Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ir J Med Sci. 2024 Apr;193(2):721-724. doi: 10.1007/s11845-023-03488-2. Epub 2023 Aug 14.
Obesity is one of the risk factors for polycystic ovarian syndrome (PCOS), and weight loss is the mainstay of treatment. This study investigates the effects of sleeve gastrectomy on clinical and paraclinical signs and symptoms of PCOS patients referred to a tertiary hospital.
Female patients with a definite diagnosis of PCOS and body mass index (BMI) > 40 kg/m who were candidates for sleeve gastrectomy were enrolled in this cohort study and followed for 1 year postoperatively. Clinical signs and symptoms of PCOS, sonographic examination, and laboratory hormonal assessments were assessed preoperatively and 1 year following surgery.
Fifty patients enrolled in the study. The mean age of patients was 31.69 ± 9.54 years. The mean BMI before and after the surgery was 44.28 ± 3.03 and 29.37 ± 2.41 kg/m, respectively. Oligomenorrhea was improved in 66% of patients. According to the sonographic criteria, PCOS was improved in 74% of patients. After a year post-operation, while the mean serum levels of the follicular stimulating hormone (FSH), testosterone, and dehydroepiandrostenedione have improved significantly in all patients (p < 0.001 in all), the significant decrease in serum luteinizing hormone (LH), LH/ FSH ratio, and estrogen was only noted in patients with improved clinical response (p < 0.05, p < 0.001, and p < 0.001 respectively).
Weight loss and improvements in hyperandrogenism following sleeve gastrectomy result in clinical and paraclinical improvement of PCOS signs and symptoms, including oligomenorrhea and ovulation induction.
肥胖是多囊卵巢综合征（PCOS）的危险因素之一，而减肥是治疗的主要方法。本研究旨在探讨袖状胃切除术对三级医院转诊的 PCOS 患者的临床和临床前体征和症状的影响。
本队列研究纳入了明确诊断为 PCOS 且 BMI>40kg/m²的女性患者，并对其进行了袖状胃切除术，随访时间为术后 1 年。在术前和术后 1 年评估了 PCOS 的临床体征和症状、超声检查和实验室激素评估。
本研究共纳入 50 例患者。患者的平均年龄为 31.69±9.54 岁。手术前后的平均 BMI 分别为 44.28±3.03 和 29.37±2.41kg/m²。66%的患者月经稀少得到改善。根据超声标准，74%的患者 PCOS 得到改善。术后 1 年，所有患者的血清卵泡刺激素（FSH）、睾酮和脱氢表雄酮水平均显著改善（p<0.001），但只有临床反应改善的患者血清黄体生成素（LH）、LH/FSH 比值和雌激素水平显著下降（p<0.05、p<0.001 和 p<0.001）。
袖状胃切除术可减轻体重和改善高雄激素血症，从而改善 PCOS 的临床和临床前体征和症状，包括月经稀少和排卵诱导。
