Partial recovery of luteal function after bariatric surgery in obese women  

Oleh:

Rochester, Dana ; Jain, Akas ; Polotsky, Alex J. ; Polotsky, Hanah ; Gibbs, Karen

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 92 no. 04 (Oct. 2009), page 1410-1415.
Topik: Obesity; weight loss; luteal function; LH; FSH; E1c; Pdg; fertility

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2009.04 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective To determine whether obesity-related reproductive endocrine abnormalities in ovulatory women are reversible with weight loss. Design Observational cohort study. Setting Healthy volunteers in an academic research environment. Patient(s) Women aged 18–48 years with regular menstrual cycles 21–40 days and a body mass index (BMI) =35 kg/m2 planning to undergo bariatric surgery were recruited. Intervention(s) Twenty-five eumenorrheic (non–polycystic ovary syndrome) women with a mean BMI of 47.3 ± 5.2 kg/m2 were sampled with daily menstrual cycle urinary hormones before (n = 25) and 6 months after (n = 9) weight loss surgery resulting in >25% reduction of sinitial body weight. Daily hormones were compared before and after surgery and with 14 normal-weight control subjects. Main Outcome Measure(s) Metabolites of LH, FSH, E2, and P were measured daily for one menstrual cycle. Group means were compared using t tests among ovulatory cycles. Result(s) Luteal pregnanediol glucuronide (Pdg) increased from 32.8 ± 10.9 to 73.7 ± 30.5 µg/mg creatinine (Cr) and whole-cycle LH increased from 168.8 ± 24.2 to 292.1 ± 79.6 mIU/mg Cr after surgically induced weight loss. Luteal Pdg remained lower than in normal-weight control subjects (151.7 ± 111.1 µg/mg Cr). Obese women took longer to attain a postovulatory Pdg rise of >2 µg/mg Cr than control subjects (3.91 ± 1.51 vs. 1.71 ± 1.59 days); this improved after surgery (2.4 ± 1.82 days). Whole-cycle estrone conjugates (E1c) was similar to control subjects at baseline, but decreased after weight loss (from 1,026.7 ± 194.2 to 605.4 ± 167.1 ng/mg Cr). Follicle-stimulating hormone did not relate to body size in this sample. Conclusion(s) Women of very high BMI have deficient luteal LH and Pdg excretion and a delayed ovulatory Pdg rise compared with normal-weight women. Although these parameters improved with weight loss, Pdg did not approach levels seen in normal-weight women. Luteinizing hormone may be less effective in stimulating the corpus luteum in obesity. The large postoperative decrease in E1c may reflect the loss of estrone-producing adipose tissue after weight loss.

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