Efeitos de diferentes cirurgias bariátricas metabólicas nos níveis de testosterona: uma revisão sistemática e metanálise

Abstract

Introduction: Obesity, a globally prevalent condition associated with various comorbidities, has significant impacts on male endocrine health, including alterations in testosterone levels. Metabolic Bariatric Surgery stands out as an effective approach to promoting weight loss and improving hormonal outcomes. Objective: This study aims to evaluate and compare the effects of Roux-en-Y gastric bypass (RYGB) and Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic adjustable gastric banding (LAGB) on testosterone levels in men. Methodology: This systematic review and meta-analysis followed the Cochrane Handbook and PRISMA guidelines. Searches in Medline, Embase, and Web of Science (up to July 2024) focused on studies comparing RYGB and LSG or LAGB and reporting pre- and post-surgery testosterone levels. 290 articles were found, 159 of which were eligible for consideration. After applying the screening flowchart, three articles remained for analysis. Data on patients, interventions, and outcomes were extracted, and statistical analyses employed random-effects models and heterogeneity assessment. Results: The combined analysis showed a mean difference of 113.07 ng/dL (95% CI: 1.47 to 224.67) favoring RYGB, with high heterogeneity (I² = 65%). Individual studies indicated a greater increase in testosterone levels in the RYGB group. Despite variability among studies, the results suggest that RYGB may provide an advantage in increasing testosterone levels. Conclusion: The results of this review suggest that RYGB is associated with a more significant increase in testosterone levels compared to LSG or LAGB. These findings should be interpreted cautiously, and future studies with larger samples and standardized protocols are needed.