Male Gonadal Axis Assessment in Bariatric Surgery Candidates

Program: Abstracts - Orals, Poster Previews, and Posters
Session: SUN 176-202-Male Reproductive Endocrinology and Male Reproductive Tract (posters)
Bench to Bedside
Sunday, April 3, 2016: 1:15 PM-3:15 PM
Exhibit/Poster Hall (BCEC)

Poster Board SUN 202
Alexandre Hohl*1, Gabriela Ghisi e Ghisi2, Giovana De Nardin3, Fernanda Augustini Rigon3, Maiara Ferreira Peixer3, Marisa Helena Cesar Coral4, Simone van de Sande-Lee3 and Marcelo Fernando Ronsoni1
1Federal University of Santa Catarina, Florianopolis-SC, Brazil, 2Federal University of Santa Catarina, Florianópolis, Brazil, 3Federal University of Santa Catarina, Florianopolis, Brazil, 4Federal University of Santa Catarina, Brazil
Background: Obesity is increasingly prevalent worldwide and has profound impacts on health and quality of life. Testosterone plays an important role in the pathology of metabolic diseases such as obesity. Although very prevalent, this association is underdiagnosed.

Objective: To evaluate the male gonadal axis in patients with body mass index (BMI) ≥ 35 kg/m2.

Methods: Cross-sectional study, including male patients evaluated for bariatric surgery with BMI ≥ 35 kg/m2. Blood samples were collected in the morning, after overnight fasting, and all tests were performed in the same laboratory.

Results: We evaluated 69 subjects, mean age 39 ± 10 years and 87% caucasian. Type 2 Diabetes Mellitus (T2DM) was found in 47.8%, hypertension in 72.5%, dyslipidemia in 23.2% and metabolic syndrome according to the IDF in 87%. Mean weight, waist circumference and BMI were respectively: 157.4 ± 31.0 kg, 148.2 ± 14.9 cm and 51.2 ± 8.3 kg/m2. The average fasting glycemia was 111.1 ± 34.7 mg/dL (NR <100), HbA1c 6.5 ± 1.3% (NR <5.7), total testosterone (TT) 232.8 ± 96.9 mg/dL (NR> 300) and calculated free testosterone (CFT) 5.9 ± 2.7 mg/dL (NR> 6.5). 79.7% of subjects had TT ≤ 300 mg/dL and 56.5% CFT ≤ 6.5 mg/dL. Categorizing patients according to the levels of TT [G1 (≤ 200 md/dL): 53.8 ± 8.5 kg/m2 x G2 (201-299 mg/dL): 49.3 ± 7.2 kg/m2 x G3 (≥ 300 mg/dL): 48.7± 8.7 kg/m2], there was a statistically significant difference only in relation to BMI (p = 0.04). There were no statistically significant differences in mean TT and CFT between individuals with and without T2DM [TT: 218.8 ± 89.4 x 245.5 ± 102.8 mg/dL (p = 0.25); CFT: 5.65 ± 2.7 x 2.6 ± 6.21 mg/dL (p = 0.39)].

Discussion / Conclusion: The evaluation of our group of patients with BMI ≥ 35 kg/m2 showed a high rate of individuals with TT less than 300 mg/dL. We also identified a statistically significant difference in BMI according to the categorizations of TT, with higher BMI levels in patients with TT ≤ 200 mg/dL. In this sense, it reinforces the need for gonadal axis assessment in obese patients and their appropriate monitoring and treatment.

(1) Saboor SA, Kumar S, Barber TM. The role of obesity and type 2 diabetes mellitus in the development of male obesity-associated secondary hypogonadism. Clin Endocrinol (Oxf). 2013;78(3):330–7. (2) Dandona P, Dhindsa S. Update: hypogonadotropic hypogonadism in type 2 diabetes and obesity. J Clin Endocrinol Metab. 2011;96(9):2643–51. (3) Shores MM, Matsumoto AM. Testosterone, aging and survival: biomarker or deficiency. Curr Opin Endocrinol Diabetes Obes [Internet]. 2014;209–16. Available from: (4) Pantalone KM, Faiman C. Male hypogonadism: More than just a low testosterone. Cleve Clin J Med. 2012;79(10):717–25. (5) Hohl A, Ronsoni MF. Falência testicular. In: Endocrinologia e Diabetes. 3ª ed. Rio de Janeiro: MedBook, 2015,   p. 592-609.

Nothing to Disclose: AH, GGEG, GD, FAR, MFP, MHCC, SV, MFR

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