Male hypogonadism in obese patients with BMI> 30 in Endocrinology Service of Brazil

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 554-583-Male Reproductive Endocrinology & Case Reports
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-580
Alexandre Hohl*, Marcelo Fernando Ronsoni, Raquel Ronconi Tomaz, Thiago Lenoir da Silva, Bruno da Silveira Colombo, Mariana Costa Silva, Julia Michels Ferreira, Emerson Leonildo Marques, Cristina da Silva Schreiber de Oliveira and Marisa Helena Cesar Coral
Federal University of Santa Catarina
Background: Obesity is increasingly prevalent in worldwide and, together with the associated disorders, promotes important impacts on health and quality of life(1). It is known that there is a direct relationship between degree of obesity and low levels of serum testosterone. Although very prevalent, this association is under diagnosed, and this is due in part to a lack of appreciation of this condition by the medical team(2).

Objectives: To study the levels of testosterone in male patients with grade 3 obesity in the preoperative evaluation for bariatric surgery assisted in the Endocrinology Department, University Hospital (HU-UFSC).

Results: We evaluated 36 male patients enrolled in 2012 in HU-UFSC, with a mean age of 41 ± 12 y.o. The mean weight, body mass index (BMI) and waist circumference were respectively 149.7 ± 28.6 kg, 49.0 ± 7.3 kg/m2 and 143.4 ± 13.50 cm. The mean hormone levels were: total testosterone (TT) 231.8 ± 92.4ng/dL, calculated free-testosterone (FT) 5.8 ± 3.4 ng/dL, LH 3.1 ± mU/ml (normal [nl] 0.8 to 7.6) The mean score of the Aging Male's Symptoms (AMS) questionnaire was 40 ± 12 points. Stratifying testosterone levels, 23.1% of patients had levels below 150 ng/dL and 73.1% of those levels between 150 and 400 ng/dL (twilight zone (3)). Total testosterone levels were positively correlated with FT (r: 0.74 / p <0.001) and inversely with weight (r: -0.39 / p = 0.046) and BMI (r: -0.47 / p = 0.015). According to BMI, the mean TT levels tended to further reduce the higher the value of BMI (BMI 40 to 49.9: 261.3 ± 89.4 / BMI 50 to 59.9: 203.2 ± 82.5 / BMI > 60: 160.7 ± 98.1 ng/dL). The AMS score was positively correlated with age (r = 0.44 / p = 0.023). The metabolic profile of patients was (mean): fasting glucose 112.5 ± 32.2 mg/dL (nl<100), glycated hemoglobin 6.6 ± 1.1% (nl<5.7), LDL-cholesterol 119.3 ± 30.7 mg/dL (nl<100), HDL-cholesterol 36.0 ± 6.8 mg/dL (nl> 40), triglycerides 154.1 ± 85.7 mg/dL (nl <150).

Conclusions: This study demonstrates that male patients with grade 3 obesity have high prevalence of hypogonadism. The preoperative evaluation and reassessment of testosterone levels after gastroplasty should be part of the evaluation protocol for these patients.

1.         Hohl A, Marques MOT, Coral MHC, Walz R, . Evaluation of late-onset hypogonadism (andropause) treatment using three different formulations of injectable testosterone. Arq Bras Endocrinol Metabol. 2009;53(8). 2.         Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, et al. Testosterone therapy in men with androgen deficiency syndromes: An endocrine society clinical practice guideline. The Journal of clinical endocrinology and metabolism. 2010;95:2536-59. 3.         Anawalt BD, Hotaling JM, Walsh TJ, Matsumoto AM. Performance of total testosterone measurement to predict free testosterone for the biochemical evaluation of male hypogonadism. The Journal of Urology 2012;187:1369-73.

Nothing to Disclose: AH, MFR, RRT, TLDS, BDSC, MCS, JMF, ELM, CDSSDO, MHCC

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