腹腔镜袖状胃切除术对男性肥胖症患者性激素的影响  

Effects of laparoscopic sleeve gastrectomy on sex hormones in male patients with obesity

作　　者：王浩 艾克拜尔·艾力[2,3,4] 麦麦提艾力·麦麦提明 克力木·阿不都热依木 WANG Hao;Aikebaier Aili;Maimaitiaili Maimaitiming;Kelimu Abudureyimu(Graduate School,Xinjiang Medical University,Urumqi,Xinjiang 830054,China;不详)

机构地区：[1]新疆医科大学研究生院,新疆乌鲁木齐830054 [2]新疆维吾尔自治区人民医院微创外科疝腹壁外科,新疆乌鲁木齐830011 [3]新疆维吾尔自治区胃食管反流病与减肥代谢外科临床研究中心,新疆乌鲁木齐830011 [4]新疆维吾尔自治区普外科与微创外科研究所,新疆乌鲁木齐830011

出　　处：《中国临床研究》2024年第7期1097-1100,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金地区科学基金项目(82060166);新疆维吾尔自治区重点研发任务专项(2022395588)。

摘　　要：目的评估肥胖症男性患者在接受腹腔镜袖状胃切除术(LSG)后性激素水平的变化。方法纳入新疆维吾尔自治区胃食管反流病及减重代谢外科临床研究中心于2013年1月至2021年12月接受LSG的男性肥胖患者43例,回顾性分析其术前及随访1年的临床资料。观察主要结局指标为性激素水平[雌二醇(E2)、促卵泡生成激素(FSH)、促黄体生成激素(LH)、催乳素、孕酮和睾酮]、血脂、胸围、腹围、臀围及体重指标。结果在LSG术后1年,全组胸围、腹围、臀围、体重、身体质量指数(BMI)水平均下降(P<0.01)。相关性分析显示,术前E2与体重呈正相关(r=0.340);睾酮分别与BMI(r=-0.369),腹围(r=-0.372)、臀围(r=-0.384)、胸围(r=-0.366)呈负相关(P<0.05)。与术前相比,LSG术后1年全组血清睾酮[4.8(3.9,5.8)ng/mL vs 2.6(1.9,3.0)ng/mL,Z=6.530,P<0.01]水平显著升高,E2和催乳素水平显著下降(P<0.01);FSH、LH和孕酮水平有所下降,但差异无统计学意义(P>0.05)。术后总胆固醇、三酰甘油、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇均较术前改善(P<0.05)。结论LSG减重手术是安全有效的,且男性的肥胖程度与睾酮水平呈负相关,LSG可有效提升肥胖男性患者睾酮水平,降低E2、催乳素水平。Objective To evaluate the changes in sex hormone levels in male patients with obesity after receiving laparoscopic sleeve gastrectomy(LSG).Methods Forty-three male obese patients who received LSG at the Clinical Research Center for Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery in Xinjiang Uygur Autonomous Region from January 2013 to December 2021 were retrospectively analyzed for preoperative and 1-year follow-up clinical data.The main outcomes were sex hormone levels[estradiol(E2),follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin,progesterone,and testosterone],blood lipids,chest circumference,abdominal circumference,hip circumference,and body weight.Results One year after LSG,the levels of chest circumference,abdominal circumference,hip circumference,body weight,and body mass index(BMI)decreased in the whole group(P<0.01).Correlation analysis showed that preoperative E2 was positively correlated with body weight(r=0.340),while testosterone was negatively correlated with BMI(r=-0.369),abdominal circumference(r=-0.372),hip circumference(r=-0.384),and chest circumference(r=-0.366),respectively(P<0.05).Compared with the preoperative levels,the serum testosterone level increased in the whole group one year after LSG[4.8(3.9,5.8)ng/mL vs 2.6(1.9,3.0)ng/mL,Z=6.530,P<0.01],while the levels of of E2 and prolactin decreased significantly(P<0.01);the levels of FSH,LH and progesterone decreased slightly,but no statistically difference was found(P>0.05).Postoperative total cholesterol,triacylglycerol,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were improved compared with preoperative(P<0.05).Conclusion LSG bariatric surgery is safe and effective,and the degree of obesity in men is negatively correlated with testosterone levels.LSG can effectively increase testosterone levels,and reduce E2 and prolactin levels in male obesity patients.

关 键 词：肥胖症 性激素 腹腔镜袖状胃切除术 睾酮 血脂 雌二醇 促卵泡生成激素 促黄体生成激素 催乳素 孕酮 

分 类 号：R589.2[医药卫生—内分泌]