Avaliação precoce do perfil hormonal, seminal e funcional de espermatozóides de pacientes obesos submetidos à cirurgia bariátrica.
Data
2013
Autores
Lima, Cindy Ferreira 
Orientadores
Fraietta, Renato
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Avaliar mudancas no perfil hormonal, seminal e funcional de espermatozoides de homens obesos que foram submetidos a cirurgia bariatrica de bypass gastrico em Y de roux (BGYR). Metodos: Estudo prospectivo composto por 12 homens obesos com indicacao de cirurgia bariatrica acompanhados por 3 meses apos procedimento. Os pacientes realizaram dosagem de testosterona total e livre (TT e TL), estradiol (E2), prolactina (PRL), hormonios luteinizante e foliculo estimulante (LH e FSH). As amostras seminais foram obtidas e analisadas de acordo com as recomendacoes da Organizacao Mundial da Saúde (1999) e a morfologia segundo o criterio estrito de Kruger (1986). A integridade do DNA nuclear dos espermatozoides foi avaliada pelo ensaio de dispersao da cromatina espermatica (SCD). As celulas foram classificadas de acordo com a morfologia do DNA observada: A) grande halo (alta integridade); B) medio halo (integro ou em inicio de fragmentacao); C) pequeno halo (moderada a altamente fragmentado); e D) halo ausente (altamente fragmentado). A atividade mitocondrial foi avaliada por um metodo colorimetrico, atraves do qual as celulas foram classificadas em: classe I (100% de mitocondrias ativas), classe II (mais de 50% de mitocondrias ativas), classe III (menos de 50% de mitocondrias ativas) e classe IV (100% de mitocondrias inativas). O nivel de peroxidacao lipidica foi determinado usando-se metodo baseado na reacao de malonaldeido (MDA) com o acido tiobarbiturico (TBA). Resultados: Foram observados aumento nos niveis de TT e diminuicao nos niveis de E2. Nao houve mudancas em TL, FSH e PRL. Quanto aos parametros seminais foi observada diminuicao no numero de celulas redondas. Nao houve mudancas nos niveis de peroxidacao lipidica, integridade de DNA e atividade mitocondrial. Tendencias estatisticas foram observadas quanto ao aumento nos niveis de LH, contagem total e contagem total de espermatozoides moveis. Conclusoes: A perda de peso atraves de BGYR tem impacto positivo sobre o perfil hormonal reprodutivo, mas sem comprovacao estatistica de mudancas nos parametros seminais e funcionais.
Objectives: To evaluate changes in hormonal, seminal and sperm functional profile of obese men who underwent bariatric gastric bypass roux-Y surgery (RYGB). Methods: Prospective study of 12 obese men followed by 3 months after the procedure. Patients underwent measurement of total and free testosterone (TT and FT), estradiol (E2), prolactin (PRL), luteinizing and follicle stimulating hormones (LH and FSH). The semen samples were obtained and analyzed according to the criteria of the World Health Organization (2010) and morphology according to strict criteria of Kruger (1986). The integrity of the sperm nuclear DNA was evaluated by testing the sperm chromatin dispersion (SCD). Cells were classified according to morphology of the DNA observed: a) large halo (high integrity), b) medium halo (intact or fragmented top) c) small halo (moderate to highly fragmented) and D) absent halo (highly fragmented). The mitochondrial activity was assessed by a colorimetric method, where cells were classified into Class I (100% active mitochondria), class II (over 50% active mitochondria), class III (less than 50% active mitochondria) and class IV (100% of mitochondria inactive). The level of lipid peroxidation was determined using a method based on the reaction of MDA with TBA. Results: We observed increased levels of TT and decreased levels of E2. There were no changes in FT, FSH and PRL. In semen parameters decrease in the number of round cells was observed. There were no changes in the levels of lipid peroxidation, DNA integrity and mitochondrial activity. Statistical trends were observed as an increase in the levels of LH, total count and total motile sperm count. Conclusions: Weight loss via RYGB has a positive impact on the reproductive hormone profile, but no statistical evidence of changes in semen parameters and functional profile.
Objectives: To evaluate changes in hormonal, seminal and sperm functional profile of obese men who underwent bariatric gastric bypass roux-Y surgery (RYGB). Methods: Prospective study of 12 obese men followed by 3 months after the procedure. Patients underwent measurement of total and free testosterone (TT and FT), estradiol (E2), prolactin (PRL), luteinizing and follicle stimulating hormones (LH and FSH). The semen samples were obtained and analyzed according to the criteria of the World Health Organization (2010) and morphology according to strict criteria of Kruger (1986). The integrity of the sperm nuclear DNA was evaluated by testing the sperm chromatin dispersion (SCD). Cells were classified according to morphology of the DNA observed: a) large halo (high integrity), b) medium halo (intact or fragmented top) c) small halo (moderate to highly fragmented) and D) absent halo (highly fragmented). The mitochondrial activity was assessed by a colorimetric method, where cells were classified into Class I (100% active mitochondria), class II (over 50% active mitochondria), class III (less than 50% active mitochondria) and class IV (100% of mitochondria inactive). The level of lipid peroxidation was determined using a method based on the reaction of MDA with TBA. Results: We observed increased levels of TT and decreased levels of E2. There were no changes in FT, FSH and PRL. In semen parameters decrease in the number of round cells was observed. There were no changes in the levels of lipid peroxidation, DNA integrity and mitochondrial activity. Statistical trends were observed as an increase in the levels of LH, total count and total motile sperm count. Conclusions: Weight loss via RYGB has a positive impact on the reproductive hormone profile, but no statistical evidence of changes in semen parameters and functional profile.
Descrição
Citação
LIMA, Cindy Ferreira. Avaliação precoce do perfil hormonal, seminal e funcional de espermatozóides de pacientes obesos submetidos a cirurgia bariátrica. 2013. 54 f. Dissertação (Mestrado em Urologia) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.