Background: To observe the basic metabolic characteristics of obese patients with polycystic ovarian syndrome (PCOS), and observe and compare the effect of laparoscopic sleeve gastrectomy and metformin treatment after 3 months.
Methods: In January to December 2018, the Second Hospital of Hebei Medical University selected 104 women who were classified as obese with a body mass index (BMI) of 28 kg/cm2 or higher and had PCOS. They were divided into obese PCOS group (53 cases) and obese non-PCOS group (51 cases).
Results: 1. There was no significant difference in waist circumference and WHR between patients who are obese with PCOS and patients who are obese without PCOS (P > 0.05). Obese PCOS patients were significantly higher in anti-Müllerian hormone (AMH), LH/FSH, T, FAI, homa-ir, triglyceride (TG), low density lipoprotein (LDL), Apo-B and uric acid than the group of non-PCOS patients who were obese. (P<0.05). The SHBG levels of obese patients with PCOS were obviously lower when contrasted with the levels in obese patients without PCOS (P < 0.05). 2. Body weight, BMI, INS, homa-ir and TG of obese PCOS patients were significantly decreased 3 months after laparoscopic sleeve gastrectomy compared with that before surgery (P < 0.05). After three months of medical treatment with metformin, the patients' homeostatic model assessment of insulin resistance (HOMA-IR) was obviously reduced when contrasted with the pre-treatment HOMA-IR levels (P < 0.05), and there was no significant difference in the improvement degree of homa-ir between the two groups (P > 0.05).
Conclusions: 1. Obese patients with PCOS demonstrated higher expression of AMH, LH/FSH, T, SHBG, and FAI when contrasted with the control group. Additionally, they experienced more severe insulin resistance and lipid metabolism disorders. 2. The weight and BMI of obese PCOS patients were significantly decreased after weight loss, while IR and blood lipid were significantly improved, while IR was improved in metformin group, and no significant discrepancy was observed in the degree of improvement of insulin resistance between both groups.
Uvod: Cilj je bio da se sagledaju osnovne metaboličke karakteristike gojaznih pacijenata sa sindromom policističnih jajnika (PCOS), i posmatra i uporedi efekat laparoskopske sleeve gastrektomije i lečenja metforminom posle 3 meseca.
Metode: U periodu od januara do decembra 2018. Druga bolnica Medicinskog univerziteta Hebei odabrala je 104 žene koje su klasifikovane kao gojazne sa indeksom telesne mase (BMI) od 28 kg/cm 2 ili više i koje su imale PCOS. Oni su podeljeni u gojaznu grupu sa PCOS (53 slučaja) i gojaznu grupu bez PCOS (51 slučaj).
Rezultati: 1. Nije bilo značajne razlike u obimu struka i VHR između pacijenata koji su gojazni sa PCOS i pacijenata koji su gojazni bez PCOS (P > 0,05). Gojazni pacijenti sa PCOS su bili značajno viši u anti-Mullerian hormonu (AMH), LH /FSH, T, FAI, homair, triglicerid (TG), lipoprotein niske gustine (LDL), Apo-B i mokraćna kiselina u odnosu na grupu pacijenata bez PCOS koji su bili gojazni. (P<0,05). Nivoi SHBG kod gojaznih pacijenata sa PCOS su očigledno bili niži u poređenju sa nivoima kod gojaznih pacijenata bez PCOS (P <0,05). 2. Telesna težina, BMI, INS, homa-ir i TG gojaznih pacijenata sa PCOS su značajno smanjeni 3 meseca nakon laparoskopske rukavne gastrektomije u poređenju sa onim pre operacije (P < 0,05). Nakon tri meseca lečenja metforminom, homeostatska procena insulinske rezistencije (HOMA-IR) pacijenata je očigledno smanjena u poređenju sa nivoima HOMA-IR pre tretmana (P < 0,05), i nije bilo značajne razlike u stepen poboljšanja homa-ir izme|u dve grupe (P > 0,05).
Zaključak: 1. Gojazni pacijenti sa PCOS su pokazali veću ekspresiju AMH, LH/FSH, T, SHBG i FAI u poređenju sa kontrolnom grupom. Pored toga, iskusili su ozbiljniju insulinsku rezistenciju i poremećaje metabolizma lipida. 2. Težina i BMI gojaznih pacijenata sa PCOS su znaćajno smanjeni nakon gubitka težine, dok su IR i lipid u krvi značajno poboljšani, dok je IR poboljšan u metformin grupi i nije uočena značajna razlika u stepenu poboljšanja insulinske rezistencije između oba. grupe.
Keywords: PCOS; laparoscopic sleeve gastrectomy; metformin; obesity.
2024 Qingya Ma, Xiaojing He, Zijie Fu, Xiaodong Ren, Ranran Sun, Siqi Zhu, Yahui Bian, Xiaodong Li, published by CEON/CEES.