Abstract
Polycystic ovary syndrome (PCOS) is a complicated reproductive endocrine disease that is closely related to obesity. Metabolic surgery ameliorates a series of clinical manifestations and related comorbidities of PCOS. However, the overall efficacy of metabolic surgery on PCOS remains uncertain. This systematic review and meta-analysis aimed to evaluate the therapeutic effects of metabolic surgery on obese patients with PCOS. A systematic literature search for relevant studies was conducted on PubMed, Embase, Web of Science, and the Cochrane Library from inception to June 2021. Data extraction and quality evaluation were performed by three researchers, and RevMan 5.4 software was used to conduct the meta-analysis. A total of 14 studies involving 501 obese patients with PCOS were included. Incidence of PCOS in obese women ranged from 5.5% to 63.5% among the included studies. The results showed the incidence of abnormal menstruation decreased from 81% to 15% (OR=0.03, 95% confidence interval (CI): 0.01–0.08), while the incidence of hirsutism dropped from 71% to 38% (OR=0.21, 95% CI: 0.06–0.74). Serum total testosterone and free testosterone levels decreased by 25.92 ng/dL (MD = -25.92, 95% CI: -28.90– -22.93) and 2.28 ng/dL (SMD = -2.28, 95% CI: -3.67– -0.89), respectively. Sex hormone-binding globulin (SHBG) levels increased by 26.46 nmol/L (MD = 26.46, 95% CI: 12.97–39.95). Serum anti-Mullerian hormone (AMH) levels decreased by 1.29 ng/mL (MD = -1.29, 95% CI: -1.92– -0.66). Small sample size studies revealed that pregnancy rates ranged from 95.2% to 100% postoperatively. Metabolic surgery contributed to marked improvement of abnormal menstruation, hirsutism, and levels of free testosterone, total testosterone, SHBG, and AMH in patients with PCOS. Our findings indicate that patients with PCOS are expected to benefit from metabolic surgery, and could help potentially improve their reproductive outcomes. Metabolic surgery could thus be a new viable option for the clinical treatment of PCOS.Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021251524.
Highlights
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age and is characterized by ovulation dysfunction, hyperandrogenism, and polycystic ovarian morphology (PCOM)
The results showed the incidence of abnormal menstruation decreased from 81% to 15% (OR=0.03, 95% confidence interval (CI): 0.01–0.08), while the incidence of hirsutism dropped from 71% to 38% (OR=0.21, 95% CI: 0.06–0.74)
There was a significant difference between groups [Mean difference (MD) = -1.29, 95%CI (-1.92, -0.66), P
Summary
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age and is characterized by ovulation dysfunction, hyperandrogenism, and polycystic ovarian morphology (PCOM). Women with PCOS exhibit menstrual irregularities, hirsutism, and infertility. This syndrome can lead to long-term comorbidities, including obesity, type 2 diabetes mellitus, cardiometabolic diseases, endometrial carcinoma, and psychological disorders [3–5]. Hyperandrogenism, chronic inflammation, and family history of diabetes contributed to insulin resistance as the main pathogenetic mechanism of PCOS, with 5070% of patients with PCOS exhibiting insulin resistance and compensatory hyperinsulinism [7, 8]. Obesity, a frequent feature among PCOS patients (60-70%), has a major contribution to the aggravation of insulin resistance [9]. Lifestyle management targeting weight reduction is the first-line treatment for PCOS [12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
