Surgical management of metabolic dysfunction in PCOS - PubMed (original) (raw)
Review
. 2012 Mar 10;77(4):312-6.
doi: 10.1016/j.steroids.2011.12.004. Epub 2011 Dec 8.
Affiliations
- PMID: 22172592
- DOI: 10.1016/j.steroids.2011.12.004
Review
Surgical management of metabolic dysfunction in PCOS
Héctor F Escobar-Morreale. Steroids. 2012.
Abstract
Metabolic disturbances are common in women with polycystic ovary syndrome (PCOS). Obesity is the major link in the association of PCOS with diabetes, metabolic syndrome, hypertension, low-grade chronic inflammation and increased body iron stores, among others. Metabolic prevention in PCOS women should start as early as possible, usually meaning at diagnosis. Among preventive strategies, those promoting a healthy life-style based on diet, regular exercising and smoking cessation are possibly the most effective therapies, but also are the most difficult to achieve. To this regard, every effort must be made to avoid weight gain and obesity, given the deleterious impact that obesity exerts on the metabolic and cardiovascular associations of PCOS. Unfortunately, classic strategies that address obesity by life-style modification and dieting are seldom successful on a long-term basis, especially in women with severe obesity. In selected cases, metabolic surgery in severely obese women may resolve signs and symptoms of PCOS restoring insulin sensitivity and fertility, and avoiding the long-term risks associated with PCOS and morbid obesity. Surgical techniques for bariatric surgery have evolved in the past decades and newer procedures do not longer carry the severe side effects associated with earlier bariatric procedures. The choice of bariatric procedure should consider both the severity of obesity and the possibility of future pregnancy, since fertility may be restored by the sustained and marked weight loss usually attained after bariatric surgery. Finally, avoidance of the risks associated with morbid obesity compensate for the possible residual risks for pregnancy derived from the previous bariatric procedure itself.
Copyright © 2011 Elsevier Inc. All rights reserved.
Similar articles
- Obesity and the polycystic ovary syndrome.
Martínez-Bermejo E, Luque-Ramírez M, Escobar-Morreale HF. Martínez-Bermejo E, et al. Minerva Endocrinol. 2007 Sep;32(3):129-40. Minerva Endocrinol. 2007. PMID: 17912153 Review. - Cardiovascular risk in women with polycystic ovary syndrome.
Giallauria F, Orio F, Palomba S, Lombardi G, Colao A, Vigorito C. Giallauria F, et al. J Cardiovasc Med (Hagerstown). 2008 Oct;9(10):987-92. doi: 10.2459/JCM.0b013e32830b58d4. J Cardiovasc Med (Hagerstown). 2008. PMID: 18799960 Review. - The impact of obesity on reproduction in women with polycystic ovary syndrome.
Pasquali R, Gambineri A, Pagotto U. Pasquali R, et al. BJOG. 2006 Oct;113(10):1148-59. doi: 10.1111/j.1471-0528.2006.00990.x. Epub 2006 Jul 7. BJOG. 2006. PMID: 16827825 Review. - Dietary therapy in polycystic ovary syndrome.
Moran LJ, Brinkworth GD, Norman RJ. Moran LJ, et al. Semin Reprod Med. 2008 Jan;26(1):85-92. doi: 10.1055/s-2007-992928. Semin Reprod Med. 2008. PMID: 18181086 Review. - Understanding and managing disturbances in insulin metabolism and body weight in women with polycystic ovary syndrome.
Moran L, Norman RJ. Moran L, et al. Best Pract Res Clin Obstet Gynaecol. 2004 Oct;18(5):719-36. doi: 10.1016/j.bpobgyn.2004.05.003. Best Pract Res Clin Obstet Gynaecol. 2004. PMID: 15380143 Review.
Cited by
- Obesity: A Doorway to a Molecular Path Leading to Infertility.
Ahmad R, Haque M. Ahmad R, et al. Cureus. 2022 Oct 27;14(10):e30770. doi: 10.7759/cureus.30770. eCollection 2022 Oct. Cureus. 2022. PMID: 36320802 Free PMC article. Review. - Coagulation Biomarkers in Women with Recurrent Miscarriage and Polycystic Ovarian Syndrome: Systematic Review and Meta-Analysis.
Cavalcante MB, Sarno M, Cavalcante CTMB, Araujo Júnior E, Barini R. Cavalcante MB, et al. Geburtshilfe Frauenheilkd. 2019 Jul;79(7):697-704. doi: 10.1055/a-0884-3212. Epub 2019 Jul 10. Geburtshilfe Frauenheilkd. 2019. PMID: 31303657 Free PMC article. - Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance.
Barber TM, Dimitriadis GK, Andreou A, Franks S. Barber TM, et al. Clin Med (Lond). 2016 Jun;16(3):262-6. doi: 10.7861/clinmedicine.16-3-262. Clin Med (Lond). 2016. PMID: 27251917 Free PMC article. Review. - How to manage the reproductive issues of PCOS: a 2015 integrated endocrinological and gynecological consensus statement of the Italian Society of Endocrinology.
Moghetti P, Carmina E, De Leo V, Lanzone A, Orio F, Pasquali R, Toscano V. Moghetti P, et al. J Endocrinol Invest. 2015 Sep;38(9):1025-37. doi: 10.1007/s40618-015-0274-y. Epub 2015 Apr 3. J Endocrinol Invest. 2015. PMID: 25835559 No abstract available. - Polycystic ovary syndrome as a paradigm for prehypertension, prediabetes, and preobesity.
Luque-Ramírez M, Escobar-Morreale HF. Luque-Ramírez M, et al. Curr Hypertens Rep. 2014 Dec;16(12):500. doi: 10.1007/s11906-014-0500-6. Curr Hypertens Rep. 2014. PMID: 25304109 Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous