Prevalence of 'obesity-associated gonadal dysfunction' in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis.

摘要: Background Sexual dimorphism manifests noticeably in obesity-associated gonadal dysfunction. In women, obesity is associated with androgen excess disorders, mostly the polycystic ovary syndrome (PCOS), whereas deficiency frequently present obese men what has been termed as male secondary hypogonadism (MOSH). Obesity-associated dysfunction, consisting of PCOS women and MOSH men, a frequent finding patients severe it may be ameliorated or even resolve marked weight loss, especially after bariatric surgery. Objective rationale We aimed to obtain an estimation prevalence dysfunction among presenting evaluate response surgery terms resolution and/or improvement this condition changes circulating sex hormone concentrations. Search methods searched PubMed EMBASE for articles published up June 2016. After deleting duplicates, abstract 757 were analyzed. subsequently excluded 712 leaving 45 studies full-text assessment eligibility. Of these, 16 excluded. Hence, 29 included quantitative synthesis different meta-analyses. Quality was assessed using index Assessment Tool Before-After (Pre-Post) Studies With No Control Group available from National Heart, Lung Blood Institute. For meta-analyses including more than 10 studies, we used funnel Doi plots estimate publication bias. Outcomes severely submitted surgery, very prevalent: 36% (95CI 22-50) 64% 50-77) men. found 96% 89-100) affected occurred 87% 76-95) Sex hormone-binding globulin concentrations increased (22 pmol/l, 95CI 2-47) 19-26) serum estradiol decreased (-104 -171 -39) lesser extent (-22 -38 -7). On contrary, sex-specific observed concentrations: example, total testosterone concentration (8.1 nmol/l, 6-11) but (-0.7 -0.9 -0.5). The latter accompanied by hirsutism 53% 29-76), menstrual 88-100), showing these symptoms before Wider implications most prevalent comorbidities should ruled out routinely during their initial diagnostic workup. Considering excellent regarding both MOSH, offered