Men Have No Impact on Weight Loss Following Bariatric Surgery

Abstract

Abstract Background In severe obesity, hypogonadism in men and androgen excess in women are frequently observed. Sex hormones play an important role in body composition and glucose and lipid metabolism. However, whether pre-operative gonadal dysfunction impacts weight loss after bariatric surgery is not fully known. Methods A total of 49 men and 104 women were included in a retrospective analysis. Anthropometric characteristics, glucose and lipid metabolism, and androgen concentrations were assessed pre-operatively and 17.9 ± 11 or 19.3 ± 12 months post-operatively in men and women. Men with (HYPO male ) and without (controls: CON male) pre-operative hypogonadism, as well as women with (HYPER female ) and without (controls: CON female) pre-operative hyperandrogenemia, were compared. Results In men, pre-operative hypogonadism was present in 55% and linked to a higher body mass index (BMI): HYPO male 50 ± 6 kg/m 2 vs. CON male 44 ± 5 kg/m 2 , p = 0.001. Bariatric surgery results in comparable changes in BMI in HYPO male and CON male − 16 ± 6 kg/m 2 vs. − 14 ± 5 kg/m 2 , p = 0.30. Weight loss reversed hypogonadism in 93%. In women, androgen excess was present in 22%, independent of pre-operative BMI: CON female 44 ± 7 kg/m 2 vs. HYPER female 45 ± 7 kg/m 2 , p = 0.57. Changes in BMI were comparable in HYPER female and CON female after bariatric surgery − 15 ± 6 kg/m 2 vs. − 15 ± 5 kg/m 2 , p = 0.88. Hyperandrogenemia was reversed in 61%. Conclusions Besides being frequently observed, hypogonadism in men and androgen excess in women have no impact on post-surgical improvements in body weight and glucose and lipid metabolism. Weight loss resulted in reversal of hypogonadism in almost all men and of hyperandrogenemia in the majority of women.

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