The factors that independently impair menstrual recovery in obese women with polycystic ovary syndrome include total testosterone levels, body mass index, and time since PCOS diagnosis at baseline.
Menstruation recovery is a useful indicator of treatment effectiveness in women diagnosed with polycystic ovary syndrome (PCOS). This clinical trial investigated the predictive factors of menstrual recovery in obese PCOS patients following laparoscopic sleeve gastrectomy (LSG). It was concluded that total testosterone (TT), body mass index (BMI), and time from PCOS diagnosis at baseline were negatively and independently associated with menstrual recovery in obese women with PCOS. The findings are published in the journal Diabetes, Metabolic Syndrome, and Obesity.
Baseline Characteristics of Participants
This clinical trial recruited 88 obese PCOS patients and 76 patients with normal menstrual cycles. Compared to the control group, the PCOS group patients demonstrated a higher waist-to-hip ratio (WHR), waist circumference, and visceral adipose tissue mass, as well as significantly lower levels of high-density lipoprotein cholesterol (HDL-c) and the mean number of menstruations/year. The PCOS group patients also had significantly higher levels of TT, fasting insulin, postprandial insulin, aspartate aminotransferase, alanine aminotransferase (ALT), fibrinogen-like protein 1 (FGL-1), calculated free testosterone (cFT), and uric acid, and scores on the homeostatic model assessment insulin resistance index (HOMA-IR).
Comparison of Follow-Up Parameters
In the PCOS group, there were significant increases in the number of menstruations/year and serum HDL-c levels and significant decreases in cFT, FGL-1, and TT levels. The two groups demonstrated significant differences in serum ALT, HDL-c, and changes in the menstruation number.
Changes in Weight Loss, Menstrual Status, and Fertility
There was a significant improvement in the number of menstruations/year and the proportion of regular menstruation in the PCOS group patients at the final follow-up after LSG. In the PCOS group, 16.49% of patients experienced menstruation within 7 postoperative days, and the rates of spontaneous pregnancy, miscarriage, and live birth were estimated to be 19.31%, 2.27%, and 17.04%, respectively. There were no significant differences in the weight loss between controls and women with PCOS at the 6-month postoperative follow-up.
Predictive Factors of Menstrual Recovery
There was a significant association between menstrual recovery within 6 months following LSG and time from diagnosis of PCOS, HOMA-IR, TT, duration of obesity, and the number of menstruations/year. BMI, TT, and time from PCOS diagnosis at baseline were estimated to be independent predictive factors of menstrual recovery.
TT, BMI, and time from PCOS diagnosis at baseline were found to be negatively and independently associated with menstrual recovery in obese women with PCOS.
Cai, M., Zhang, Y., Gao, J., Dilimulati, D., Bu, L., Cheng, X., Du, L., Zhou, D., Zhu, J., Qu, S., & Zhang, M. (2023). Predictive Factors of Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women with Obesity. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 16, 1755–1766. https://doi.org/10.2147/dmso.s411573