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Submitted on July 6, 2005
Accepted on September 21, 2005
Department of Endocrinology (H.F.E.-M., J.I.B.-C., F.A.-B. and J.S.) and Molecular Genetics (J.L.S.M.), Hospital Ramón y Cajal, Madrid, Spain
* To whom correspondence should be addressed. E-mail: hescobarm.hrc{at}salud.madrid.org.
Context The polycystic ovary syndrome (PCOS) is frequently associated with obesity. However, there are very few data about PCOS in morbid obesity, especially with regards to its evolution after bariatric surgery.
Objective To evaluate the response of PCOS to the sustained and marked weight loss achieved by bariatric surgery in morbidly obese women.
Design Longitudinal prospective nonrandomized evaluation
Settings Academic hospital.
Patients Thirty-six consecutive premenopausal women submitted to bariatric surgery were screened for PCOS, which was present in seventeen.
Interventions Bariatric surgery
Main Outcome Measures Hyperandrogenism, menstrual function and insulin resistance were estimated before and at least six months after bariatric surgery in twelve patients with PCOS.
Results Weight loss (41 ± 9 kg after 12 ± 5 months) was paralleled by a decrease in the hirsutism score (from 9.5 ± 6.8 to 4.9 ± 4.2, P = 0.001), total (69 ± 32 to 42 ± 19 ng/dL, P < 0.02) and free testosterone (from 1.6 ± 0.7 to 0.6 ± 0.3 ng/dL, P < 0.005), androstendione (from 4.1 ± 1.5 to 3.0 ± 0.9 ng/mL, P < 0.02) and dehydroepiandrosterone-sulfate (from 2000 ± 1125 to 1353 ± 759 ng/mL, P < 0.005), amelioration of insulin resistance estimated by homeostasis model assessment (from 6.0 ± 3.0 to 1.6 ± 1.0, P < 0.001) and the restoration of regular menstrual cycles and/or ovulation in all the patients.
Conclusions The polycystic ovary syndrome is a frequent finding in women with morbid obesity, and may resolve after weight loss induced by bariatric surgery.
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