Department of Obstetrics and Gynecology, People's Hospital, Peking University, Beijing, China.
Department of Digestive Surgery, Xijing Hospital, Xi'an Medical University, Xi'an, China.
Surg Obes Relat Dis. 2021 Aug;17(8):1399-1408. doi: 10.1016/j.soard.2021.04.009. Epub 2021 Apr 21.
Bariatric surgery is effective for polycystic ovary syndrome (PCOS), while the exact mechanism remains unclear.
To assess the impact of bariatric surgery on PCOS patients and further explore the possible mechanism.
A meta-analysis.
We searched PubMed, Web of Science, The Cochrane Library, and Embase to identify relevant studies published before November 2020.
Twenty-one studies met our inclusion criteria, and we identified 552 patients with PCOS study. Results showed that the prevalence of preoperative PCOS, menstrual irregularity, hirsutism, type 2 diabetes (T2D), hypertension, infertility, and depression significantly decreased after bariatric surgery. Levels of total testosterone, fasting insulin, and luteinizing hormone (LH) decreased and estradiol increased, while levels of follicle-stimulating hormone (FSH) and LH/FSH did not show significant changes during the 3-month follow-up. There were decreases in testosterone and fasting insulin levels when the postoperative follow-up time was 6 months or ≥12 months. Levels of fasting blood glucose and triglycerides were significantly reduced after 6 months or ≥12 months of bariatric surgery. High-density lipoprotein (HDL) and sex hormone-binding globulin (SHBG) significantly improved ≥12 months after bariatric surgery.
Symptoms of PCOS and related complications are significantly alleviated after bariatric surgery. In addition, we found a significant improvement on anomalous secretion of gonadotropins, glucose metabolism, and lipid metabolism in patients with PCOS after bariatric surgery.
减重手术对多囊卵巢综合征（PCOS）有效，但其确切机制尚不清楚。
评估减重手术对 PCOS 患者的影响，并进一步探讨可能的机制。
荟萃分析。
我们检索了 PubMed、Web of Science、The Cochrane Library 和 Embase，以确定截至 2020 年 11 月发表的相关研究。
21 项研究符合纳入标准，我们共纳入了 552 例 PCOS 患者。结果显示，减重手术后 PCOS 术前患病率、月经不规律、多毛症、2 型糖尿病（T2D）、高血压、不孕和抑郁显著降低。总睾酮、空腹胰岛素和黄体生成素（LH）水平降低，雌二醇水平升高，而卵泡刺激素（FSH）和 LH/FSH 水平在 3 个月随访期间没有显著变化。术后随访 6 个月或≥12 个月时，睾酮和空腹胰岛素水平下降。减重手术后 6 个月或≥12 个月时，空腹血糖和甘油三酯水平显著降低。高密度脂蛋白（HDL）和性激素结合球蛋白（SHBG）在减重手术后≥12 个月时显著改善。
减重手术后 PCOS 的症状和相关并发症明显缓解。此外，我们发现 PCOS 患者术后促性腺激素分泌异常、糖代谢和脂代谢有明显改善。
