Department of Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Department of Internal Medicine, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Horm Metab Res. 2022 Mar;54(3):194-198. doi: 10.1055/a-1756-4798. Epub 2022 Mar 11.
This study was aimed to investigate the effect of weight loss by bariatric surgery on the level of anti-Mullerian hormone (AMH) in morbidly obese female patients with or without polycystic ovary syndrome (PCOS). This prospective study includes 70 females, obese, and fertile patients of reproductive age. All patients were evaluated to determine the changes in weight, body mass index (BMI), serum AMH, and other biochemical parameters at the end of six months. The mean levels of the preop and postop AMH were 1.66±0.87 ng/ml and 5.99±1.39 ng/ml in the PCOS group; 1.35±0.76 ng/ml and 6.23±1.47 ng/ml in the non-PCOS group, respectively. The postop AMH levels were significantly higher than the preop levels for both groups (p<0.001). There were significant differences in the level of glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, total cholesterol, hemoglobin A1c, HOMA-IR, insulin between preop and postop 6th month. A negative correlation was found between postop AMH and body weight in all patients (r=-0.337, p=0.031). Postop AMH levels were negatively correlated with postop BMI levels in the non-PCOS patient group (r=-0.408, p=0.043). No significant difference was observed between the PCOS and non-PCOS groups in terms of all the parameters examined. In conclusion, our study suggests that the significantly increased AMH levels by losing weight with bariatric surgery in patients with morbid obesity with and without PCOS may indicate the improvement of fertilization potential. It could be considered when evaluating fertility in patients with morbid obesity.
这项研究旨在探讨肥胖症女性患者接受减重手术对抗苗勒管激素（AMH）水平的影响，这些患者分为多囊卵巢综合征（PCOS）和非多囊卵巢综合征（非 PCOS）两种。本前瞻性研究纳入了 70 名肥胖且有生育能力的育龄女性患者。所有患者均接受评估，以确定体重、体重指数（BMI）、血清 AMH 和其他生化参数在术后 6 个月的变化。PCOS 组的术前和术后 AMH 平均值分别为 1.66±0.87ng/ml 和 5.99±1.39ng/ml；非 PCOS 组的术前和术后 AMH 平均值分别为 1.35±0.76ng/ml 和 6.23±1.47ng/ml。两组患者术后 AMH 水平均明显高于术前（p<0.001）。两组患者的血糖、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、甘油三酯、总胆固醇、糖化血红蛋白（HbA1c）、稳态模型评估的胰岛素抵抗指数（HOMA-IR）、胰岛素等指标的水平在术前和术后第 6 个月均存在显著差异。所有患者术后 AMH 与体重呈负相关（r=-0.337，p=0.031）。非 PCOS 患者组术后 AMH 与术后 BMI 呈负相关（r=-0.408，p=0.043）。在所有检查参数方面，PCOS 组和非 PCOS 组之间无显著差异。总之，本研究表明，肥胖症患者接受减重手术后 AMH 水平显著升高，无论是否患有 PCOS，均可提示生育能力的提高。在评估肥胖症患者的生育能力时，可以考虑这一点。
