Bariatric Surgery Improves Metabolic Syndrome for PCOS

ORLANDO -- Women who were overweight or obese and had polycystic ovarian syndrome (PCOS) saw significant improvements in all major metabolic syndrome components 8 months after undergoing bariatric surgery, researchers reported here.

The retrospective analysis of baseline factors and outcomes in 19 women, most of them black, showed significant improvements from pre-surgery values in body weight (P<0.0001), body mass index (P<0.0001), systolic blood pressure (P=0.0002), diastolic blood pressure (P=0.007), triglycerides (P=0.04), HbA1c (P=0.03), and HDL cholesterol (P=0.04).

Before surgery, about half (47%) of the women met the criteria for metabolic syndrome; only 21% after the surgery did, according to authors Mc Anto Antony, MBBS, and Shannon Sullivan, MD, PhD, at MedStar Washington Hospital in the District of Columbia.

Antony presented the findings at a poster session here at the annual meeting of the American Association of Clinical Endocrinologists.

"The reason we conducted this study is because PCOS is a very commonly seen disorder in reproductive-aged women, and most of these women are either overweight or obese, and obesity exacerbates the metabolic phenotype in these women; and, in the long run, because of the metabolic syndrome they are at risk for developing cardiovascular problems," said Antony in an interview with MedPage Today. "So we wanted to see if bariatric surgery could provide a solution in this population."

He added that for women who find it hard to achieve weight loss through diet and exercise, bariatric surgery could be a good option that might reduce cardiovascular risk.

All of the patients had visited MedStar at some point, and all were at least 18 years old. All values were taken at least 6 months after surgery (mean 7.9 ±3.4 months). Fifty-three percent of the women were black, 41% were white, and 6% were Asian. Prior to surgery, the mean number of metabolic syndrome factors per patient was 2.7 (±1.1) versus 1.9 (±1.2) after surgery (P<0.01).

Antony said that most of the time the first-line intervention among this populations is weight loss through diet and exercise. "But it's very hard for most of them to achieve that, and even if they achieve that, it's hard for them to sustain it," he said. "Hence we thought of bariatric surgery as an option."

Antony said that a significant limitation of the study was that there were not enough data to determine how the surgery affected the patients' PCOS. "We tried to look up whether the surgery had any effect on the PCOS itself, but there were not enough data in the patients' notes," he said.

But he added that other studies have showed an improvement after bariatric surgery for some PCOS symptoms, "like an improvement of menstrual irregularities and hormone markers." Participants in one study were more likely to conceive after surgery, he said.

He added that the topic needs more research, however. "It would be really interesting to follow a larger population to see if they are able to sustain the weight loss after surgery," he said.

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