Objective:

To identify distinct patterns of BMI decline during the 12 months after metabolic-bariatric surgery (MBS) in women with obesity and Polyendocrine Metabolic Ovarian Syndrome (PMOS), and to characterize the associated metabolic improvements.

Approach:

• Study Design: An exploratory prospective cohort study conducted at China-Japan Friendship Hospital, including 201 women with obesity and PMOS who underwent MBS.
• Data Collection: Data were collected at baseline and during follow-up visits at 1, 3, 6, and 12 months post-surgery, including anthropometric and metabolic measurements.
• Surgical Procedure: All participants underwent sleeve gastrectomy (SG) performed by experienced bariatric surgeons.

Key Findings:

• MBS significantly improves BMI, metabolic profiles, ovulation, menstrual regularity, and hormonal disturbances in women with PMOS.
• Irregular menstruation resolved in 79.03% of PMOS patients post-surgery.
• Fasting insulin concentrations decreased from 34.2 mIU/mL pre-surgery to 9.0 mIU/mL post-surgery.

Interpretation:

The findings suggest that metabolic-bariatric surgery can lead to substantial weight loss and metabolic improvements in women with PMOS. The significant reduction in fasting insulin levels indicates enhanced insulin sensitivity, which may contribute to the resolution of metabolic disturbances associated with PMOS. Furthermore, the high rate of menstrual regularity post-surgery underscores the potential reproductive benefits of MBS in this population.

Limitations:

• The study may not generalize to all populations due to its specific cohort of Chinese women.
• Limited exploration of the relationship between weight-loss trajectories and metabolic outcomes.

Conclusion:

In conclusion, metabolic-bariatric surgery appears to be an effective intervention for improving BMI and metabolic health in women with PMOS. The resolution of menstrual irregularities and significant reductions in insulin levels highlight the potential of MBS to address both weight-related and hormonal issues in this patient group. Further research is needed to explore the long-term effects of MBS on metabolic outcomes and reproductive health in diverse populations.