ALBERTO ROSENBLATT
Projetos de Pesquisa
Unidades Organizacionais
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Abnormalities of Reproductive Function in Male Obesity Before and After Bariatric Surgery-A Comprehensive Review(2015) ROSENBLATT, Alberto; FAINTUCH, Joel; CECCONELLO, IvanYoung males represent one of the populations with the steepest increases in the incidence of obesity. They are also prone to significant derangements in sexual health and fertility. Despite a growing number of reports about female reproductive health, in the setting of bariatric surgery, males have received much less attention. In the current review of reproductive abnormalities in severe obese males before and after bariatric surgery, erectile function, hypothalamic-pituitary-gonadal axis status, sex hormones, semen quality, fertility and assisted reproductive techniques, along with analysis of adipokines, gut hormones, and environmental factors are addressed. Available evidence about weight loss benefits, both medical and surgical, are highlighted, along with perspectives for future investigations, which may be relevant for the patient, for the couple, and for the community alike.
- Disability in the post-obese bariatric patient: Old and new problems(2013) FAINTUCH, J.; SOUZA, S. A. F.; FABRIS, S. M.; ROSENBLATT, A.; CECCONELLO, I.Sustained and lifelong weight loss for severely obese people is not anymore an impossible dream, and a Swedish journal has described bariatric surgery as the fairy tale about the ugly duckling (Olbers 2011). Of course this is a bittersweet remark, because although for millions such is an advantageous and even life-saving intervention, all of them have to cope with the post-obesity status. Obesity is a chronic incurable disease and the postobesity status is an attenuated albeit ongoing illness, not a mere sequela. Appropriate follow-up and secondary interventions, be they surgical, clinical, physiatric, dietary, or psycho-social, may be demanded. Obesity entails widespread disorders involving as far away organs, structures, needs and abilities as the teeth, the central nervous system, the gut microbiome, the susceptibility to cancer, the performance at the workplace, and the demand for health care resources. Subsequent weight gain and comorbidity relapse is a permanent possibility, as endogenous and environmental obesogenic stimuli are not suppressed, only weakened. Gastrointestinal restriction and bypass are highly successful maneuvers when correctly indicated and conducted, however, they do not signal the end of the battle. Patients have to be educated and followed for life. It is hoped that such experience along with general public-health initiatives will eventually trickle down to their families, their offspring, and society in general, so that the new generations might be born and nurtured with obesity prevention in mind. © 2013 Springer-Verlag Berlin Heidelberg. All rights are reserved.
- Semen Analysis and Fertility Rates after Bariatric Surgery in Males(2017) ROSENBLATT, Alberto; FAINTUCH, Joel; PAJECKI, Denis; SANTO, Marco Aurelio; FAINTUCH, Salomao; CECCONELLO, IvanBackground: Obesity poses challenges to male reproduction, but the effect of bariatric surgery on semen parameters and fertility is debated. This study evaluates Roux-en-Y gastric bypass (RYGB) influence on these variables. Methods: Seventy-nine sexually active men attempting to conceive with a partner were stratified into four groups: Group 1 (n = 23)-bariatric follow-up >= 5 years; Group 2 (n = 23)-mean bariatric follow-up 2 years; Group 3-obese controls (n = 18); Group 4-lean controls (n = 15). Groups 2, 3, and 4 were matched for age; Groups 1, 2, and 3 were matched for body mass index (BMI). Sexual quality of life questionnaire for males (SQOL-M), fasting blood glucose, C-reactive protein, vitamin D, zinc, total testosterone (TT), and free testosterone (FT), estradiol (E2), sex hormone-binding globulin (SHBG), and semen parameters were investigated. Results: SQOL-M scores increased; vitamin D was low in most of Group 2 and Group 3 participants, negatively correlating with BMI (p < 0.01). TT, FT, and SHBG improved postoperatively; however, E2 remained elevated. Semen aberrations occurred in 57.1% of Group 2 patients and BMI correlated with oligoasthenoteratospermia. Scant bariatric men fathered a child (13.0% preoperatively, 4.3% postoperatively, not significant). Conclusion: Semen abnormalities and subfertility were observed after RYGB, despite improved androgenic profile and SQOL-M. Possible negative impacts of hyperestrogenism and hypovitaminosis D on semen parameters warrant further studies.
- Sexual hormones and erectile function more than 6 years after bariatric surgery(2013) ROSENBLATT, Alberto; FAINTUCH, Joel; CECCONELLO, IvanBackground: The long-term effect of bariatric intervention on androgenic hormones and erectile function is not well known. In a prospective comparative study, the profile of sexual function was ascertained. The setting was a large public academic hospital. Methods: A total of 51 patients were included in the present study. Of these, 23 were in the bariatric surgery cohort (with 6-14 yr of follow-up), 14 were obese controls, and 14 were lean controls, aged 30-65 years. The groups were matched for age and, in the case of obese controls, the current body mass index. The measurements included orchidometry, an assessment of gynecomastia, the International Index of Erectile Function, the Aging Males Symptoms questionnaire, the measurement of 12 hormones, and general biochemical measurements. Results: Bariatric patients lost substantial weight (59.8 +/- 12.1 versus 35.1 +/- 7.7 kg/m(2)), albeit residual obesity was the rule, with varying degrees of sleep apnea, hypertension, and glucose/lipid aberrations. The total and free testosterone and sex hormone-binding globulin levels were greater in the gastric bypass patients than in the obese controls and comparable to those of lean individuals. The International Index of Erectile Function final score revealed no differences; however, the domains of erectile dysfunction (P =.015) and overall satisfaction (P =.028) were better than those in the obese controls, although still lower than those in the lean group. The correlation between the body mass index and the International Index of Erectile Function score in the entire population (n = 51) was negative, as expected, with, however, low r and r(2) indexes (.354 and.125, respectively). Conclusion: The findings are consistent with long-term normalization of androgenic hormones but less than complete normalization of erectile function. This seeming contradiction might be explained by the remaining or relapsing obesity or its co-morbidities.
- Androgen and Estrogen Shifts in Men Before and After Bariatric Surgery and Links to Vitamins and Trace Elements(2016) ROSENBLATT, Alberto; FAINTUCH, Joel; CECCONELLO, IvanAndrogens and estrogens play a key role regarding sexual life and reproduction. Along with hypotestosteronemia, obese men exhibit a 2-fold increase in estradiol concentration, adversely influencing these parameters. Estrogens and adipokines also influence bone metabolism, exerting a direct effect on vitamin D, calcium homeostasis and bone health. Bariatric procedures normalize some sex hormones, and may reverse several obesity-related conditions. Estrogens levels may remain elevated postoperatively, and despite its protective effect on the skeleton, bariatric patients are more prone to fractures when compared to the general population. Multiple nutritional deficits are common after bariatric interventions, and hypozincemia is the most likely to negatively influence reproductive parameters. Zinc is an essential element for normal spermatogenesis, and severe hypozincemia is associated with infertility in both sexes. Vitamin D also acts as a regulator of several enzymes involved in steroid hormone production, and its deficiency could impair reproductive function. Few studies have addressed changes in sex hormones and in reproductive function in the male bariatric population, as they represent a minority of surgical candidates. Although obesity rates and burden are similar for both sexes, society is more lenient with the obese male. Moreover, 73 % of overweight/obese men are satisfied with their health, causing body weight and obesity-related health problems to increase when they opt for bariatric surgery. In the present article, we discuss shifts of sex hormones before and after bariatric surgery, surgery impact on semen quality, skeletal health and nutrients, and new research directions regarding links between vitamin D, zinc, androgens and reproduction.