袖状胃切除术对肥胖患者月经功能和卵巢储备的影响

G. V. Semikova, S. Dora, Z. V. Shvets, E. A. Kulchitskaya, A. Volkova
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摘要

背景:肥胖与月经紊乱(MD)、卵巢储备功能下降和不孕有关。肥胖的治疗有助于女性生殖功能的正常化。减肥手术是治疗肥胖最有效的方法,而最常见的干预措施是袖式胃切除术(SG),其对月经功能和卵巢储备的影响尚未得到足够的研究。目的:研究SG对肥胖育龄女性月经功能及卵巢储备的影响。材料与方法:选取25 ~ 36岁BMI≥35 kg/m2的女性患者为研究对象。在基线和SG后6个月,测定月经功能特征,计算BMI和HOMA-IR,测定抗勒氏管激素(AMH)水平。将获得的参数在有和没有mre的患者中进行比较。在所有患者中,SG后6个月,BMI分别下降30.1 kg/m2(29.3-32.1)和39.3 kg/m2 (37.3-41.0) (p<0.001), HOMA -IR分别下降5.0(4.1-5.9)和2.8 (2.1-3.2)(p=0.001)。MD患者(n=12)的AMH初始水平低于月经功能正常患者(n=10):分别为2.4 ng/ml(1.9 ~ 2.0)和3.2 ng/ml (2.6 ~ 4.2) (p=0.032)。AMH水平的显著升高仅发生在MD患者组(p=0.04)。只有3名女性患有MD。结论:育龄肥胖患者SG与月经功能正常化、AMH升高、胰岛素抵抗程度降低有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of sleeve gastrectomy on menstrual function and ovarian reserve in patients with obesity
BACKGROUND: Obesity is associated with development of menstrual disorders (MD), a decrease in ovarian reserve and infertility. Treatment of obesity contributes to the normalization of the reproductive function of women. Bariatric surgery is known to be the most effective method of obesity treatment, while the most common intervention is the sleeve gastrectomy (SG), the effect of which on menstrual function and ovarian reserve has not been studied enough.AIM: To study the effect of SG on menstrual function and ovarian reserve in obese women of reproductive ageMATERIALS AND METHODS: Female patients with BMI ≥ 35 kg/m2 aged 25 to 36 years were examined. At baseline and 6 months after SG, the characteristics of menstrual function were determined, BMI and HOMA-IR were calculated, and the level of anti-Müllerian hormone (AMH) was measured. The obtained parameters were compared in patients with and without MDRESULTS: . In all patients, 6 months after SG, there was a decrease in BMI: 30.1 kg/m2 (29.3–32.1) and 39.3 kg/m2 (37.3–41.0) (p<0.001), HOMA -IR: 5.0 (4.1–5.9) and 2.8 (2.1–3.2) (p=0.001). The initial level of AMH in patients with MD (n=12) was lower than in patients with normal menstrual function (n=10): 2.4 ng/ml (1.9–2.0) and 3.2 ng/ml (2.6–4.2), respectively (p=0.032). A significant increase in AMH levels occurred only in the group of patients with MD (p=0.04). MD remained only in 3 women.CONCLUSION: SG in patients of reproductive age with obesity is associated with the normalization of menstrual function and an increase in AMH, as well as a decrease in the degree of insulin resistance.
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