Cai Meili, Zhang Yuqin, Gao Jingyang, Dilimulati Diliqingna, Bu Le, Cheng Xiaoyun, Du Lei, Zhou Donglei, Zhu Jiangfang, Qu Shen, Zhang Manna
Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China.
National Metabolic Management Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Jun 13;16:1755-1766. doi: 10.2147/DMSO.S411573. eCollection 2023.
To explore the predictors of menstrual recovery in polycystic ovary syndrome (PCOS) women with obesity following laparoscopic sleeve gastrectomy (LSG).
A total of 88 PCOS patients with obesity and 76 control patients with obesity aged 18-45 years were enrolled between May 2013 and December 2020. PCOS was diagnosed using the Rotterdam diagnostic criteria (2003). Anthropometric measurements, biochemical parameters, sex hormones, and circulating fibrinogen-like protein 1 (FGL-1) levels were collected before and six-month after LSG. The data on postoperative menstrual status, body weight, and fertility were obtained through telephone follow-ups for all individuals with PCOS.
Patients with PCOS were followed up for at least six months after surgery, and the mean follow-up time was 3.23 years. At 6 months after LSG, circulating total testosterone (TT), calculated free testosterone (cFT), and FGL-1 levels declined significantly. The mean percent excess weight loss (%EWL) and percent total weight loss (%TWL) in PCOS patients at the final follow-up was 97.52% ± 33.90% and 31.65% ± 10.31%, respectively. The proportion of regular menstruation in PCOS patients significantly increased within six months (75.86% vs 0.03% at baseline). In the logistic regression analysis, time from PCOS diagnosis (P=0.007), body mass index (BMI) (P=0.007), TT (P=0.038) at baseline were demonstrated to be independent predictive factors for the regular menstruation in women with PCOS and obesity within 6 months after LSG.
In PCOS patients with obesity, time from PCOS diagnosis, BMI, and TT levels at baseline were independently and negatively associated with menstrual recovery within 6 months after LSG, which could be applied in preoperative evaluation.
探讨腹腔镜袖状胃切除术（LSG）后肥胖型多囊卵巢综合征（PCOS）女性月经恢复的预测因素。
2013年5月至2020年12月期间，共纳入88例年龄在18 - 45岁的肥胖型PCOS患者和76例肥胖对照患者。PCOS采用鹿特丹诊断标准（2003年）进行诊断。在LSG术前和术后6个月收集人体测量学指标、生化参数、性激素和循环纤维蛋白原样蛋白1（FGL - 1）水平。通过对所有PCOS患者进行电话随访，获取术后月经状况、体重和生育能力的数据。
PCOS患者术后至少随访6个月，平均随访时间为3.23年。LSG术后6个月，循环总睾酮（TT）、计算游离睾酮（cFT）和FGL - 1水平显著下降。PCOS患者末次随访时的平均超重体重减轻百分比（%EWL）和总体重减轻百分比（%TWL）分别为97.52%±33.90%和31.65%±10.31%。PCOS患者在6个月内月经规律的比例显著增加（基线时为0.03%，6个月时为75.86%）。在逻辑回归分析中，PCOS诊断时间（P = 0.007）、体重指数（BMI）（P = 0.007）、基线时的TT（P = 0.038）被证明是LSG术后6个月内肥胖型PCOS女性月经规律的独立预测因素。
在肥胖型PCOS患者中，PCOS诊断时间、BMI和基线时的TT水平与LSG术后6个月内的月经恢复独立且呈负相关，可应用于术前评估。
