Changes in inflammatory markers correlated with increased testosterone after laparoscopic sleeve gastrectomy in obese Chinese men with acanthosis nigricans

Abstract

Bariatric surgery is an effective method for severe obesity and its related comorbidities. This study was performed to explore the alterations of sex hormones and inflammatory markers following laparoscopic sleeve gastrectomy (LSG) among obese Chinese men with acanthosis nigricans (AN). Sixty‐five obese men who underwent LSG were enrolled, comprising simple obesity without AN (OB group, n = 20) and obesity with AN (AN group, n = 45). There were 31 healthy male controls with normal body mass index (BMI) included. Anthropometry data, inflammatory markers, sex hormones and metabolic parameters were compared preoperatively and 12 months post‐operatively. At baseline, patients in the AN group were associated with more severe metabolic abnormalities than the OB and control groups. Twelve months after surgery, AN patients obtained significant improvement in skin condition and reduction in AN score. BMI, fasting insulin (FINS), and Homeostatic Model Assessment of Insulin Resistance (HOMA‐IR), tumor necrosis factor‐α (TNF‐α) and total testosterone (TT) were significantly changed in both groups, while interleukin (IL)‐6, IL‐8 and C‐reactive protein were changed significantly only in the AN group. Moreover, FINS, HOMA‐IR, TT and IL‐6 levels were changed more in the AN group than those in the OB group. Multivariate regression analysis revealed that TT increase correlated significantly with reduction in FINS and HOMA‐IR in both groups, but correlated with changes in IL‐6 only in the AN group. In conclusion, LSG is effective in improving the skin condition of obese men with AN. The increased TT in AN patients correlated with amelioration of inflammatory state in addition to insulin resistance after LSG.

Cutaneous manifestations of obesity in Turkish children: A comparative study

“…24 Obesityassociated AN may show clinical improvement with weight loss. [25][26][27][28] Our study demonstrated that AN in children with obesity was most frequently located on the neck, a visible area not normally covered with clothing. In light of these findings, we think it important to inform the child and family that AN will improve with weight loss.…”

Adipose Tissue Dysfunction and Obesity-Related Male Hypogonadism

“…Indeed, the reduction in VAT area assessed by MRI is positively associated with the increase in total testosterone plasma levels after bariatric surgery [ 116 ]. In addition to the contribution of weight loss per se, the restoration of normal testosterone levels after bariatric surgery could also be hypothesized to occur via the amelioration of inflammation markers since total testosterone levels were found to correlate significantly with changes in IL-6 and reductions in C-reactive protein [ 117 ].…”

Lower Baseline Serum Triglyceride Levels Are Associated With Higher Decrease in Body Mass Index After Laparoscopy Sleeve Gastrectomy Among Obese Patients

“…Zhu et al. ( 25 ) found that the IL-6 and IL-8 levels also decreased significantly after LSG in obese Chinese men with AN.…”

“…The results demonstrate that 6 months after LSG surgery, total testosterone level increases and, fat mass decreases in all regions in obese male patients ( 24 ); moreover, the increased testosterone level negatively correlated with FINS and HOMA-IR, especially with IL-6 in acanthosis nigricans (AN) patients. Thus, LSG surgery can improve the skin condition of obese patients with AN ( 25 ). Similarly, 12 months after LSG, the subclinical hypothyroidism incidence, TSH levels, and inflammatory markers such as IL-6, TNF-α, and CRP also decrease significantly ( 5 ).…”