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Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome

CONTEXT: The comparative effectiveness of drugs and surgical therapy for women with obesity and polycystic ovary syndrome (PCOS) has not been systematically compared. OBJECTIVE: We aimed to determine the difference in efficacy between drug and bariatric surgery therapy for women with obesity and PCO...

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Autores principales: Hu, Lili, Ma, Li, Xia, Xinyi, Ying, Tao, Zhou, Minzhi, Zou, Shuhua, Yu, Haoyong, Yin, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282367/
https://www.ncbi.nlm.nih.gov/pubmed/35554540
http://dx.doi.org/10.1210/clinem/dgac294
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author Hu, Lili
Ma, Li
Xia, Xinyi
Ying, Tao
Zhou, Minzhi
Zou, Shuhua
Yu, Haoyong
Yin, Jun
author_facet Hu, Lili
Ma, Li
Xia, Xinyi
Ying, Tao
Zhou, Minzhi
Zou, Shuhua
Yu, Haoyong
Yin, Jun
author_sort Hu, Lili
collection PubMed
description CONTEXT: The comparative effectiveness of drugs and surgical therapy for women with obesity and polycystic ovary syndrome (PCOS) has not been systematically compared. OBJECTIVE: We aimed to determine the difference in efficacy between drug and bariatric surgery therapy for women with obesity and PCOS. METHODS: This prospective nonrandomized trial enrolled 90 women aged 18 to 40 years with body mass index (BMI) ≥ 27.5 kg/m(2) and waist circumference ≥ 85 cm and fulfilling the 2011 Chinese diagnostic criteria for PCOS; 81 subjects completed the study. In the drug group, patients were administered metformin and an oral contraceptive containing ethinyl-estradiol and cyproterone acetate for the first 6 months, and metformin alone for the second 6 months. In the surgical group, patients underwent laparoscopic sleeve gastrectomies. The follow-up period was 12 months. The main outcome was the complete remission of PCOS, requiring 6 consecutive regular menstruation cycles or spontaneous pregnancy. RESULTS: Median BMI at endpoint was 30.1 kg/m(2) in the drug group and 23.7 kg/m(2) in the surgical group; complete remission rate was 15% and 78%, respectively. Except endpoint BMI, no difference was observed in free androgen index, ovarian morphology, homeostasis model assessment for insulin resistance, and total weight loss between remission and nonremission patients. Logistic regression analyses also revealed that the final BMI was the major factor influencing the remission of PCOS. The cutoff points for the final BMI were 27.5 kg/m(2) for the drug group and 26 kg/m(2) for the surgical group. Overall, nearly 95% of patients with an endpoint BMI below the cutoff values achieved complete remission. CONCLUSION: Complete remission of PCOS in patients with obesity depends on the final BMI after weight loss. Thus, bariatric surgery should be prioritized for these patients.
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spelling pubmed-92823672022-07-18 Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome Hu, Lili Ma, Li Xia, Xinyi Ying, Tao Zhou, Minzhi Zou, Shuhua Yu, Haoyong Yin, Jun J Clin Endocrinol Metab Online Only Articles CONTEXT: The comparative effectiveness of drugs and surgical therapy for women with obesity and polycystic ovary syndrome (PCOS) has not been systematically compared. OBJECTIVE: We aimed to determine the difference in efficacy between drug and bariatric surgery therapy for women with obesity and PCOS. METHODS: This prospective nonrandomized trial enrolled 90 women aged 18 to 40 years with body mass index (BMI) ≥ 27.5 kg/m(2) and waist circumference ≥ 85 cm and fulfilling the 2011 Chinese diagnostic criteria for PCOS; 81 subjects completed the study. In the drug group, patients were administered metformin and an oral contraceptive containing ethinyl-estradiol and cyproterone acetate for the first 6 months, and metformin alone for the second 6 months. In the surgical group, patients underwent laparoscopic sleeve gastrectomies. The follow-up period was 12 months. The main outcome was the complete remission of PCOS, requiring 6 consecutive regular menstruation cycles or spontaneous pregnancy. RESULTS: Median BMI at endpoint was 30.1 kg/m(2) in the drug group and 23.7 kg/m(2) in the surgical group; complete remission rate was 15% and 78%, respectively. Except endpoint BMI, no difference was observed in free androgen index, ovarian morphology, homeostasis model assessment for insulin resistance, and total weight loss between remission and nonremission patients. Logistic regression analyses also revealed that the final BMI was the major factor influencing the remission of PCOS. The cutoff points for the final BMI were 27.5 kg/m(2) for the drug group and 26 kg/m(2) for the surgical group. Overall, nearly 95% of patients with an endpoint BMI below the cutoff values achieved complete remission. CONCLUSION: Complete remission of PCOS in patients with obesity depends on the final BMI after weight loss. Thus, bariatric surgery should be prioritized for these patients. Oxford University Press 2022-05-12 /pmc/articles/PMC9282367/ /pubmed/35554540 http://dx.doi.org/10.1210/clinem/dgac294 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Online Only Articles
Hu, Lili
Ma, Li
Xia, Xinyi
Ying, Tao
Zhou, Minzhi
Zou, Shuhua
Yu, Haoyong
Yin, Jun
Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome
title Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome
title_full Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome
title_fullStr Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome
title_full_unstemmed Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome
title_short Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome
title_sort efficacy of bariatric surgery in the treatment of women with obesity and polycystic ovary syndrome
topic Online Only Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282367/
https://www.ncbi.nlm.nih.gov/pubmed/35554540
http://dx.doi.org/10.1210/clinem/dgac294
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