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Bariatric Surgery Improves Hyperandrogenism, Menstrual Irregularities, and Metabolic Dysfunction Among Women with Polycystic Ovary Syndrome (PCOS)

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Abstract

Objective

To characterize the impact of bariatric surgery on reproductive and metabolic features common to polycystic ovary syndrome (PCOS) and to assess the relevance of preoperative evaluations in predicting likelihood of benefit from surgery.

Methods

A retrospective chart review of records from 930 women who had undergone bariatric surgery at the Cleveland Clinic Foundation from 2009 to 2014 was completed. Cases of PCOS were identified from ICD coding and healthy women with pelvic ultrasound evaluations were identified using Healthcare Common Procedure Coding System coding. Pre- and postoperative anthropometric evaluations, menstrual cyclicity, ovarian volume (OV) as well as markers of hyperandrogenism, dyslipidemia, and dysglycemia were evaluated.

Results

Forty-four women with PCOS and 65 controls were evaluated. Both PCOS and non-PCOS had significant reductions in body mass index (BMI) and markers of dyslipidemia postoperatively (p < 0.05). PCOS had significant reductions in androgen levels (p < 0.05) and percent meeting criteria for hyperandrogenism and irregular menses (p < 0.05). OV did not significantly decline in either group postoperatively. Among PCOS, independent of preoperative BMI and age, preoperative OV associated with change in hemoglobin A1c (β 95% (confidence interval) 0.202 (0.011–0.393), p = 0.04) and change in triglycerides (6.681 (1.028–12.334), p = 0.03), and preoperative free testosterone associated with change in total cholesterol (3.744 (0.906–6.583), p = 0.02) and change in non-HDL-C (3.125 (0.453–5.796), p = 0.03).

Conclusions

Bariatric surgery improves key diagnostic features seen in women with PCOS and ovarian volume, and free testosterone may have utility in predicting likelihood of metabolic benefit from surgery.

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Acknowledgements

We thank our colleagues in the Data Access Committee of the Digestive Disease Institute for aiding in the acquisition of patient data.

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Authors and Affiliations

  1. Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Jacob P. Christ

  2. Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Tommaso Falcone

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  1. Jacob P. Christ
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Correspondence to Tommaso Falcone.

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This study was approved by the Cleveland Clinic Foundation institutional review board IRB number 15-1326.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Christ, J.P., Falcone, T. Bariatric Surgery Improves Hyperandrogenism, Menstrual Irregularities, and Metabolic Dysfunction Among Women with Polycystic Ovary Syndrome (PCOS). OBES SURG 28, 2171–2177 (2018). https://doi.org/10.1007/s11695-018-3155-6

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