Brief Article
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World J Diabetes. Jun 15, 2013; 4(3): 64-69
Published online Jun 15, 2013. doi: 10.4239/wjd.v4.i3.64
Cardiometabolic health among gastric bypass surgery patients with polycystic ovarian syndrome
Carley A Gomez-Meade, Gabriela Lopez-Mitnik, Sarah E Messiah, Kristopher L Arheart, Adriana Carrillo, Nestor de la Cruz-Muñoz
Carley A Gomez-Meade, Adriana Carrillo, Division of Pediatric Endocrinology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL 33130, United States
Gabriela Lopez-Mitnik, Sarah E Messiah, Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL 33130, United States
Kristopher L Arheart, Department of Epidemiology and Public Health Sciences, Division of Biostatistics, University of Miami Miller School of Medicine, Miami, FL 33130, United States
Nestor de la Cruz-Muñoz, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33130, United States
Author contributions: Gomez-Meade CA, Messiah SE, Carrillo A and de la Cruz-Muñoz N conceived of the study design and acquisition of data; Lopez-Mitnik G and Arheart KL analyzed and interpreted the data; Messiah SE assisted in interpreting the data; all authors assisted with drafting and revising it critically for important intellectual content and as such gave final approval of the version to be published.
Correspondence to: Sarah E Messiah, PhD, MPH, Research Associate Professor, Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Batchelor Children’s Research Institute 541, 1580 NW 10th Avenue, Miami, FL 33130, United States. smessiah@med.miami.edu
Telephone: +1-305-2431943 Fax: +1-305-2438475
Received: January 7, 2013
Revised: April 23, 2013
Accepted: May 9, 2013
Published online: June 15, 2013
Processing time: 163 Days and 16.4 Hours
Abstract

AIM: To examine the effect of gastric bypass surgery on cardiometabolic health among women with polycystic ovarian syndrome (PCOS).

METHODS: Retrospective medical chart review identified women (n = 389) with PCOS who underwent Roux-en-Y gastric bypass surgery from 2001-2009 in one surgical practice. Separate repeated measures linear mixed models were fit using the MIXED procedure to assess mean change in cardiometabolic disease risk factors from before to 1-year after surgery and were evaluated by ethnicity [Hispanic, non-Hispanic black (NHB) and white (NHW)].

RESULTS: The majority of the sample was Hispanic (66%, 25% NHB, 9% NHW). Mean body mass index significantly improved 1 year post-surgery for all ethnic groups (45.5 to 35.5 kg/m2 for Hispanics, 46.8 to 37.7 kg/m2 for NHB and 45.7 to 36.7 kg/m2 for NHW, P < 0.001). Among Hispanic women mean total cholesterol (198.1 to 160.2 mg/dL), low-density lipoproteins (LDL) cholesterol (120.9 to 91.0 mg/dL), triglycerides (148.6 to 104.8 mg/dL), hemoglobin A1c (6.2% to 5.6%), alanine aminotransferase (28.1 to 23.0 U/L) and aspartate aminotransferase (23.5 to 21.6 U/L) decreased significantly (P < 0.001). Among NHB, mean total cholesterol (184.5 to 154.7 mg/dL), LDL cholesterol (111.7 to 88.9 mg/dL) and triglycerides (99.7 to 70.0 mg/dL) decreased significantly (P < 0.05). Among NHW, mean total cholesterol (200.9 to 172.8 mg/dL) and LDL cholesterol (124.2 to 96.6 mg/dL), decreased significantly (P < 0.05). Pairwise ethnic group comparisons of all cardiometabolic outcomes adjusted for age and type of surgery before and 1 year after surgery showed no statistical difference between the three groups for any outcome.

CONCLUSION: Cardiometabolic disease risk improvements vary by ethnicity and obesity may impact glucose tolerance and liver function changes more in Hispanic women with PCOS vs non-Hispanic women.

Keywords: Bariatric surgery; Polycystic ovary syndrome; Cardiometabolic outcomes; Weight outcomes; Morbid obesity

Core tip: Morbidly obese women with polycystic ovary syndrome (PCOS) who have undergone Roux-en-Y gastric bypass surgery show improvement in cardiometabolic disease risk at one year after the procedure. All women demonstrated a decrease in cardiometabolic disease risk factors including body mass index, glycated hemoglobin A1c (HgA1c), alanine aminotransferase (ALT), total cholesterol (TC), low-density lipoproteins (LDL) and triglyceride (TG). However, only Hispanic women showed a significant decreasing HgA1c and ALT, TC, LDL and TG one year after surgery. These ethnic group differences suggest there may be more comprehensive benefits in terms of cardiometabolic disease risk reduction after bariatric surgery in Hispanic women with PCOS vs other ethnic groups.