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减重手术后多囊卵巢综合征女性的特征及临床结局

Characteristics and Clinical Outcomes of Women with Polycystic Ovary Syndrome After Bariatric Surgery.

作者信息

Haley Erin, Coyne Paige, Carlin Arthur, Santarossa Sara, Loree Amy, Braciszewski Jordan, Brescacin Carly, Matero Lisa

机构信息

Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA.

Henry Ford Health + Michigan State University Health Sciences, East Lansing, USA.

出版信息

Obes Surg. 2025 Feb;35(2):419-425. doi: 10.1007/s11695-024-07633-3. Epub 2025 Jan 16.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) commonly co-occurs with obesity, medical comorbidities, and psychiatric symptoms. Bariatric surgery is an effective treatment for co-occurring obesity and PCOS. While the incidence of PCOS declines substantially after bariatric surgery, the condition is still present for a subset of women. Examining characteristics and clinical outcomes of those with and without PCOS post-surgery may underscore potential risk factors or intervention targets.

METHODS

Individuals up to four years after bariatric surgery were invited to participate in this cross-sectional survey study, which included validated measures of depression, anxiety, eating disorder pathology, and quality of life. Post-surgical weight outcomes, medical comorbidities, and mental health treatment engagement were also assessed. Regression analyses were performed to examine differences in outcomes between those with and without a PCOS diagnosis after bariatric surgery.

RESULTS

Of the 657 female (sex assigned at birth) participants who underwent bariatric surgery, 7% (n = 46) reported having a current diagnosis of PCOS. All females identified as women. Women with PCOS were significantly younger (p < 0.001) and were more likely to endorse migraines (p < 0.007) and loss of control (LOC) eating episodes (< 0.001) since undergoing surgery. Additionally, 47.8% of women with PCOS endorsed clinically significant anxiety, compared to 25.7% of women without PCOS (p = 0.03). There were no differences in other demographic, psychiatric, or medical characteristics.

CONCLUSION

Despite the low prevalence of PCOS diagnoses in the four years after bariatric surgery, this subpopulation may be particularly susceptible to migraines, disinhibited eating behavior, and anxiety, although weight and cardiometabolic outcomes were comparable to those without a diagnosis of PCOS post-surgically.

摘要

背景

多囊卵巢综合征(PCOS)常与肥胖、内科合并症及精神症状同时出现。减重手术是治疗肥胖与PCOS并存情况的有效方法。虽然减重手术后PCOS的发病率大幅下降,但仍有一部分女性存在该病症。研究手术后患有和未患有PCOS的患者的特征及临床结局,可能会凸显潜在的危险因素或干预靶点。

方法

邀请减重手术后四年内的个体参与这项横断面调查研究,其中包括经过验证的抑郁、焦虑、饮食失调病理学及生活质量测量指标。还评估了术后体重结局、内科合并症及心理健康治疗参与情况。进行回归分析以检验减重手术后患有和未患有PCOS诊断的患者在结局上的差异。

结果

在657名接受减重手术的女性(出生时指定的性别)参与者中,7%(n = 46)报告目前被诊断患有PCOS。所有女性均认同自己为女性。患有PCOS的女性更年轻(p < 0.001),且自手术后更有可能认可偏头痛(p < 0.007)及失控(LOC)饮食发作(< 0.001)。此外,47.8%患有PCOS的女性认可临床上显著的焦虑,而未患有PCOS的女性这一比例为25.7%(p = 0.03)。在其他人口统计学、精神或内科特征方面没有差异。

结论

尽管减重手术后四年内PCOS诊断的患病率较低,但这一亚组人群可能特别容易出现偏头痛、饮食行为失控及焦虑,尽管术后体重和心脏代谢结局与未诊断为PCOS的人群相当。

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Racial and ethnic disparities in polycystic ovary syndrome.多囊卵巢综合征的种族和民族差异。
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