Impact of laparoscopic sleeve gastrectomy on metabolism in obese patients with polycystic ovary syndrome: a report of 33 cases

doi:10.16139/j.1007-9610.2018.06.008

Abstract

Abstract: Objective To investigate the impact of laparoscopic sleeve gastrectomy (LSG) on metabolic improvement in obese patients with polycystic ovary syndrome(PCOS). Methods Thirty-three obese patients with PCOS who underwent LSG at our hospital were investigated retrospectively including clinical data and parameter changes in PCOS after 3 months and 6 months of follow-up. Results The average age of obese patients was (27±5) years and body mass index (BMI) all was ≥27.5. Patients had symptoms of menstrual disorders or amenorrhea and were diagnosed as PCOS according to Rotterdam ESHRE/ASRM-sponsored PCOS consensus. Preoperative BMI was (36.75±4.96), testosterone (TESTO) (0.489±0.186) μg/L, luteinizing hormone/follicle stimulating hormone (LH/FSH) （1.72±0.90）, homeostatic model assessment-insulin resistance (HOMA-IR) (14.14±16.79) and glycosylated hemoglobin (HbA1c) 6.35 %±1.41 %. Operations were completed successfully without conversion to laparotomy and severe postoperative complications. Follow-up study showed that mean BMI was (29.55±4.65) at 3 months and (25.07±3.81) at 6 months postoperatively. Mean TESTO and LH/FSH were（0.336±0.112） μg/L and (1.68±1.08) at 3 months, （0.216±0.115） μg/L and (1.28±0.95) at 6 months postoperative respectively. Mean HOMA-IR was (3.07±2.14) and (2.35±1.14) at 3 months and 6 months follow-up, and HbA1c was 5.35%±0.40% and 5.22%±0.30%, respectively. The decrease in BMI, TESTO, FPG, HOMA-IR, peptide C, HbA1c, total cholesterol and triglyceride was found obviously at 3 months and 6 months postoperative compared to those preoperative with significant difference (P<0.05). The significant change in LH/FSH did not present at 3 months and 6 months after operation compared that before operation (P>0.05). At 3 months, 11 (33.3%) of 33 cases with menstrual disorders including amenorrhea were in clinical remission and 26 (78.8%) of 33 cases were at 6 months. PCOS in clinical remission was 17 (51.5%) of 33 cases at 3 months of follow-up and 26(78.8%) of 33 cases at 6 months. Conclusions LSG has a significant effect on menstrual disorder and hyperandrogenism in obesity patients with PCOS by the mechanism of improving insulin resistance.

Key words: Sleeve gastrectomy, Polycystic ovary syndrome, Obesity, Hyperandrogenism, Insulin resistance

CLC Number:

R589.2

MA Chiye, ZHU Jiangfan, MA Yingzhang, MAN Lin, LU Wei, ZHANG Qiying, ZHANG Yali. Impact of laparoscopic sleeve gastrectomy on metabolism in obese patients with polycystic ovary syndrome: a report of 33 cases[J]. Journal of Surgery Concepts & Practice, 2018, 23(06): 506-510.

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