SAT-126 Total Testosterone Before and After Metabolic Bariatric Surgery in Adolescent Females with Obesity

Abstract Disclosure: H. Vanden Brink: None. S. Ha: None. L.C. Torchen: None. E. Nonni: None. J.R. Ryder: None. T. Jenkins: None. S. Sisley: None. T. Burgert: None. M.G. Cree: None. F.F. Bacha: None. T. Inge: None. Introduction. Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder that presents in adolescence and is closely intertwined with obesity. Elevated total testosterone (TT) reflects increased androgen production and contributes to the pathophysiology between obesity and PCOS. Metabolic bariatric surgery (MBS) in adults with PCOS and obesity can lower total testosterone concentrations. Whether MBS in adolescents similarly affects PCOS related testosterone excess is unknown. Similarly, whether the severity of testosterone excess affects weight loss following MBS is unclear. Objectives: To determine whether TT decreases following MBS in female adolescents with obesity, and if TT concentration before MBS is associated with change in PCOS phenotype after MBS. Methods: We utilized data and biospecimens from the Teen-LABS longitudinal adolescent bariatric cohort for analyses. Clinical diagnostic features of PCOS were obtained by self-report before and following MBS at 1, 3, 5, 8 and 10 years. Sera were analyzed for TT at each timepoint at which participants were not taking exogenous hormones. PCOS was defined as menstrual irregularity with either clinical symptoms or elevated TT. PCOS Risk was defined as having one diagnostic feature of PCOS; Non-PCOS was defined as having no diagnostic features of PCOS. Longitudinal change in TT by pre-MBS phenotype was evaluated using mixed models on transformed TT, controlling for BMI and accounting for the influence of potential TT outliers (TT>90.4ng/dL). Whether pre-MBS TT predicted changes in PCOS phenotype after MBS, maximal BMI reduction (nadir) or weight regain were assessed using logistic and linear regression. Results. Before MBS, 17 participants met criteria for PCOS (TT: M+SD = 41.3+20.7 ng/dL), 34 for PCOS Risk (TT= 33.1 + 19.2 ng/dL), and 23 were categorized as non-PCOS (TT= 25.4+9.8 ng/dL). Overall, TT did not change over the 10-year sampling period (p=0.22). However, pre-MBS phenotype predicted TT over the 10-year period such that TT in those with PCOS before MBS remained consistently higher versus PCOS Risk and No PCOS following MBS (Effect of Phenotype, p = 0.003; post hoc after Bonferroni correction: PCOS vs PCOS Risk, p = 0.06; PCOS vs No PCOS, p = 0.003). Pre-MBS TT did not predict a change in PCOS phenotype following MBS at 1 year or at BMI nadir, nor did baseline TT predict the degree of weight loss at BMI nadir or amount of weight regain following BMI nadir (p > 0.05 for all analyses). Conclusion: TT did not significantly change over time and may be persistently elevated in adolescents who met criteria for PCOS before MBS. TT was not associated with PCOS phenotypic response to MBS nor the maximal BMI reduction following MBS, suggesting that improvements in PCOS phenotype with MBS during adolescence may not be attributed to changes in ovarian hyperandrogenism. Presentation: Saturday, July 12, 2025