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

  • Agostinho S. Machado JúniorEmail author
  • Cláudio B. L. Ribeiro
  • Fernando Santa-Cruz
  • Brena F. Sena
  • Jose-Luiz Figueiredo
  • Álvaro A. B. Ferraz
  • Josemberg M. Campos
Original Contributions

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.

Keywords

Bariatric surgery Sleeve gastrectomy Polycystic ovary syndrome Obesity Infertility LH/FSH ratio 

Notes

Compliance with Ethical Standards

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This research project was approved by the Ethics Committee for Research involving human beings of the Federal University of Pernambuco’s Center of Health Sciences (N. 1.435.611) CAAE: 52297315.7.0000.5208. Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    World Health Organization (WHO). Global Strategy on Diet, Physical Activity and Health, Geneva: WHA57; 2004.Google Scholar
  2. 2.
    Centers for Disease Control and Prevention. Overweight and obesity: data and statistics. CDC; 2015. Available from: https://www.cdc.gov/obesity/data/index.html.
  3. 3.
    World Health Organization. Childhood overweight and obesity. WHO; 2016. Available from: http://www.who.int/dietphysicalactivity/childhood/en/.
  4. 4.
    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.CrossRefGoogle Scholar
  5. 5.
    Messinis IE, Messini CI. Polycystic ovaries and obesity. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):479–88.CrossRefGoogle Scholar
  6. 6.
    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.CrossRefGoogle Scholar
  7. 7.
    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.CrossRefGoogle Scholar
  8. 8.
    Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Front Biosci (Elite Ed). 2014;6:104–19.Google Scholar
  9. 9.
    Teitelman M, Grotegut CA, Williams NN, et al. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006;16:1457–63.CrossRefGoogle Scholar
  10. 10.
    Wolfe BM, Kvach E, Eckel RH. Treatment of obesity: weight loss and bariatric surgery. Circ Res. 2016;118(11):1844–55.CrossRefGoogle Scholar
  11. 11.
    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 FactsGoogle Scholar
  12. 12.
    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.Google Scholar
  13. 13.
    Marshall JC, Dunaif A. All women with PCOS should be treated for insulin resistance. Fertil Steril. 2012;97(1):18–22.CrossRefGoogle Scholar
  14. 14.
    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.Google Scholar
  15. 15.
    Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015;16(2):111–7.CrossRefGoogle Scholar
  16. 16.
    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.CrossRefGoogle Scholar
  17. 17.
    Bruni V, Dei M, Pontello V. The management of polycystic ovary syndrome. Ann N Y Acad Sci. 2003;997:301–21.CrossRefGoogle Scholar
  18. 18.
    Spritzer PM, Motta AB. Novel strategies in the management of polycystic ovary syndrome. Minerva Endocrinol. 2015;40(3):195–212.Google Scholar
  19. 19.
    Skubleny D, Switzer NJ, Gill RS. The impact of bariatric surgery on polycystic ovary syndrome: a systematic. Obes Surg. 2016;26(1):169–76.CrossRefGoogle Scholar
  20. 20.
    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.CrossRefGoogle Scholar
  21. 21.
    Butterworth J, Deguara J, Borg CM. Bariatric surgery, polycystic ovary syndrome, and infertility. J Obes. 2016;2016:1871594.CrossRefGoogle Scholar
  22. 22.
    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.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Agostinho S. Machado Júnior
    • 1
    Email author
  • Cláudio B. L. Ribeiro
    • 1
  • Fernando Santa-Cruz
    • 2
  • Brena F. Sena
    • 3
  • Jose-Luiz Figueiredo
    • 4
  • Álvaro A. B. Ferraz
    • 4
  • Josemberg M. Campos
    • 4
  1. 1.Department of Maternal and Child HealthFederal University of PernambucoRecifeBrazil
  2. 2.Federal University of Pernambuco School of MedicineRecifeBrazil
  3. 3.Harvard T.H. Chan School of Public HealthBostonUSA
  4. 4.Department of SurgeryFederal University of PernambucoRecifeBrazil

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