Relationship of androgens to insulin resistance and chronic inflammation in morbidly obese premenopausal women: studies before and after vertical banded gastroplasty

Morbid obesity is associated with insulin resistance (IR), type 2 diabetes, lipid abnormalities, and hypertension. The association of obesity with increased androgen production and low concentrations of sex hormone-binding globulin (SHBG) in women has been demonstrated as well as a strong associatio...

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Bibliographic Details
Published in:Obesity surgery 2006-09, Vol.16 (9), p.1214-1220
Main Authors: Kopp, Hans-Peter, Krzyzanowska, Katharina, Schernthaner, Gerit-Holger, Kriwanek, Stefan, Schernthaner, Guntram
Format: Article
Language:English
Subjects:
Adult
C-Reactive Protein - metabolism
Female
Follow-Up Studies
Gastrointestinal surgery
Gastroplasty
Humans
Insulin resistance
Insulin Resistance - physiology
Interleukin-6 - blood
Middle Aged
Obesity
Obesity, Morbid - blood
Obesity, Morbid - surgery
Premenopause - blood
Prospective Studies
Sex Hormone-Binding Globulin - metabolism
Testosterone
Testosterone Congeners - blood
Weight Loss - physiology
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Summary:Morbid obesity is associated with insulin resistance (IR), type 2 diabetes, lipid abnormalities, and hypertension. The association of obesity with increased androgen production and low concentrations of sex hormone-binding globulin (SHBG) in women has been demonstrated as well as a strong association of androgens with markers of inflammation such as high-sensitive C-reactive protein (hsCRP). Because weight loss results in a significant decrease in cardiovascular risk factors, IR and inflammation, we questioned a possible interrelationship between androgens, IR and inflammation in a prospective study with 43 morbidly obese female patients undergoing bariatric surgery. SHBG, dehydroepiandrosterone-sulfate (DHEA-S), and insulin were measured by ELISA, cortisol by fluorescence polarization immunoassay, androstendione by RIA, and testosterone by electrochemiluminescence immunoassay. The free androgen index (FAI) was calculated as the total testosterone/SHBG ratio. High sensitivity assays were used to obtain concentrations of fasting hsCRP, Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). Weight loss resulted in a significant increase in SHBG (17+/-12 vs 70+/-30 nmol/l, P
ISSN:0960-8923
1708-0428
DOI:10.1381/096089206778392130