AB046. SOH25_AB_399. Male obesity-associated secondary hypogonadism in patients presenting for bariatric surgery

Background: Male obesity-associated secondary hypogonadism (MOSH) commonly affects men living with obesity and has been estimated to affect up to 50% of these patients. Hypogonadism is diagnosed when biochemical evidence of testosterone deficiency (i.e., <12 nmol/L) exists in association with symptoms. Uncertainty exists regarding the true incidence of hypogonadism in patients living with obesity and the role of associated factors has yet to be fully elucidated.

Methods: We undertook a retrospective review of a prospectively maintained database of bariatric surgical patients in Saint Vincent’s University Hospital over a 2-year period. We collected data on demographics, anthropometrics and medical and medication history. Descriptive statistics and linear regression analysis were performed to assess the incidence of biochemical hypogonadism in our population and identify associated factors that predicted severity of androgen deficiency when present.

Results: A total of 49 patients were identified, of whom 38 had requisite results of biochemical testing. Their mean age was 48 years, mean body mass index (BMI) was 49 kg/m² and mean absolute body weight was 159 kg. The mean serum testosterone was 8.8 nmol/L, mean sex hormone binding globulin was 31 nmol/L and mean oestradiol was 149 pmol/L. Biochemical hypogonadism was seen in 31/38 patients (82%). Biochemical hypogonadism was associated with increased BMI and younger age in our cohort.

Conclusions: The incidence of biochemical hypogonadism in our cohort exceeds that of reported literature. Our results should prompt incorporation of gonadal assessment, including symptoms screening, of all men presenting for consideration of bariatric surgery.

Keywords: Bariatric; hypogonadism; male; obesity; surgery