Bariatric Surgery As a Molecular Modulator: The Role of FSHR Polymorphisms in Enhancing ENOS Expression and Reproductive Hormone Dynamics in Women with Severe Obesity

Overview

Journal Biomedicines

Date 2025 Jan 25

PMID 39857651

Authors

Charalampos Voros

Despoina Mavrogianni

Kyriakos Bananis

Alexios Karakasis

Anthi-Maria Papahliou

Vasileios Topalis

Antonia Varthaliti

Raphail Mantzioros

Panagiota Kondili

Menelaos Darlas

Regina Sotiropoulou

Diamantis Athanasiou

Dimitris Mathiopoulos

Panagiotis Antsaklis

Dimitrios Loutradis

Georgios Daskalakis

Affiliations

Soon will be listed here.

Abstract

Background/objectives: Severe obesity (BMI > 40 kg/m) has a severe influence on vascular health and reproduction. This study looks at how bariatric surgery affects endothelial nitric oxide synthase (eNOS) expression and reproductive hormone regulation across different follicle-stimulating hormone receptor (FSHR) polymorphism groups in women with extreme obesity.

Methods: Twenty-nine women with extreme obesity had bariatric surgery. Pre- and post-surgery levels of eNOS and reproductive hormones such as follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), anti-Müllerian hormone (AMH), and antral follicle count (AFC) were assessed. Patients were divided into three FSHR polymorphism groups (Ser/Ser, Asn/Asn, and Ser/Asn), and results were compared between them. Statistical techniques were used to determine changes and relationships.

Results: Bariatric surgery led to substantial increases in eNOS expression across all FSHR polymorphism groups ( < 0.0001), with the Ser/Ser group exhibiting the most variability. Prior to surgery, the Ser/Ser group had substantially higher FSH levels (7.41 ± 0.60 mIU/mL) than the Asn/Asn group (5.20 ± 0.63 mIU/mL, < 0.001). Following surgery, FSH levels rose in the Ser/Ser group (9.45 ± 0.87 mIU/mL), with significant differences between the Ser/Ser and Ser/Asn groups (mean difference = 0.97, = 0.019). SHBG levels had a negative connection with eNOS expression after surgery (r = -0.365, = 0.049). AMH and AFC remained constant throughout polymorphism groups. BMI decreased uniformly, with an average of 15.2 ± 1.8 kg six months after surgery.

Conclusions: Bariatric surgery improves vascular health and regulates reproductive hormones, especially in individuals with the Ser/Ser genotype. These findings indicate the possibility of combining genetic testing and bariatric therapies to improve infertility treatment in obese women.

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