Bariatric Surgery Improves Hyperandrogenism, Menstrual Irregularities, and Metabolic Dysfunction Among Women with Polycystic Ovary Syndrome (PCOS)

被引:46
|
作者
Christ, Jacob P. [1 ]
Falcone, Tommaso [2 ]
机构
[1] Cleveland Clin, Lerner Coll Med, 9500 Euclid Ave, Cleveland, OH 44195 USA
[2] Cleveland Clin Fdn, Dept Obstet & Gynecol, 9500 Euclid Ave, Cleveland, OH 44195 USA
关键词
Polycystic ovary syndrome; Weight loss; Bariatric surgery; Hyperandrogenism; Dyslipidemia; Ultrasound; INSULIN-RESISTANCE; WEIGHT-LOSS; OBESE WOMEN; ASSOCIATION; PARAMETERS; MANAGEMENT; ROTTERDAM; CONSENSUS; COMMON; LIFE;
D O I
10.1007/s11695-018-3155-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
To characterize the impact of bariatric surgery on reproductive and metabolic features common to polycystic ovary syndrome (PCOS) and to assess the relevance of preoperative evaluations in predicting likelihood of benefit from surgery. A retrospective chart review of records from 930 women who had undergone bariatric surgery at the Cleveland Clinic Foundation from 2009 to 2014 was completed. Cases of PCOS were identified from ICD coding and healthy women with pelvic ultrasound evaluations were identified using Healthcare Common Procedure Coding System coding. Pre- and postoperative anthropometric evaluations, menstrual cyclicity, ovarian volume (OV) as well as markers of hyperandrogenism, dyslipidemia, and dysglycemia were evaluated. Forty-four women with PCOS and 65 controls were evaluated. Both PCOS and non-PCOS had significant reductions in body mass index (BMI) and markers of dyslipidemia postoperatively (p < 0.05). PCOS had significant reductions in androgen levels (p < 0.05) and percent meeting criteria for hyperandrogenism and irregular menses (p < 0.05). OV did not significantly decline in either group postoperatively. Among PCOS, independent of preoperative BMI and age, preoperative OV associated with change in hemoglobin A1c (beta 95% (confidence interval) 0.202 (0.011-0.393), p = 0.04) and change in triglycerides (6.681 (1.028-12.334), p = 0.03), and preoperative free testosterone associated with change in total cholesterol (3.744 (0.906-6.583), p = 0.02) and change in non-HDL-C (3.125 (0.453-5.796), p = 0.03). Bariatric surgery improves key diagnostic features seen in women with PCOS and ovarian volume, and free testosterone may have utility in predicting likelihood of metabolic benefit from surgery.
引用
收藏
页码:2171 / 2177
页数:7
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