Effect of laparoscopic sleeve gastrectomy on related variables of obesity complicated with polycystic ovary syndrome

Xiao-Tao Wang; Yi-Sen Hou; Hao-Liang Zhao; Jian Wang; Chen-Hao Guo; Jie Guan; Zhi-Gan Lv; Peng Ma; Jian-Li Han

doi:10.4240/wjgs.v15.i11.2423

Effect of laparoscopic sleeve gastrectomy on related variables of obesity complicated with polycystic ovary syndrome

World J Gastrointest Surg. 2023 Nov 27;15(11):2423-2429. doi: 10.4240/wjgs.v15.i11.2423.

Authors

Xiao-Tao Wang¹, Yi-Sen Hou¹, Hao-Liang Zhao¹, Jian Wang¹, Chen-Hao Guo¹, Jie Guan¹, Zhi-Gan Lv², Peng Ma¹, Jian-Li Han³

Affiliations

¹ Department of Thyroid & Bariatric Metabolic Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China.
² Department of Anesthesia, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China.
³ Department of Thyroid & Bariatric Metabolic Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China. hjl13803456545@126.com.

Abstract

Background: Polycystic ovary syndrome (PCOS) is closely related to obesity, and weight loss can significantly improve the metabolic, endocrine and reproductive functions of obese individuals with PCOS. However, the efficacy of laparoscopic sleeve gastrectomy (LSG) for obesity with PCOS are unclear.

Aim: The purpose of the study was to investigate the effect of LSG on related variables in obese patients with PCOS.

Methods: A retrospective analysis was performed on 32 obese patients with PCOS who received LSG treatment at the Third Hospital of Shanxi Medical University from 2013 to 2020. The changes in anthropometric indices, insulin, testosterone, estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH), menstrual cycle and LH/FSH ratio before and 1 mo, 3 mo, 6 mo and 12 mo after the operation were statistically analyzed.

Results: At 1 mo, 3 mo, 6 mo and 12 mo after surgery, the anthropometric indices, such as body weight and body mass index, of all patients were lower than those before the operation. The percentage excess weight loss (EWL%) at 1 mo, 3 mo, 6 mo and 1 year of follow-up were 25, 40, 46 and 65, respectively. The PCOS-related indices, such as insulin, testosterone, estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH) and menstrual cycle, were improved to varying degrees. During the 1-year follow-up, the average serum testosterone decreased from preoperative 0.72 ng/mL to 0.43 ng/mL (P < 0.05), average fasting insulin level (9.0 mIU/mL, preoperative 34.2 mil, LH level, 4.4 mIU/mL, preoperative 6.1 mIU/mL). The level of FSH (3.8 U/L, 4.8 U/p0.05) and the ratio of LH/FSH (0.7, 1.3/p0.05) were more relieved than those before surgery. During the postoperative follow-up, it was found that the menstrual cycle of 27 patients (nasty 27) returned to normal, and 6 patients (18%) who intended to become pregnant became pregnant within 1 year after surgery.

Conclusion: The weight loss effect of LSG is obvious and affirmative, and the endocrine index of obese patients with PCOS is also improved to some extent, although the mechanism is not clear. Laparoscopic sleeve gastrectomy is expected to become a backup choice for patients with polycystic ovaries in the future.

Keywords: Hyperandrogenism; Insulin resistance; Laparoscopic sleeve gastrectomy; Polycystic ovary syndrome.