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Published in: Obesity Surgery 1/2019

01-01-2019 | Original Contributions

Sleeve Gastrectomy for Obesity in Polycystic Ovarian Syndrome: a Pilot Study Evaluating Weight Loss and Fertility Outcomes

Authors: Joshua Dilday, Michael Derickson, John Kuckelman, Cara Reitz, Eric Ahnfeldt, Matthew Martin, J. Paul Sanders

Published in: Obesity Surgery | Issue 1/2019

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Abstract

Purpose

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder associated with obesity and infertility. Gastric bypass has been shown to be effective in treating these symptoms. However, the efficacy of vertical sleeve gastrectomy (VSG) has not been studied in the PCOS population. This study analyzed weight loss and fertility outcomes of VSG in this population.

Methods

A retrospective review of patients with PCOS and without PCOS (CON) undergoing VSG from 2008 to 2016 was performed at two bariatric centers. BMI and percent excess weight loss (%EWL) were collected at 3, 6, and 12 months postoperatively. Patient characteristics and postoperative pregnancy status were compared between the two cohorts.

Results

One hundred nineteen PCOS patients were compared to 119 CON patients. Similar attrition rates were seen between cohorts at 3-month (5 vs 8%), 6-month (13 vs. 14%), and 12-month (18 vs. 13%) evaluation. PCOS patients had greater ΔBMI at 3 months (− 7.64 vs. − 6.82; p = 0.05), 6 months (− 10.56 vs. − 9.49; p = 0.02), and 12 months (− 12.43 vs. − 11.49; p = 0.04). PCOS patients also had greater %EWL at 12 months compared to CON (66 vs 60%; p = 0.05). Twenty-two percent of PCOS patients became pregnant within 12 months, 69% of which were previously nulliparous.

Conclusion

Compared to non-PCOS patients, PCOS patients had greater postoperative ΔBMI and %EWL at 1 year. The majority of patients becoming pregnant after VSG were previously nulliparous. This study shows that VSG is effective for weight loss in PCOS patients with obesity and may positively augment effect fertility rates.
Literature
1.
go back to reference Eid GM, Cottam DR, Velcu LM, et al. Effective treatment of polycystic ovarian syndrome with roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(2):77–80.CrossRefPubMed Eid GM, Cottam DR, Velcu LM, et al. Effective treatment of polycystic ovarian syndrome with roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(2):77–80.CrossRefPubMed
2.
go back to reference Lim SS, Davies MJ, Norman RJ, et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618–37.CrossRefPubMed Lim SS, Davies MJ, Norman RJ, et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618–37.CrossRefPubMed
3.
go back to reference Wang K, Jiang Q, Zhi Y, et al. Contrasting sleeve gastrectomy with lifestyle modification therapy in the treatment of polycystic ovary syndrome. J Laparoendosc Adv Surg Tech. 2015;25(6):493–8.CrossRef Wang K, Jiang Q, Zhi Y, et al. Contrasting sleeve gastrectomy with lifestyle modification therapy in the treatment of polycystic ovary syndrome. J Laparoendosc Adv Surg Tech. 2015;25(6):493–8.CrossRef
4.
go back to reference Chen X, Jia X, Qiao J, et al. Adipokines in reproductive function: a link between obesity and polycystic ovary syndrome. J Mol Endocrinol. 2013;50(2):R21–37.CrossRefPubMed Chen X, Jia X, Qiao J, et al. Adipokines in reproductive function: a link between obesity and polycystic ovary syndrome. J Mol Endocrinol. 2013;50(2):R21–37.CrossRefPubMed
5.
go back to reference Escobar-Morreale HF, Botella-Carretero JI, Álvarez-Blasco F, et al. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90(12):6364–9.CrossRefPubMed Escobar-Morreale HF, Botella-Carretero JI, Álvarez-Blasco F, et al. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90(12):6364–9.CrossRefPubMed
6.
go back to reference Ressler IB, Grayson BE, Seeley RJ. Metabolic, behavioral, and reproductive effects of vertical sleeve gastrectomy in an obese rat model of polycystic ovary syndrome. Obes Surg. 2014;24(6):866–76.CrossRefPubMedPubMedCentral Ressler IB, Grayson BE, Seeley RJ. Metabolic, behavioral, and reproductive effects of vertical sleeve gastrectomy in an obese rat model of polycystic ovary syndrome. Obes Surg. 2014;24(6):866–76.CrossRefPubMedPubMedCentral
7.
go back to reference Wilson-Pérez HE, Seeley RJ. The effect of vertical sleeve gastrectomy on a rat model of polycystic ovarian syndrome. Endocrinology. 2011;152(10):3700–5.CrossRefPubMedPubMedCentral Wilson-Pérez HE, Seeley RJ. The effect of vertical sleeve gastrectomy on a rat model of polycystic ovarian syndrome. Endocrinology. 2011;152(10):3700–5.CrossRefPubMedPubMedCentral
8.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed
9.
go back to reference Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefPubMed Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefPubMed
10.
go back to reference Lemus R, Karni D, Hong D, et al. The impact of bariatric surgery on insulin-treated type 2 diabetes patients. Surg Endosc. 2017;25:1–12. Lemus R, Karni D, Hong D, et al. The impact of bariatric surgery on insulin-treated type 2 diabetes patients. Surg Endosc. 2017;25:1–12.
11.
go back to reference Scinta W. Measuring success: a comparison of weight loss calculations. Bariatric Times. 2012;9(7):18–20. Scinta W. Measuring success: a comparison of weight loss calculations. Bariatric Times. 2012;9(7):18–20.
12.
go back to reference Sjostrom L, Nabro K, Sjostrom CD, et al. Swedish obese subjects study: effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed Sjostrom L, Nabro K, Sjostrom CD, et al. Swedish obese subjects study: effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed
13.
go back to reference Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity, 2013:1(21) Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity, 2013:1(21)
14.
go back to reference Osland E, Yunus RM, Khan S, et al. Weight loss outcomes in laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic roux-en-Y gastric bypass (LRYGB) procedures: a meta-analysis and systematic review of randomized controlled trials. Surg Laparosc Endosc Percutan Tech. 2017;27(1):8–18.PubMed Osland E, Yunus RM, Khan S, et al. Weight loss outcomes in laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic roux-en-Y gastric bypass (LRYGB) procedures: a meta-analysis and systematic review of randomized controlled trials. Surg Laparosc Endosc Percutan Tech. 2017;27(1):8–18.PubMed
Metadata
Title
Sleeve Gastrectomy for Obesity in Polycystic Ovarian Syndrome: a Pilot Study Evaluating Weight Loss and Fertility Outcomes
Authors
Joshua Dilday
Michael Derickson
John Kuckelman
Cara Reitz
Eric Ahnfeldt
Matthew Martin
J. Paul Sanders
Publication date
01-01-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3473-8

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