MON-LB043 Bariatric Surgery and Weight Loss: Effect on Glucose/Insulin Dynamics in Adolescent PCOS

Background: Polycystic ovary syndrome (PCOS) is a prevalent disease that impacts approximately 4-8% of the United States population. Bariatric surgery has been found to not only treat obesity but also reverse the symptoms associated with PCOS. The aim of this study was to investigate in adolescent girls with PCOS changes in glucose-insulin dynamics after significant weight loss and to determine how hyperandrogenism is influenced. We hypothesized that girls with PCOS would demonstrate improvements in glucose-insulin dynamics and hyperandrogenism after bariatric surgery. Methods: This study was a retrospective analysis of a longitudinal dataset with participants divided into two groups: 1) girls without PCOS (Ctrls), and 2) girls with PCOS (PCOS), as defined by the NIH criteria. Primary outcomes were HOMA-IR, Matsuda index, and oral disposition index (ODI) after oral glucose tolerance test. Data were analyzed by T-tests comparison of parameters at baseline, and changes in parameters at 6 and 12 months post-surgery between groups with p<0.05 as significant. Results: 71 girls (mean weight =128.0±20 kg, mean BMI=47.0 ±7.0 kg/m2) between the ages of 14.4 and 18.8 yrs were evaluated for PCOS. 28 met NIH criteria for the diagnosis of PCOS. Another, 14 were hyperandrogenic (total testosterone>50ng/dl and/or free testosterone >5.3 pg/ml) with regular menses. The remaining 29 had regular menses and normal androgen levels but were grouped with the 14 without irregular periods as the control group. Surgery occurred at a mean age of 16.9± 1.1yr. At 6m, 61 were available for analysis (25 with PCOS, and 36 Ctrl) while at 12m, 41 were available (11 with PCOS, 29 Ctrls). At baseline HOMA-IR was significantly higher in PCOS patients (3.6±2.3) compared to controls (2.51±1.71), p<.05, though weight was similar(127.7±18.7 kg vs 127.8±21.1kg). At 6m and 12 months post-surgery there were no significant differences between groups in the amount of change of the HOMA-IR (1.4±2.3 vs 0.68±1.86 ), and (2.3±2.3 vs 0.98±2.24 ). The Matsuda Index (4.8±4.5 vs 7.0±5.3) and ODI (9.3±20.8 vs7.8±11.4 ) both showed no significant difference between PCOS and Control patients at baseline with no significant change at 6month in either, though the Matsuda Index changed more significantly in the controls compared to the PCOS group (-6.0±12.4 vs -3.2±3.0, p<0.05) at 12 months Conclusion: Although there were improvements in the glucose/insulin indices for both PCOS and Control groups only a modest increase in insulin sensitivity was noted for the controls compared to PCOS at 12 months. Further studies to determine the relationship between insulin dynamics, cycling and hyperandrogenism are in process. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.