Diabetes, Metabolic Syndrome and Obesity (Jun 2023)

Predictive Factors of Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women with Obesity

  • Cai M,
  • Zhang Y,
  • Gao J,
  • Dilimulati D,
  • Bu L,
  • Cheng X,
  • Du L,
  • Zhou D,
  • Zhu J,
  • Qu S,
  • Zhang M

Journal volume & issue
Vol. Volume 16
pp. 1755 – 1766

Abstract

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Meili Cai,1,* Yuqin Zhang,1,* Jingyang Gao,1,* Diliqingna Dilimulati,1 Le Bu,1,2 Xiaoyun Cheng,1,2 Lei Du,2,3 Donglei Zhou,2,3 Jiangfang Zhu,2,3 Shen Qu,1,2 Manna Zhang1,2 1Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, People’s Republic of China; 2National Metabolic Management Center, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, People’s Republic of China; 3Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shen Qu; Manna Zhang, Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, 301 Middle Yanchang Road, Shanghai, 200072, People’s Republic of China, Tel +86-021-66301004, Email [email protected]; [email protected]: To explore the predictors of menstrual recovery in polycystic ovary syndrome (PCOS) women with obesity following laparoscopic sleeve gastrectomy (LSG).Methods: A total of 88 PCOS patients with obesity and 76 control patients with obesity aged 18– 45 years were enrolled between May 2013 and December 2020. PCOS was diagnosed using the Rotterdam diagnostic criteria (2003). Anthropometric measurements, biochemical parameters, sex hormones, and circulating fibrinogen-like protein 1 (FGL-1) levels were collected before and six-month after LSG. The data on postoperative menstrual status, body weight, and fertility were obtained through telephone follow-ups for all individuals with PCOS.Results: Patients with PCOS were followed up for at least six months after surgery, and the mean follow-up time was 3.23 years. At 6 months after LSG, circulating total testosterone (TT), calculated free testosterone (cFT), and FGL-1 levels declined significantly. The mean percent excess weight loss (%EWL) and percent total weight loss (%TWL) in PCOS patients at the final follow-up was 97.52% ± 33.90% and 31.65% ± 10.31%, respectively. The proportion of regular menstruation in PCOS patients significantly increased within six months (75.86% vs 0.03% at baseline). In the logistic regression analysis, time from PCOS diagnosis (P=0.007), body mass index (BMI) (P=0.007), TT (P=0.038) at baseline were demonstrated to be independent predictive factors for the regular menstruation in women with PCOS and obesity within 6 months after LSG.Conclusion: In PCOS patients with obesity, time from PCOS diagnosis, BMI, and TT levels at baseline were independently and negatively associated with menstrual recovery within 6 months after LSG, which could be applied in preoperative evaluation.Keywords: polycystic ovary syndrome, obesity, laparoscopic sleeve gastrectomy, menstruation, fibrinogen-like protein 1

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