Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2423-2429
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2423
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
Xiao-Tao Wang, Yi-Sen Hou, Hao-Liang Zhao, Jian Wang, Chen-Hao Guo, Jie Guan, Peng Ma, Jian-Li Han, 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
Zhi-Gan Lv, Department of Anesthesia, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
Author contributions: Wang XT and Han JL contributed to protocol/project development; Wang XT, Hou YS, Zhao HL, Wang J, Guo CH, and Han JL contributed to data collection or management; Wang XT, Guan J, Lv ZG, Ma P, and Han JL contributed to data analysis; Wang XT, and Han JL contributed to manuscript writing/editing; All authors reviewed the manuscript.
Supported by Shanxi Province “136” Revitalization Medical Project Construction Funds, No. 2019XY003.
Institutional review board statement: The study was reviewed and approved by the Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences Review Board.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Li Han, Doctor, Chief Physician, Department of Thyroid & Bariatric Metabolic Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, No. 99 Longcheng Street, Taiyuan 030032, Shanxi Province, China. hjl13803456545@126.com
Received: August 7, 2023
Peer-review started: August 7, 2023
First decision: August 24, 2023
Revised: September 18, 2023
Accepted: October 11, 2023
Article in press: October 11, 2023
Published online: November 27, 2023
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: Laparoscopic sleeve gastrectomy, Polycystic ovary syndrome, Hyperandrogenism, Insulin resistance

Core Tip: The clinical data of 32 obese patients with polycystic ovary syndrome (PCOS) after laparoscopic sleeve gastrectomy were retrospectively analyzed, and the changes in PCOS after laparoscopic sleeve gastrectomy were analyzed.