Effects of bariatric surgery on obese polycystic ovary syndrome: a systematic review and meta-analysis.

BACKGROUND: Bariatric surgery has been widely used for the treatment of obesity and its related metabolic diseases, such as type 2 diabetes (T2D), hypertension, and sleep apnea syndrome. Polycystic ovary syndrome (PCOS) is a common reproductive endocrine metabolic disease; however, little attention has been paid to the efficacy of bariatric surgery on PCOS.
OBJECTIVE: To evaluate the efficacy of bariatric surgery on obese PCOS patients.
SETTING: A systematic review and meta-analysis at a university hospital.
METHODS: Online databases were searched for all studies reporting the efficacy of bariatric surgery for obese patients with PCOS up to October 2018.
RESULTS: A total of 9 studies with 234 obese PCOS patients were included in this article. The results of meta-analysis showed that after bariatric surgery, there was a significant reduction of the incidence of abnormal menstruation (relative risk [RR] .23; 95% confidence interval [CI] .13-.43; P < .00001) and hirsutism (RR .47; 95% CI .28-.79; P = .004). Bariatric surgery can also cause a decrease in the serum total testosterone level (mean difference [MD] = -25.82; 95% CI -30.06 to -21.58; P < .00001), serum free testosterone level (MD = -4.10; 95% CI -6.97 to -1.23; P = .005), and body mass index (MD = -14.51; 95% CI -17.88 to -11.14; P < .00001). It also showed a significant effect on T2D (RR .09; 95% CI .03-.32; P = .0002) and hypertension (RR .21; 95% CI .05-.98; P = .05) in obese patients with PCOS.
CONCLUSIONS: Bariatric surgery can reduce the incidence of abnormal menstruation, improve hyperandrogenism and its clinical manifestations, and decrease the body mass index, prevalence of T2D, and hypertension in obese patients with PCOS.