Dataset Information

Predictive Factors of Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women with Obesity.

ABSTRACT:

Objective

To explore the predictors of menstrual recovery in polycystic ovary syndrome (PCOS) women with obesity following laparoscopic sleeve gastrectomy (LSG).

Methods

A total of 88 PCOS patients with obesity and 76 control patients with obesity aged 18-45 years were enrolled between May 2013 and December 2020. PCOS was diagnosed using the Rotterdam diagnostic criteria (2003). Anthropometric measurements, biochemical parameters, sex hormones, and circulating fibrinogen-like protein 1 (FGL-1) levels were collected before and six-month after LSG. The data on postoperative menstrual status, body weight, and fertility were obtained through telephone follow-ups for all individuals with PCOS.

Results

Patients with PCOS were followed up for at least six months after surgery, and the mean follow-up time was 3.23 years. At 6 months after LSG, circulating total testosterone (TT), calculated free testosterone (cFT), and FGL-1 levels declined significantly. The mean percent excess weight loss (%EWL) and percent total weight loss (%TWL) in PCOS patients at the final follow-up was 97.52% ± 33.90% and 31.65% ± 10.31%, respectively. The proportion of regular menstruation in PCOS patients significantly increased within six months (75.86% vs 0.03% at baseline). In the logistic regression analysis, time from PCOS diagnosis (P=0.007), body mass index (BMI) (P=0.007), TT (P=0.038) at baseline were demonstrated to be independent predictive factors for the regular menstruation in women with PCOS and obesity within 6 months after LSG.

Conclusion

In PCOS patients with obesity, time from PCOS diagnosis, BMI, and TT levels at baseline were independently and negatively associated with menstrual recovery within 6 months after LSG, which could be applied in preoperative evaluation.

SUBMITTER: Cai M

PROVIDER: S-EPMC10276569 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Predictive Factors of Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women with Obesity.

Cai Meili M Zhang Yuqin Y Gao Jingyang J Dilimulati Diliqingna D Bu Le L Cheng Xiaoyun X Du Lei L Zhou Donglei D Zhu Jiangfang J Qu Shen S Zhang Manna M

Diabetes, metabolic syndrome and obesity : targets and therapy 20230613

<h4>Objective</h4>To explore the predictors of menstrual recovery in polycystic ovary syndrome (PCOS) women with obesity following laparoscopic sleeve gastrectomy (LSG).<h4>Methods</h4>A total of 88 PCOS patients with obesity and 76 control patients with obesity aged 18-45 years were enrolled between May 2013 and December 2020. PCOS was diagnosed using the Rotterdam diagnostic criteria (2003). Anthropometric measurements, biochemical parameters, sex hormones, and circulating fibrinogen-like prot ...[more]

PMID: 37334183

Similar Datasets

Project description:Metabolic surgery, including laparoscopic sleeve gastrectomy (LSG), may improve hypertension (HTN) complicated by severe obesity; however, insufficient deliberation exists regarding the therapeutic effect of post-metabolic surgery on HTN. This study aimed to analyze the factors correlated with HTN remission and recurrence post-LSG in patients who have severe obesity, and to create a classification system to predict HTN remission and recurrence. Of the 102 patients who underwent LSG at Iwate Medical University Hospital between 2008 and 2020, 62 were enrolled in this study. Factors correlated with HTN remission and recurrence post-LSG were retrospectively analyzed. The HTN remission rate 12-months post-LSG was 40.3%. The remission cohort had a lower number of preoperative antihypertensive drugs (ADs) than that of the non-remission cohort (one and two tablets, respectively; p< 0.001). Additionally, the remission cohort had a statistically significantly smaller visceral fat area (VFA) than that of the non-remission cohort, at all time points. Logistic regression analysis revealed that the number of preoperative ADs and VFA were independent predictors of remission. The HTN recurrence rate 36-months post-LSG was 36.0%. In the recurrence cohort, the number of preoperative ADs and VFA were higher and larger than that in the non-recurrence cohort, respectively. Stratification, based on the number of preoperative ADs and VFA, revealed that the HTN remission and recurrence rates in the sub-cohort with a small number of preoperative ADs and small VFA (100% and 16.7%, respectively) were better than those in the sub-cohort with a large number of preoperative ADs and large VFA (5.3% and 100%, respectively). In Japanese patients with severe obesity, the number of preoperative ADs and VFA were correlated with HTN remission and recurrence post-LSG. Stratification, by combining the number of preoperative ADs and VFA, may be useful in predicting HTN remission and recurrence.

Project description:BackgroundLaparoscopic sleeve gastrectomy (LSG) modifies the upper gastrointestinal tract motility. Controversial data currently exist. The aim of the study was to evaluate esophageal motility before and after LSG.Patients and methodsMorbid obese patients scheduled for LSG underwent reflux symptoms evaluation and manometry preoperatively and postoperatively. The preoperative and postoperative results were compared and analyzed.ResultsEighteen patients were enrolled. Heartburn and regurgitation improved in 38.9% and 11.1% of the patients, but deteriorated in 11.1% and 27.8% of the patients, respectively. Lower esophageal sphincter (LES) total length decreased postoperatively (p=0.002). Resting and residual pressures tended to decrease postoperatively (mean difference [95% confidence interval]: -4 [-8.3/0.2] mmHg, p=0.060; -1.4 [-3/0.1] mmHg, p=0.071, respectively). Amplitude pressure decreased from 95.7±37.3 to 69.8±26.3 mmHg at the upper border of LES (p=0.014), and tended to decrease at the distal esophagus from 128.5±30.1 to 112.1±35.4 mmHg (p=0.06) and mid-esophagus from 72.7±34.5 to 49.4±16.7 mmHg (p=0.006). Peristaltic normal swallow percentage increased from 47.2±36.8 to 82.8±28% (p=0.003). Postoperative regurgitation was strongly negatively correlated with LES total length (Spearman's r=-0.670). When groups were compared according to heartburn status, statistical significance was observed between the groups of improvement and deterioration regarding postoperative residual pressure and postoperative relaxation (p<0.002, p<0.002, respectively). With regard to regurgitation status, there was statistically significant difference between groups regarding preoperative amplitude pressure at the upper border of LES (p<0.056).ConclusionPatients developed decreased LES length and weakened LES pressure after LSG. Esophageal body peristalsis was also affected in terms of decreased amplitude pressure, especially at the upper border of LES. Nevertheless, body peristalsis was normalized postoperatively. LSG might not deteriorate heartburn. Regurgitation might increase following LSG due to shortening of LES length, particularly in patients with range of preoperative amplitude pressure at the upper border of LES of 38.9-92.6 mmHg.

Project description:BackgroundBariatric surgery is the most effective intervention for severe pediatric obesity, but a subset of youth experience suboptimal weight loss and/or recurrent weight gain. Early re-initiation of obesity pharmacotherapy postoperatively may improve outcomes, though this has not been evaluated in pediatric populations.MethodsA retrospective cohort study at a tertiary care children's hospital evaluated the safety and efficacy of reintroducing obesity pharmacotherapy within six weeks after laparoscopic sleeve gastrectomy (LSG). Youth were offered obesity pharmacotherapy reinitiation at their 2-week postoperative visit. The study compared outcomes between 25 youth who chose early obesity pharmacotherapy reinitiation and 21 who received standard care without restarting medication. Primary outcomes included weight trajectory, eating behaviors, complications, readmissions, and reoperation rates, analyzed using independent t-tests, Chi-squared tests, and logistic regressions.ResultsBetween November 2023 and July 2024, 53 youth had surgical consults, and 46 (86% conversion rate; mean age 16.5 ± 1.9 years, mean BMI 53 ± 9.7 kg/m2; 70% (32/46) female, 80% (37/46) Hispanic, 87% (40/46) publicly insured) underwent LSG, with 93% (43/46) using obesity pharmacotherapy preoperatively. Mixed-effects multivariate regression, adjusting for baseline BMI, age, and sex, revealed that early reinitiation (5.1 weeks [IQR 3.7, 8.4]) significantly reduced BMI, percent BMI, percent total weight loss (TWL), and percent excess weight loss (EWL) at 3 and 6 months compared to standard care, with no significant differences in complications or readmissions. At 6 months, the mean differences were: %BMI: -6.5% (95% CI: -9.13, -3.86), p < 0.001; %TWL: -5.9% (95% CI: -8.52, -3.25), p < 0.001; %EWL: Reinitiators: -45.5% vs. standard care: -39.4%; mean difference: -8.2% (95% CI: -14.69, -1.63), p < 0.001. Early reinitiation also resulted in a significant reduction in emotional overeating at 3 and 6 months compared to standard care, with mean differences of -2.5 points (95% CI: -3.29, -1.76), p < 0.001, and -3.5 points (95% CI: -4.38, -2.69), p < 0.001, respectively on self-reported eating behavior questionnaires.ConclusionEarly obesity pharmacotherapy reinitiation after LSG was safe and well tolerated, improving weight outcomes without negatively impacting complication or readmission rates.

Dataset Information

Predictive Factors of Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women with Obesity.

Objective

Methods

Results

Conclusion

Publications

Predictive Factors of Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women with Obesity.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets