The relationship between gender-related diffrenoe in immune response and DHEA following surgical stress

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Object : To determine whether gender differences are observed in circulating sex hormone and inflammatory cytokine levels following major surgery.Method : Twenty-nine patients (male ; n = 21, female ; n = 8) who underwent gastrectomy for gastric cancer, 42 patients (male ; n = 26, female ; n = 16) who underwent colorectal surgery for colorectal cancer, and 21 patients (male ; n = 17, female ; n = 4) who underwent thoracic-abdominal surgery for esophageal cancer were measured the circulating 17β-estradial, testosterone, DHEA and inflammatory cytokines.Results : The percentage of patients in female group who had severe complications was significantly lower than the corresponding percentage of the male group. Inflammatory cytokines and CRP levels in male group increased significantly compared to the female group. The 17β-estradiol-to-testostrone ratio in the postoperative complication of male group was significantly higher in the control male group. There were no differences in DHEA levels between the postoperative complication and control groups in male.After surgery, the circulating adiponectin levels decreased and leptin levels increased. The alteration of adiponectin and leptin levels were significantly correlated with the 17β-estradiol-to-testostrone ratio and testosterone levels.Conclusion : Our data revealed that the adipocyte dysfunction under the regulation of sex hormones might develop postoperative complications after major surgery.These results were already presented in the surgical-related meeting. Two original papers "Depressed adipocyte function is a risk factor for postoperative infection following colorectal cancer surgery" and "Gender-related difference in immune responses following major surgical trauma are diminished by preoperative steroid administration" were submitted.