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.
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
.
DOI: 10.16139/j.1007-9610.2018.06.008
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