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Comment on: The male patient with obesity undergoing bariatric-metabolic surgery: Changes in testosterone levels correlate with weight loss after OAGB and RYGB

  • Ann-Cathrin Koschker
    Affiliations
    Dept. of Internal Medicine I, Division of Endocrinology and Diabetology, University Hospital Würzburg, Würzburg, Germany

    Dept. Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany
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  • Florian Seyfried
    Correspondence
    Corresponding author Prof. Florian Seyfried, MD Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery University Hospital Würzburg Oberdürrbacherstr. 6, 97080 Würzburg, Germany Tel. +49-931-201-31046 Fax +49 931 201-39994
    Affiliations
    Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
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Published:January 18, 2023DOI:https://doi.org/10.1016/j.soard.2023.01.009
      Male obesity-associated secondary hypogonadism (MOSH) is among a number of comorbidities and health consequences associated with obesity (

      Carrageta DF, Oliveira PF, Alves MG, et al. Obesity and male hypogonadism: Tales of a vicious cycle..Obes Rev. 2019 Aug;20(8):1148-1158.

      ). Although frequently neglected, this disorder has a relevant impact on both patients’ quality of life but also potentially life expectancy. Obesity has been identified as a primary cause of secondary hypogonadism and reproductive dysfunction. Adipose tissue aromatase can reduce testosterone levels by irreversibly converting testosterone to estradiol. Low testosterone levels may lead to alterations in body composition and promote abdominal fat accumulation while obesity, in turn, can further reduce testosterone levels. Additionally, high estradiol concentrations have shown to mediate deleterious effects on male gonadal function. Thus, this bidirectional relationship of obesity-hypogonadism can easily become a vicious cycle.
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      Literature:

      1. Carrageta DF, Oliveira PF, Alves MG, et al. Obesity and male hypogonadism: Tales of a vicious cycle..Obes Rev. 2019 Aug;20(8):1148-1158.

      2. Jedamzik J, Bichler C, Felsenreich DM, et al. The male patient with obesity undergoing bariatric-metabolic surgery: Changes in testosterone levels correlate with weight loss after OAGB and RYGB, SOARD 2022, Epub ahead of print.

      3. Hofstra J, Loves S, van Wageningen B, et al. High prevalence of hypogonadotropic hypogonadism in men referred for obesity treatment. Neth J Med. 2008 Mar;66(3):103-109.

      4. Corona G, Rastrelli G, Monami M, et al. Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis. Eur J Endocrinol. 2013 May 2;168(6):829-843.

      5. Carette C, Levy R, Eustache F, et al. Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study. Surg Obes Relat Dis. 2019 Aug;15(8):1271-1279.

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