Bariatric surgery associated with disease remission in women with PCOS and obesity

A study was conducted to determine the difference in efficacy between drug and bariatric surgery therapy for women with obesity and polycystic ovary syndrome (PCOS).

A total of 90 women aged 18–40 years with body mass index (BMI) ≥ 27.5 kg/m 2 and waist circumference ≥85 cm fulfilling the 2011 Chinese diagnostic criteria for PCOS were enrolled and 81 subjects completed this study. In the drug group, patients were administered metformin and an oral contraceptive containing ethinylestradiol 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 time was 12 months. The main outcome was set as the complete remission of PCOS requiring six consecutive regular menstruation or spontaneous pregnancy.

Results:

Median BMI at the endpoint was 30.1 kg/m 2 in the drug group and 23.7 kg/m 2 in the surgical group, the complete remission rate was 15% and 78%, respectively. Except for 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 non-remission patients. Logistic regression analyses also revealed that the final BMI was the major factor influencing the remission of PCOS. The cut-off points of 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 cut-off values achieved complete remission.

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.

Reference:

Efficacy of bariatric surgery in the treatment of women with obesity and polycystic ovary syndrome by Lili Hu, et al. published in The Journal of Clinical Endocrinology & Metabolism

https://doi.org/10.1210/clinem/dgac294