胃旁路术后伴或不伴多囊卵巢综合征的女性的体重减轻和代谢结果：一项病例匹配研究。

Weight loss and metabolic outcomes in women with or without polycystic ovarian syndrome after Roux-en-Y gastric bypass: A case-matched study.

机构信息

Department of Bariatric and Metabolic Surgery, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.

Department of Bariatric and Metabolic Surgery, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK; The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.

出版信息

Surgeon. 2022 Jun;20(3):137-141. doi: 10.1016/j.surge.2021.02.012. Epub 2021 Apr 30.

DOI:10.1016/j.surge.2021.02.012

PMID:33863670

Abstract

BACKGROUND AND OBJECTIVES

Weight loss is the mainstay of management for women with polycystic ovarian syndrome (PCOS). However, lifestyle and dietary modifications, and gastric banding have generally poor long-term efficacy. We aimed to investigate whether gastric bypass is equally efficacious in women with or without PCOS.

METHODS

We performed a matched case-control study of primary Roux-en-Y gastric bypass surgery in women with PCOS (cases, n = 30) compared to women without PCOS (controls, n = 60) matched for baseline age, body mass index (BMI) and presence or absence of type 2 diabetes (T2D). Data shown represent mean values.

RESULTS

At 24 months after surgery the 90 participants (age 36.1 years) experienced significant reductions in BMI (53.4 vs. 34.9 kg/m, p < 0.0001), glycated haemoglobin (HbA1c) in 21 women with T2D (68.2 vs. 38.7 mmol/mol, p < 0.0001) and blood pressure (BP) in 29 women with hypertension (144/91 vs. 129/83 mmHg, p < 0.01), while obstructive sleep apnoea (OSA) resolved in 88.0% of the 25 affected patients. Women with PCOS compared to women without PCOS achieved equivalent reductions in percentage total weight loss (32.6% vs. 32.6% at 12 months and 34.8% vs. 36.1% at 24 months) and HbA1c (T2D subgroup; 38.3 vs. 41.6 mmol/mol at 12 months and 37.0 vs. 39.6 mmol/mol at 24 months) and comparable improvement in BP (hypertension subgroup) and resolution of OSA (87.5% vs. 88.2% at 24 months).

CONCLUSION

In women with PCOS with morbid obesity, gastric bypass resulted in significant weight loss and metabolic outcomes similar to women without PCOS.

摘要

背景与目的

减肥是多囊卵巢综合征（PCOS）女性管理的主要方法。然而，生活方式和饮食的改变，以及胃束带手术的长期效果通常较差。我们旨在研究胃旁路手术是否对患有或不患有 PCOS 的女性同样有效。

方法

我们对接受 PCOS（病例组，n=30）和无 PCOS（对照组，n=60）的原发性 Roux-en-Y 胃旁路手术的女性进行了匹配病例对照研究，这些女性在基线年龄、体重指数（BMI）和是否存在 2 型糖尿病（T2D）方面相匹配。所示数据代表平均值。

结果

在手术后 24 个月时，90 名参与者（年龄 36.1 岁）的 BMI（53.4 对 34.9 kg/m，p<0.0001）、21 名患有 T2D 的女性的糖化血红蛋白（HbA1c）（68.2 对 38.7 mmol/mol，p<0.0001）和 29 名患有高血压的女性的血压（BP）（144/91 对 129/83 mmHg，p<0.01）显著降低，而 25 名患有阻塞性睡眠呼吸暂停（OSA）的患者中有 88.0%得到缓解。与无 PCOS 的女性相比，患有 PCOS 的女性在总体重减轻百分比方面取得了同等程度的降低（12 个月时为 32.6%，24 个月时为 34.8%）和 HbA1c（T2D 亚组；12 个月时为 38.3 mmol/mol，24 个月时为 37.0 mmol/mol），BP（高血压亚组）也得到了类似的改善，OSA 的缓解率（24 个月时为 87.5%）与无 PCOS 的女性相似。