Department of Surgical Disciplines, All India Institute of Medical Sciences, Room no. 5034, New Delhi, India.
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
Obes Surg. 2020 Jun;30(6):2294-2300. doi: 10.1007/s11695-020-04487-3.
There is limited data on the impact of bariatric surgery on polycystic ovarian syndrome (PCOS) especially in the Indian population.
To study the impact of bariatric surgery in women with PCOS in terms of clinical, hormonal, and radiological aspects of polycystic ovarian syndrome.
A prospective observational study of 50 women who underwent bariatric surgery at our tertiary care center. Evaluation of anthropometric data and menstrual cyclicity as well as markers of hyperandrogenism was done preoperatively and at 3- and 6-month and 1-year follow-up.
Eighteen (36%) women were diagnosed to have PCOS. % EWL at 3-months (n = 14), 6-month (n = 14), and 1-year (n = 11) follow-up was 31%, 49%, and 63% respectively among women with PCOS. All females regained their normal menstrual cycle at 3 months of follow-up. Hirsutism resolved completely among 44% (5/11) with a decline in median hirsutism score from 11 to 9 at 1-year follow-up. Mean serum testosterone decreased from 0.83 ± 0.38 ng/ml preoperatively to 0.421 ± 0.25 ng/ml at 1-year follow-up (p ˂ 0.01), whereas changes in levels of serum LH and FSH were not significant. Seventy-seven percent of females (14/18) had polycystic ovaries preoperatively on USG; out of which, 55% (i.e., 4/7) showed complete resolution at 1-year follow-up. Metabolic syndrome resolved completely at 1-year follow-up in both PCOS and non PCOS group.
Bariatric surgery results in an effective and sustained weight loss with improvement in clinical, hormonal, and radiological parameters associated with PCOS.
研究减重手术对多囊卵巢综合征（PCOS）患者的临床、激素和影像学方面的影响。
这是一项在我们的三级护理中心进行的前瞻性观察研究，共纳入了 50 名接受减重手术的女性。在术前、术后 3 个月、6 个月和 1 年随访时，评估了人体测量学数据、月经周期以及高雄激素血症的标志物。
18 例（36%）女性被诊断为 PCOS。在 3 个月（n=14）、6 个月（n=14）和 1 年（n=11）随访时，PCOS 患者的体重减轻百分比分别为 31%、49%和 63%。所有女性在 3 个月的随访时恢复了正常的月经周期。44%（5/11）的患者完全缓解了多毛症，多毛症评分中位数从术前的 11 分下降到 1 年随访时的 9 分。血清睾酮均值从术前的 0.83±0.38ng/ml 下降到 1 年随访时的 0.421±0.25ng/ml（p<0.01），而血清 LH 和 FSH 水平的变化无统计学意义。术前超声检查发现 77%（14/18）的女性有多囊卵巢，其中 55%（4/7）在 1 年随访时完全缓解。PCOS 和非 PCOS 组在 1 年随访时均完全缓解了代谢综合征。
减重手术可有效且持续地减轻体重，改善与 PCOS 相关的临床、激素和影像学参数。
