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袖状胃切除术对多囊卵巢综合征患者激素谱的影响。

The Effect of Sleeve Gastrectomy on the Hormonal Profile of Patients with Polycystic Ovary Syndrome.

机构信息

Department of Maternal and Child Health, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil.

Federal University of Pernambuco School of Medicine, Recife, PE, Brazil.

出版信息

Obes Surg. 2019 Aug;29(8):2415-2419. doi: 10.1007/s11695-019-03854-z.

Abstract

PURPOSE

To prospectively evaluate the hormonal profile and weight loss of women with obesity and PCOS submitted to sleeve gastrectomy (SG).

METHODS

A Prospective study carried out at the Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil, in 2018, where 18 patients with PCOS, whose age varied from 18 to 40 years, with an indication for bariatric surgery were evaluated. Plasma estradiol (E2), fasting insulin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured prior to bariatric surgery and 3 months after surgery. The LH/FSH ratio and BMI of the study participants were also calculated.

RESULTS

Postoperative E2 levels were higher (preoperative mean of 63.4 pg/dL versus postoperative mean of 91.0 pg/dL), with no statistical significance then (p = 0.139). It was observed, at the postoperative period, statistically significant decreases in mean fasting insulin levels (24.4 mIU/mL vs. 9.0 mIU/mL; p < 0.001), LH levels (7.2 vs. 4.5; p = 0.047), and an inverted LH/FSH ratio (1.5 vs. 0.9; p = 0.008); relevant weight loss occurred (mean BMI, 40.5 kg/m vs. 33.4 kg/m; p < 0.001).

CONCLUSION

Relevant changes in the hormone profile and significant alterations in the gonadotropic and insulin patterns were seen. In addition to satisfactory weight loss, the observed endocrine alterations revealed an internal environment that was more homeostatic and conducive to reproduction, indicating that SG was able to produce attractive physiological outcomes for women with PCOS.

摘要

目的

前瞻性评估肥胖合并多囊卵巢综合征(PCOS)女性接受袖状胃切除术(SG)后的激素谱和体重减轻情况。

方法

2018 年在巴西累西腓联邦大学临床医院进行了一项前瞻性研究,共评估了 18 名年龄在 18 至 40 岁之间、有减重手术适应证的 PCOS 患者。在减重手术前和手术后 3 个月测量血浆雌二醇(E2)、空腹胰岛素、促黄体生成素(LH)和卵泡刺激素(FSH)。还计算了研究参与者的 LH/FSH 比值和 BMI。

结果

术后 E2 水平升高(术前平均 63.4 pg/dL 与术后平均 91.0 pg/dL),但无统计学意义(p=0.139)。术后观察到空腹胰岛素水平(24.4 mIU/mL 与 9.0 mIU/mL;p<0.001)、LH 水平(7.2 与 4.5;p=0.047)和 LH/FSH 比值(1.5 与 0.9;p=0.008)显著下降;体重显著减轻(平均 BMI,40.5 kg/m 与 33.4 kg/m;p<0.001)。

结论

观察到激素谱的显著变化,以及促性腺激素和胰岛素模式的明显改变。除了满意的体重减轻外,观察到的内分泌变化显示出更内稳态和有利于生殖的内部环境,表明 SG 能够为 PCOS 女性带来有吸引力的生理结果。

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