Testosterone Changes in Men With Obesity and Type 2 Diabetes 6 Months After Sleeve Gastrectomy With Transit Bipartition

Abstract

Background: Metabolic/bariatric surgery has been shown to increase testosterone in males with obesity. This study investigated the effect of the novel metabolic/bariatric surgery procedure, sleeve gastrectomy with transit bipartition (SG-TB), on serum total testosterone and metabolic variable changes in men with obesity and type 2 diabetes. Methods: In a prospective single-center cohort study, laboratory samples were analyzed preoperatively and at 6 months following SG-TB in patients with a body mass index (BMI) >= 30 kg/m(2). Changes in metabolic parameters and testosterone were evaluated. Results: Between July 2018 and March 2019, 166 patients with a mean baseline BMI of 34.9 +/- 3.8 kg/m(2) (mean age 51.5 +/- 9.3 y), glycosylated hemoglobin 9.5 +/- 1.3%, and testosterone 3.1 +/- 1.3 underwent SG-TB. At 6-month follow-up, mean excess BMI loss was 70.2 +/- 24.3%; glycosylated hemoglobin, 6.6 +/- 1.1% (P<0.001); and testosterone, 4.5 +/- 1.5 (P<0.001). Conclusion: In the early term following SG-TB, more than any other factor assessed, BMI loss was found to be a significant driver of improvement in testosterone levels. Regardless of preoperative obesity classification, patients with initially low testosterone attained significantly increased testosterone levels at 6-month follow-up.