Effect of bariatric surgery on endogenous sex hormones and sex hormone-binding globulin levels: a systematic review and meta-analysis

Background: Most studies have shown beneficial effect of bariatric surgery (BS) on serum levels of sex hormones. Objective: A systematic review and meta-analysis was conducted to examine the magnitude of possible changes in levels of sex hormones following BS. Settings: Electronic databases were searched, including PubMed, Scopus, Web of Science, and Embase, for relevant studies. Methods: The heterogeneity of the studies was examined by chi(2) tests and the degree of heterogeneity was estimated using I-2 statistic. Results: The results of pooled analyses revealed that BS caused a significant increase in luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), and sex hormone binding globulin (SHBG) levels and conversely, decreased dehydroepiandrosterone (DHEA) and estradiol (E2) levels in males. For females, BS significantly increased LH, FSH, and SHBG levels and conversely, decreased androstenedione (AE), E2 and TT levels. Additionally, the level of progesterone (P), prolactin (PRL), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S) showed no significant changes in patients who had undergone BS. Conclusion: BS changed most sex hormones levels including LH, FSH, TT, SHBG, AE, DHEA, and E2. It seems that BS is able to exert substantial impacts on sex hormones levels and as well as sexual function, however, larger, and more precise trials are required to specifically focus on these claims. (C) 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.