Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
-
Vivian L. Chin
,
Rushika Conroy
Abstract
Background
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.
Methods
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.
Results
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).
Conclusions
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.
Acknowledgments
This work was supported by National Institutes of Health (NIH) Grant NIDDK T32 DK 06552 (PI Sharon Oberfield). Baseline data analysis was previously presented at the 95th Annual Endocrine Society Meeting, San Francisco, CA, June 2013, and follow-up analysis was presented at the 10th International Meeting of Pediatric Endocrinology held during September 2017 in Washington, DC. We would like to thank Chengchen Zhang for her help with statistical analysis.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: U.S. Department of Health and Human Services, National Institutes of Health, NIH Clinical Center, NIH Grant NIDDK T32 DK 06552, Funder Id: 10.13039/100000098.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: Dr. Oberfield reports grants from NIH/NIDDK (U.S. Department of Health and Human Services, National Institutes of Health, NIH Clinical Center, NIH Grant NIDDK T32 DK 06552) during the conduct of the study. Dr. Fennoy reports grants and personal fees from Novo Nordisk, and personal fees from Island Peer Review Organization outside the submitted work. The other authors have no financial relationships or conflicts of interest to disclose.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Original Articles
- Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
- Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
- Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
- Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states
- High urate concentration is associated with elevated blood pressure in schoolchildren
- The association of hs-CRP and fibrinogen with anthropometric and lipid parameters in non-obese adolescent girls with polycystic ovary syndrome
- Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study
- Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
- Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation
- Morning vs. bedtime levothyroxine administration: what is the ideal choice for children?
- Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
- The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
- SHOX gene deletion screening by FISH in children with short stature and Madelung deformity and their characteristics
- FGFR3-related hypochondroplasia: longitudinal growth in 57 children with the p.Asn540Lys mutation
- Case Reports
- A variable course of Cushing’s disease in a 7 year old: diagnostic dilemma
- Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation
Articles in the same Issue
- Frontmatter
- Original Articles
- Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
- Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
- Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
- Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states
- High urate concentration is associated with elevated blood pressure in schoolchildren
- The association of hs-CRP and fibrinogen with anthropometric and lipid parameters in non-obese adolescent girls with polycystic ovary syndrome
- Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study
- Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
- Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation
- Morning vs. bedtime levothyroxine administration: what is the ideal choice for children?
- Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
- The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
- SHOX gene deletion screening by FISH in children with short stature and Madelung deformity and their characteristics
- FGFR3-related hypochondroplasia: longitudinal growth in 57 children with the p.Asn540Lys mutation
- Case Reports
- A variable course of Cushing’s disease in a 7 year old: diagnostic dilemma
- Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation
