High prevalence of subnormal testosterone in obese adolescent males: reversal with bariatric surgery

Sandeep Dhindsa*, Husam Ghanim, Todd Jenkins, Thomas H. Inge, Carroll M. Harmon, Amit Ghoshal, Zengru Wu, Michael J. McPhaul, Farid Saad, Paresh Dandona

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objective: Obesity in adolescent males is associated with the lowering of total and free testosterone concentrations. Weight loss may increase testosterone concentrations. Design and methods: We evaluated the changes in sex hormones following bariatric surgery in 34 males (age range: 14.6–19.8 years) with obesity. These participants were part of a prospective multicenter study, Teen-Longitudinal Assessment of Bariatric Surgery. The participants were followed up for 5 years after surgery. Total testosterone, total estradiol, luteinizing hormone, follicle-stimulating hormone, sex hormone-binding globulin, C-reactive protein, insulin and glucose were measured at baseline, 6 months and annually thereafter. Free testosterone, free estradiol and HOMA2-IR were calculated. Results: Study participants lost one-third of their body weight after bariatric surgery, with maximum weight loss achieved at 24 months for most participants. Free testosterone increased from 0.17 (95% CI: 0.13 to 0.20) at baseline to 0.34 (95% CI: 0.30 to 0.38) and 0.27 nmol/L (95% CI: 0.23 to 0.32) at 2 and 5 years (P < 0.001 for both), respectively. Total testosterone increased from 6.7 (95% CI: 4.7 to 8.8) at baseline to 17.6 (95% CI: 15.3 to 19.9) and 13.8 (95% CI: 11.0 to 16.5) nmol/L at 2 and 5 years (P < 0.001), respectively. Prior to surgery, 73% of the participants had subnormal free testosterone (<0.23 nmol/L). After 2 and 5 years, only 20 and 33%, respectively, had subnormal free testosterone concentrations. Weight regain was related to a fall in free testosterone concentrations. Conclusions: Bariatric surgery led to a robust increase in testosterone concentrations in adolescent males with severe obesity. Participants who regained weight had a decline in their testosterone concentrations.

Original languageEnglish (US)
Pages (from-to)319-327
Number of pages9
JournalEuropean journal of endocrinology
Volume186
Issue number3
DOIs
StatePublished - Mar 2022

Funding

The N 阀H (National 阀nstitute of Diabetes and Digestive and Kidney Diseases) provided grant funding for the Teen-LABS study through grants UM1DK072493 (University of Colorado) and UM1DK095710 (University of Cincinnati). Funding for this ancillary study was provided by Divisions of Endocrinology of University at Bu 贀alo and Saint Louis University. The NIH (National Institute of Diabetes and Digestive and Kidney Diseases) provided grant funding for the Teen-LABS study through grants UM1DK072493 (University of Colorado) and UM1DK095710 (University of Cincinnati). Funding for this ancillary study was provided by Divisions of Endocrinology of University at Buffalo and Saint Louis University. The authors are grateful to Jennifer Boring and Julia Larsen from Quest diagnostics, and the Teen-LABS Consortium (5UM1DK072493-16/5UM1DK0957710-10), for their assistance in conducting the study.

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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