甲状腺癌患者在甲状腺切除术后会体重增加吗？

Do patients gain weight after thyroidectomy for thyroid cancer?

机构信息

Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.

出版信息

Thyroid. 2011 Dec;21(12):1339-42. doi: 10.1089/thy.2010.0393. Epub 2011 Nov 8.

DOI:10.1089/thy.2010.0393

PMID:22066475

Abstract

BACKGROUND

Patients who undergo thyroidectomy often complain of weight gain, which they frequently attribute to inadequate thyroid hormone replacement. To assess the weight changes associated with thyroid hormone replacement or suppressive therapy after thyroidectomy, we measured the weights of patients before and after thyroidectomy and compared them to the weights of euthyroid patients with thyroid nodules who were being followed for many years.

METHODS

The weights and heights of 67 women and 35 men who underwent total thyroidectomy for thyroid cancer were recorded before and for a mean of 8.3 years after thyroidectomy. All patients received either suppressive or replacement doses of levothyroxine. As a comparison group, 70 women and 22 men with goiter or thyroid nodules and were euthyroid had serial measurements of height and weight. They were followed for a mean of 7.6 years. The body mass index (BMI) and age-adjusted BMI percentiles were calculated. The weight, BMI, and BMI percentile changes were compared both unadjusted and adjusted for age, gender, thyrotropin (TSH) level, and duration between measurements.

RESULTS

At baseline, patients with thyroid nodules were older (mean 50.4 years) than those with thyroid cancer (mean 45.8 years). There were no significant differences in baseline weight, BMI, or BMI percentile. The baseline TSH levels were lower for patients with thyroid cancer (mean 0.8 mIU/L) than for those with nodules (mean 1.8 mIU/L) (p=0.002). There were no significant differences between the changes in weight, BMI, or BMI percentile from the start to the completion of the study whether unadjusted or after adjustment for age, gender, TSH, and duration of follow-up.

CONCLUSIONS

Despite the perception of many patients that their thyroidectomy and thyroid hormone replacement or suppressive therapy is responsible for their subsequent weight gain, there were no significant differences in weight gain over time in comparison to a control group of euthyroid patients with thyroid nodules or goiter.

摘要

背景

接受甲状腺切除术的患者常抱怨体重增加，他们常将其归因于甲状腺激素替代不足。为了评估甲状腺激素替代或甲状腺切除术后抑制治疗相关的体重变化，我们测量了甲状腺癌患者甲状腺切除术前和术后的体重，并与多年来接受随访的甲状腺结节伴甲状腺功能正常的患者进行了比较。

方法

记录了 67 名女性和 35 名男性甲状腺癌患者甲状腺全切术前和术后平均 8.3 年的体重和身高。所有患者均接受左旋甲状腺素的抑制或替代剂量治疗。作为对照组，70 名女性和 22 名患有甲状腺肿或甲状腺结节且甲状腺功能正常的男性患者进行了身高和体重的连续测量。他们的随访时间平均为 7.6 年。计算了体重指数（BMI）和年龄校正的 BMI 百分位数。未校正和校正年龄、性别、促甲状腺激素（TSH）水平和测量间隔后，比较体重、BMI 和 BMI 百分位数的变化。

结果

基线时，甲状腺结节患者年龄较大（平均 50.4 岁），甲状腺癌患者年龄较小（平均 45.8 岁）。基线时体重、BMI 或 BMI 百分位数无显著差异。甲状腺癌患者的基线 TSH 水平（0.8mIU/L）低于甲状腺结节患者（1.8mIU/L）（p=0.002）。无论是否校正年龄、性别、TSH 和随访时间，从研究开始到结束，体重、BMI 或 BMI 百分位数的变化均无显著差异。