Metabolism of testosterone during weight loss in men with obesity
•Three weeks after bariatric surgery SHBG and testosterone serum levels increase.•Decreased aromatization contributes to restoration of sex steroid profile.•Decreased metabolism of testosterone by the 5alpha-reductase pathway.•Increased production of testosterone is possible after bariatric surgery....
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| Vydáno v: | The Journal of steroid biochemistry and molecular biology Ročník 209; s. 105851 |
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| Hlavní autoři: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
Elsevier Ltd
01.05.2021
Elsevier BV |
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| ISSN: | 0960-0760, 1879-1220, 1879-1220 |
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| Abstract | •Three weeks after bariatric surgery SHBG and testosterone serum levels increase.•Decreased aromatization contributes to restoration of sex steroid profile.•Decreased metabolism of testosterone by the 5alpha-reductase pathway.•Increased production of testosterone is possible after bariatric surgery.
Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated.
Longitudinal study.
Fourteen men with obesity (age 52(45–60)years, BMI 42.6(41.8–44.8)kg/m²) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E2) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS.
Already three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E2 levels were unchanged, serum E2/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E2/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125).
Restoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity. |
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| AbstractList | Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated.
Longitudinal study.
Fourteen men with obesity (age 52(45-60)years, BMI 42.6(41.8-44.8)kg/m²) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E
) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS.
Already three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E
levels were unchanged, serum E
/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E
/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125).
Restoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity. Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated.OBJECTIVEMen with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated.Longitudinal study.DESIGNLongitudinal study.Fourteen men with obesity (age 52(45-60)years, BMI 42.6(41.8-44.8)kg/m²) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E2) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS.METHODSFourteen men with obesity (age 52(45-60)years, BMI 42.6(41.8-44.8)kg/m²) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E2) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS.Already three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E2 levels were unchanged, serum E2/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E2/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125).RESULTSAlready three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E2 levels were unchanged, serum E2/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E2/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125).Restoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity.CONCLUSIONSRestoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity. Objective: Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated. Design: Longitudinal study. Methods: Fourteen men with obesity (age 52(45–60)years, BMI 42.6(41.8–44.8)kg/m2) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E2) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS. Results: Already three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E2 levels were unchanged, serum E2/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E2/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125). Conclusions: Restoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity. •Three weeks after bariatric surgery SHBG and testosterone serum levels increase.•Decreased aromatization contributes to restoration of sex steroid profile.•Decreased metabolism of testosterone by the 5alpha-reductase pathway.•Increased production of testosterone is possible after bariatric surgery. Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss. Although this is partly explained by lower sex hormone binding globulin (SHBG) production and hypothalamic-pituitary downregulation, it is still not unravelled whether changes in androgen metabolism contribute to this phenomenon. Therefore, early changes in urinary excretion of T and its metabolites, during weight loss, in men with obesity are investigated. Longitudinal study. Fourteen men with obesity (age 52(45–60)years, BMI 42.6(41.8–44.8)kg/m²) underwent gastric bypass surgery (GBS). Before surgery and 3 weeks, 6 weeks, 6 months and 1 year thereafter, 24 h urine and fasting serum samples were collected. Serum T and estradiol (E2) levels were analyzed using LC-MS/MS and urinary metabolites of T with GC-MS/MS. Already three weeks after GBS, serum SHBG and total T levels increased and remained increased as compared to baseline (all,p < 0.0125). Gonadotropins and (free) E2 levels were unchanged, serum E2/T ratio decreased (p < 0.0125). Total amount of urinary T increased non-significantly with mean increases of 53 % one year after GBS (p = 0.026). Urinary E2/T, estrone/T, 3α-androstanediol/T and androsterone/T ratios decreased after GBS (p < 0.0125). Restoration of circulating T levels during weight loss in this population is not only brought about by normalization of circulating SHBG levels, but increased production of and alterations in T metabolism also contribute. More specifically, relative decreases in aromatization and lower 5α-reductase activity might also be involved in restoring T levels in men with obesity. |
| ArticleNumber | 105851 |
| Author | Reyns, Tim Deventer, Koen Lapauw, Bruno Van Gansbeke, Wim Fiers, Tom Van de Velde, Frederique Van Eenoo, Peter Kaufman, Jean Marc Van Renterghem, Pieter Van Nieuwenhove, Yves |
| Author_xml | – sequence: 1 givenname: Frederique orcidid: 0000-0003-4574-3396 surname: Van de Velde fullname: Van de Velde, Frederique email: frederique.vandevelde@ugent.be organization: Department of Endocrinology, Ghent University Hospital, Ghent, Belgium – sequence: 2 givenname: Koen surname: Deventer fullname: Deventer, Koen organization: Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium – sequence: 3 givenname: Wim surname: Van Gansbeke fullname: Van Gansbeke, Wim organization: Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium – sequence: 4 givenname: Peter surname: Van Eenoo fullname: Van Eenoo, Peter organization: Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium – sequence: 5 givenname: Pieter surname: Van Renterghem fullname: Van Renterghem, Pieter organization: Doping Control Laboratory, Ghent University, Zwijnaarde, Belgium – sequence: 6 givenname: Tom surname: Fiers fullname: Fiers, Tom organization: Department of Clinical Biology, Ghent University Hospital, Ghent, Belgium – sequence: 7 givenname: Tim surname: Reyns fullname: Reyns, Tim organization: Department of Clinical Biology, Ghent University Hospital, Ghent, Belgium – sequence: 8 givenname: Jean Marc orcidid: 0000-0002-1400-6812 surname: Kaufman fullname: Kaufman, Jean Marc organization: Department of Endocrinology, Ghent University Hospital, Ghent, Belgium – sequence: 9 givenname: Yves surname: Van Nieuwenhove fullname: Van Nieuwenhove, Yves organization: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium – sequence: 10 givenname: Bruno orcidid: 0000-0002-1584-4965 surname: Lapauw fullname: Lapauw, Bruno organization: Department of Endocrinology, Ghent University Hospital, Ghent, Belgium |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33610798$$D View this record in MEDLINE/PubMed |
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| Keywords | 24h Urine Obesity Testosterone Metabolism Weight loss |
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| Snippet | •Three weeks after bariatric surgery SHBG and testosterone serum levels increase.•Decreased aromatization contributes to restoration of sex steroid... Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during weight loss.... Objective: Men with obesity often have low total and, with increasing adiposity, also low free testosterone (T) levels, which can partially restore during... |
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| SubjectTerms | 17β-Estradiol 24h Urine Adipose tissue Body weight loss Estrone Gastric bypass Gastrointestinal surgery Globulins Gonadotropins Hypothalamus Metabolism Metabolites Obesity Pituitary Pituitary (anterior) Sex hormones Surgery Testosterone Weight control Weight loss |
| Title | Metabolism of testosterone during weight loss in men with obesity |
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