中国普通外科杂志2025，Vol.34Issue(4)：686-697,12.DOI:10.7659/j.issn.1005-6947.250102
肥胖合并多囊卵巢综合征患者心理特征及其对减重手术疗效的影响
Psychological characteristics of obese patients with polycystic ovary syndrome and their impact on the efficacy of bariatric surgery
摘要
Abstract
Background and Aims:Polycystic ovary syndrome(PCOS)is a common endocrine disorder among obese women,often accompanied by psychological issues such as anxiety and depression.Laparoscopic sleeve gastrectomy(LSG)is an effective treatment for obesity and its related metabolic conditions,and has shown clear benefits in improving weight and metabolic profiles in PCOS patients.However,the potential mechanisms by which psychological status may affect weight loss outcomes remain unclear.This study aimed to evaluate the psychological characteristics of obese patients with PCOS and explore their impact on postoperative weight loss outcomes,in order to provide evidence for individualized intervention strategies. Methods:Female obese patients scheduled for LSG between November 2020 and September 2022 were enrolled and divided into PCOS and non-PCOS groups.Standardized psychological scales were used to assess anxiety,depression,self-esteem,and eating behaviors.Weight loss outcomes were recorded at 6 and 12 months postoperatively.Propensity score matching was used to control for confounding factors such as age and body mass index(BMI),and correlation analysis was conducted to explore the relationship between psychological status and weight loss outcomes. Results:A total of 314 patients were included,with 130 cases(41.4％)in the PCOS group.Before matching,the PCOS group had significantly worse psychological indicators and lower weight loss outcomes compared to the non-PCOS group(all P＜0.05);after matching,these differences were no longer statistically significant(all P＞0.05).Emotional eating was positively correlated with 12-month weight loss outcomes in the PCOS group,while anxiety and internalized weight stigma were associated with weight loss outcomes in the non-PCOS group(P＜0.05).Additionally,among patients with moderate and extreme obesity,weight loss outcomes in the PCOS group were superior to those in the non-PCOS group(P＜0.05).BMI was negatively correlated with self-esteem,eating behaviors,and quality of life(all P＜0.05). Conclusion:Obese patients with PCOS exhibit notable psychological distress.However,after controlling for BMI and age,their psychological status and weight loss outcomes are comparable to those of non-PCOS patients.BMI may serve as an important confounding factor,and psychological factors may influence weight loss indirectly through eating behaviors.Preoperative psychological screening and intervention are recommended.关键词
减肥手术/肥胖症/多囊卵巢综合征/精神能力Key words
Bariatric Surgery/Obesity/Polycystic Ovary Syndrome/Mental Competency分类
医药卫生引用本文复制引用
潘荣丽,赵培凯,李宇轩,陶瑞欣,黄鑫,刘腾,李卫华,刘少壮..肥胖合并多囊卵巢综合征患者心理特征及其对减重手术疗效的影响[J].中国普通外科杂志,2025,34(4):686-697,12.基金项目
山东大学横向课题基金资助项目(21330012002202) （21330012002202）
白求恩·爱惜康卓越外科公益基金资助项目(HZB-20190528-9). （HZB-20190528-9）
