Effect of obesity therapy in women of reproductive age on leptin level and hormonal ovarian function

Abstract

Hypothesis/aims of study. Ovarian insufficiency is present in more than 30% of reproductive-age obese women. The role of leptin in the pathogenesis of ovarian insufficiency is not yet established and has to be clarified. It is of interest to study the effect of obesity therapy on hyperleptinemia, hormonal and ovulatory function in reproductive-age women with alimentary obesity. The aim of this study was to assess the effect of obesity therapy on leptin level and hormonal ovarian function in women of reproductive age.
 Study design, materials and methods. All studied women underwent a clinical and laboratory examination, including: medical history, anthropometry (height and weight measurement, waist and hip circumferences, body mass index calculation), blood pressure measurement, gynecological examination, ultrasound examination of the pelvic organs, osteodensitometry, determination of serum gonadotropins, sex hormones, insulin, leptin, and blood biochemical parameters, morning fasting blood glucose, and glucose after the glucose tolerance test. The survey and objective examination data were recorded in a specially developed application form, including the following parameters: the patients age, menarche age, the type of the menstrual cycle, data on pregnancies, childbirth and reproductive plans, gynecological and somatic diseases.
 Results. The relationship between the initial levels of leptin, estradiol, HOMA-IR, the number of follicles in the ovaries and the restoration of ovulatory function after the weight loss was revealed. The analysis produced a mathematical model to estimate the predictive value of these indicators in relation to the recovery of ovulation after the weight loss. An analysis was made of the effectiveness of drugs used to treat excess body weight (metformin and sibutramine).
 Conclusion. The predictive value of the baseline levels of leptin and estradiol, the number of antral follicles and insulin resistance in relation to the achievement of ovulation after the reduction of body weight in patients with anovulation caused by excess body weight and obesity has been established. Ovulation recovery did not depend on the choice of a drug used to treat excess body weight. When comparing the groups of women who received medication for alimentary obesity using metformin and sibutramine, no significant differences in the frequency of ovulation recovery were found.