Skip to main content
Top
Published in: Obesity Surgery 8/2019

01-08-2019 | Infertility | Original Contributions

The Effect of Sleeve Gastrectomy on the Hormonal Profile of Patients with Polycystic Ovary Syndrome

Authors: Agostinho S. Machado Júnior, Cláudio B. L. Ribeiro, Fernando Santa-Cruz, Brena F. Sena, Jose-Luiz Figueiredo, Álvaro A. B. Ferraz, Josemberg M. Campos

Published in: Obesity Surgery | Issue 8/2019

Login to get access

Abstract

Purpose

To prospectively evaluate the hormonal profile and weight loss of women with obesity and PCOS submitted to sleeve gastrectomy (SG).

Methods

A Prospective study carried out at the Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil, in 2018, where 18 patients with PCOS, whose age varied from 18 to 40 years, with an indication for bariatric surgery were evaluated. Plasma estradiol (E2), fasting insulin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured prior to bariatric surgery and 3 months after surgery. The LH/FSH ratio and BMI of the study participants were also calculated.

Results

Postoperative E2 levels were higher (preoperative mean of 63.4 pg/dL versus postoperative mean of 91.0 pg/dL), with no statistical significance then (p = 0.139). It was observed, at the postoperative period, statistically significant decreases in mean fasting insulin levels (24.4 mIU/mL vs. 9.0 mIU/mL; p < 0.001), LH levels (7.2 vs. 4.5; p = 0.047), and an inverted LH/FSH ratio (1.5 vs. 0.9; p = 0.008); relevant weight loss occurred (mean BMI, 40.5 kg/m2 vs. 33.4 kg/m2; p < 0.001).

Conclusion

Relevant changes in the hormone profile and significant alterations in the gonadotropic and insulin patterns were seen. In addition to satisfactory weight loss, the observed endocrine alterations revealed an internal environment that was more homeostatic and conducive to reproduction, indicating that SG was able to produce attractive physiological outcomes for women with PCOS.
Literature
1.
go back to reference World Health Organization (WHO). Global Strategy on Diet, Physical Activity and Health, Geneva: WHA57; 2004. World Health Organization (WHO). Global Strategy on Diet, Physical Activity and Health, Geneva: WHA57; 2004.
4.
go back to reference Vargas GP, Mendes GA, Pinto RD. Quality of life after vertical gastrectomy evaluated by the baros questionnaire. ABCD, arq bras cir dig. 2017;30(4):248–51.CrossRef Vargas GP, Mendes GA, Pinto RD. Quality of life after vertical gastrectomy evaluated by the baros questionnaire. ABCD, arq bras cir dig. 2017;30(4):248–51.CrossRef
5.
go back to reference Messinis IE, Messini CI. Polycystic ovaries and obesity. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):479–88.CrossRef Messinis IE, Messini CI. Polycystic ovaries and obesity. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):479–88.CrossRef
6.
go back to reference Charalampakis V, Tahrani AA, Helmy A, et al. Polycystic ovary syndrome and endometrial hyperplasia: an overview of the role of bariatric surgery in female fertility. Eur J Obstet Gynecol Reprod Biol. 2016;207:220–6.CrossRef Charalampakis V, Tahrani AA, Helmy A, et al. Polycystic ovary syndrome and endometrial hyperplasia: an overview of the role of bariatric surgery in female fertility. Eur J Obstet Gynecol Reprod Biol. 2016;207:220–6.CrossRef
7.
go back to reference Malini NA, Roy George K. Evaluation of different ranges of LH:FSH ratios in polycystic ovarian syndrome (PCOS) - clinical based case control study. Gen Comp Endocrinol. 2018;260:51–7.CrossRef Malini NA, Roy George K. Evaluation of different ranges of LH:FSH ratios in polycystic ovarian syndrome (PCOS) - clinical based case control study. Gen Comp Endocrinol. 2018;260:51–7.CrossRef
8.
go back to reference Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Front Biosci (Elite Ed). 2014;6:104–19. Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Front Biosci (Elite Ed). 2014;6:104–19.
9.
go back to reference Teitelman M, Grotegut CA, Williams NN, et al. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006;16:1457–63.CrossRef Teitelman M, Grotegut CA, Williams NN, et al. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006;16:1457–63.CrossRef
10.
go back to reference Wolfe BM, Kvach E, Eckel RH. Treatment of obesity: weight loss and bariatric surgery. Circ Res. 2016;118(11):1844–55.CrossRef Wolfe BM, Kvach E, Eckel RH. Treatment of obesity: weight loss and bariatric surgery. Circ Res. 2016;118(11):1844–55.CrossRef
11.
go back to reference Busetto L, Dicker D, Azran C, et al. Practical recommendations of the obesity management task force of the European Association for the Study of obesity for the post-bariatric surgery medical management. Obesity Facts Busetto L, Dicker D, Azran C, et al. Practical recommendations of the obesity management task force of the European Association for the Study of obesity for the post-bariatric surgery medical management. Obesity Facts
12.
go back to reference Arroyo A, Laughlin GA, Morales AJ, et al. Inappropriate gonadotropin secretion in polycystic ovary syndrome: influence of adiposity. J Clin Endocrinol Metab. 1997;82(11):3728–33.PubMed Arroyo A, Laughlin GA, Morales AJ, et al. Inappropriate gonadotropin secretion in polycystic ovary syndrome: influence of adiposity. J Clin Endocrinol Metab. 1997;82(11):3728–33.PubMed
13.
go back to reference Marshall JC, Dunaif A. All women with PCOS should be treated for insulin resistance. Fertil Steril. 2012;97(1):18–22.CrossRef Marshall JC, Dunaif A. All women with PCOS should be treated for insulin resistance. Fertil Steril. 2012;97(1):18–22.CrossRef
14.
go back to reference Rojas J, Chávez M, Olivar L, et al. Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. Int J Reprod Med. 2014;2014:719050.PubMedPubMedCentral Rojas J, Chávez M, Olivar L, et al. Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. Int J Reprod Med. 2014;2014:719050.PubMedPubMedCentral
15.
go back to reference Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015;16(2):111–7.CrossRef Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015;16(2):111–7.CrossRef
16.
go back to reference Eid GM, McClosney C. Changes in hormones and biomarkers in polycystic ovarian syndrome treated with gastric bypass. Surg Obes Relat Dis. 2014;10(5):787–91.CrossRef Eid GM, McClosney C. Changes in hormones and biomarkers in polycystic ovarian syndrome treated with gastric bypass. Surg Obes Relat Dis. 2014;10(5):787–91.CrossRef
17.
go back to reference Bruni V, Dei M, Pontello V. The management of polycystic ovary syndrome. Ann N Y Acad Sci. 2003;997:301–21.CrossRef Bruni V, Dei M, Pontello V. The management of polycystic ovary syndrome. Ann N Y Acad Sci. 2003;997:301–21.CrossRef
18.
go back to reference Spritzer PM, Motta AB. Novel strategies in the management of polycystic ovary syndrome. Minerva Endocrinol. 2015;40(3):195–212.PubMed Spritzer PM, Motta AB. Novel strategies in the management of polycystic ovary syndrome. Minerva Endocrinol. 2015;40(3):195–212.PubMed
19.
go back to reference Skubleny D, Switzer NJ, Gill RS. The impact of bariatric surgery on polycystic ovary syndrome: a systematic. Obes Surg. 2016;26(1):169–76.CrossRef Skubleny D, Switzer NJ, Gill RS. The impact of bariatric surgery on polycystic ovary syndrome: a systematic. Obes Surg. 2016;26(1):169–76.CrossRef
20.
go back to reference Turkmen S, Ahangari A, Bäckstrom T. Roux-en-Y gastric bypass surgery in patients with polycystic ovary syndrome and metabolic syndrome. Obes Surg. 2016;26:111–8.CrossRef Turkmen S, Ahangari A, Bäckstrom T. Roux-en-Y gastric bypass surgery in patients with polycystic ovary syndrome and metabolic syndrome. Obes Surg. 2016;26:111–8.CrossRef
21.
go back to reference Butterworth J, Deguara J, Borg CM. Bariatric surgery, polycystic ovary syndrome, and infertility. J Obes. 2016;2016:1871594.CrossRef Butterworth J, Deguara J, Borg CM. Bariatric surgery, polycystic ovary syndrome, and infertility. J Obes. 2016;2016:1871594.CrossRef
22.
go back to reference Escobar-Morreale HF, Santacruz E, Luque-Ramírez M. Prevalence of ‘obesity-associated gonadal dysfunction’ in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis. Hum Reprod Update. 2017;23:390–408.CrossRef Escobar-Morreale HF, Santacruz E, Luque-Ramírez M. Prevalence of ‘obesity-associated gonadal dysfunction’ in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis. Hum Reprod Update. 2017;23:390–408.CrossRef
Metadata
Title
The Effect of Sleeve Gastrectomy on the Hormonal Profile of Patients with Polycystic Ovary Syndrome
Authors
Agostinho S. Machado Júnior
Cláudio B. L. Ribeiro
Fernando Santa-Cruz
Brena F. Sena
Jose-Luiz Figueiredo
Álvaro A. B. Ferraz
Josemberg M. Campos
Publication date
01-08-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 8/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-03854-z

Other articles of this Issue 8/2019

Obesity Surgery 8/2019 Go to the issue