Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery.
Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery.
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DOI：
10.1515/jpem-2018-0261
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发表时间：
2018-11-27
期刊：
影响因子：
--
通讯作者：
Fennoy I
中科院分区：
文献类型：
--
作者：
Chin VL;Willliams KM;Donnelley T;Censani M;Conroy R;Lerner S;Oberfield SE;McMahon DJ;Zitsman J;Fennoy I
体重指数（BMI）升高与男性性腺功能减退有关，但在青少年中尚未得到很好的描述。本研究旨在评估肥胖青少年男性的性腺功能障碍和胃束带术后体重减轻的效果。在哥伦比亚大学医学中心的青少年减肥手术中心登记的54名男孩中有37名（年龄16.2 ± 1.2岁，平均BMI 48.2 kg/m2）的总睾酮水平较低，坦纳5 <350 ng/dL。16例患者在基线（T0）、术后1年（T1）和2年（T2）时有长期激素数据进行分析。采用t检验、卡方检验、相关分析和线性混合模型分析。在T0时，与对照组相比，性腺功能减退组的收缩压（SBP）（第75百分位数vs.第57百分位数，p = 0.02）、空腹胰岛素（19 vs. 9 µIU/mL，p = 0.0008）和稳态胰岛素抵抗指数（HOMA-IR）（4.2 vs. 1.9，p = 0.009）更高。总睾酮与空腹胰岛素和HOMA-IR呈负相关。在长期分析中，与T0相比，T1和T2的BMI、体重、腰围（WC）和超重百分比均降低。T0、T1和T2时的平均总睾酮分别为268、304和368 ng/dL（p = 0.07）。2年后，BMI和睾酮之间存在统计学显著负相关（r =-0.81，p = 0.003）。低睾酮水平但促性腺激素不变在这组中很常见，并与胰岛素抵抗有关。虽然随着时间的推移没有发现睾酮的显着增加，但BMI和睾酮之间的负相关关系仍然存在，这表明可能存在一个关于BMI的睾酮产生的最佳阈值。需要长期研究。
Elevated body mass index (BMI) is associated with hypogonadism in men but this is not well described in adolescents. The aim is to evaluate gonadal dysfunction and the effects of weight loss after gastric banding in obese adolescent boys. Thirty-seven of 54 boys (age 16.2 ± 1.2 years, mean BMI 48.2 kg/m2) enrolled at the Center for Adolescent Bariatric Surgery at Columbia University Medical Center had low total testosterone for Tanner 5 <350 ng/dL. Sixteen had long-term hormonal data for analysis at baseline (T0), 1 year (T1) and 2 years (T2) post-surgery. T-tests, chi-squared (χ2) tests, correlation and linear mixed models were performed. At T0, the hypogonadal group had higher systolic blood pressure (SBP) (75th vs. 57th percentile, p = 0.02), fasting insulin (19 vs. 9 µIU/mL, p = 0.0008) and homeostatic index of insulin resistance (HOMA-IR) (4.2 vs. 1.9, p = 0.009) compared to control group. Total testosterone was negatively correlated with fasting insulin and HOMA-IR. In the long-term analysis, BMI, weight, waist circumference (WC), and % excess weight decreased at T1 and T2 compared to T0. Mean total testosterone at T0, T1 and T2 were 268, 304 and 368 ng/dL, respectively (p = 0.07). There was a statistically significant negative correlation between BMI and testosterone after 2 years (r = −0.81, p = 0.003). Low testosterone levels but unaltered gonadotropins are common in this group and associated with insulin resistance. While a significant increase in testosterone was not found over time, the negative relationship between BMI and testosterone persisted, suggesting there may be an optimal threshold for testosterone production with respect to BMI. Long-term studies are needed.
影响因子：
3.3
作者：
Conroy R;Lee EJ;Jean A;Oberfield SE;Sopher A;Kiefer K;Raker C;McMahon DJ;Zitsman JL;Fennoy I
通讯作者：
Fennoy I