Michalaki M, Volonakis S, Mamali I, Kalfarentzos F, Vagenakis A G, Markou K B
Division of Endocrinology, Department of Internal Medicine, University of Patras Medical School, Thisseos 6, Ovria, Patras, 26500, Greece.
Obes Surg. 2014 Nov;24(11):1921-5. doi: 10.1007/s11695-014-1255-5.
Bariatric surgery is accompanied by malabsorption of protein, carbohydrates, fats, vitamins, and trace elements. Iodine is essential to the synthesis of thyroid hormones. The aim of this study was to estimate the daily iodine intake in severely obese patients before and after bariatric surgery.
Thirty-five severely obese patients (obese group) with a BMI of 51.3 ± 8.3 kg/m(2) were studied before, 3 months, and 6 months after bariatric surgery. Eleven out of 35 patients were subjected to gastric bypass operation Roux-en-Y and 24 were subjected to a variant of biliopancreatic diversion with long limb procedure. The patients did not use any iodine supplements and no iodine antiseptics were administered during the operation. The messmates of the patients, following a similar diet (control group) with a BMI of 31.2 ± 10.7 kg/m(2), were also studied. Serum T3, T4, TSH, thyroid peroxidase antibodies, urinary iodine excretion (UIE) in a spot urine, and thyroid volume were measured in all subjects, at baseline and at 3- and 6-month follow-up in the obese group.
UIE at baseline was similar in obese and control group (median (min-max), 129.5 (24.9-462) vs. 138.9 (30.8-381) μg/L, ns). In the obese group, a transient increase of UIE was observed 3 months after the operation and returned to baseline levels 6-months postsurgery.
The UIE is not reduced after malabsorptive bariatric surgery, although all stomach, duodenum, and a substantial part of jejunum were bypassed. It appears that iodine is absorbed sufficiently along the remaining gastrointestinal tract.
减肥手术会伴有蛋白质、碳水化合物、脂肪、维生素和微量元素的吸收不良。碘对于甲状腺激素的合成至关重要。本研究的目的是评估减肥手术前后重度肥胖患者的每日碘摄入量。
对35例BMI为51.3±8.3kg/m²的重度肥胖患者(肥胖组)在减肥手术前、术后3个月和6个月进行研究。35例患者中11例行Roux-en-Y胃旁路手术,24例行带长支的胆胰分流术变体手术。患者未使用任何碘补充剂,手术期间未使用碘消毒剂。对饮食相似(对照组)、BMI为31.2±10.7kg/m²的患者同伴也进行了研究。在肥胖组的基线以及术后3个月和6个月随访时,测量了所有受试者的血清T3、T4、TSH、甲状腺过氧化物酶抗体、即时尿样中的尿碘排泄量(UIE)以及甲状腺体积。
肥胖组和对照组的基线UIE相似(中位数(最小值 - 最大值),129.5(24.9 - 462)与138.9(30.8 - 381)μg/L,无显著性差异)。在肥胖组中,术后3个月观察到UIE短暂升高,术后6个月恢复到基线水平。
尽管所有胃、十二指肠和大部分空肠都被绕过,但吸收不良性减肥手术后UIE并未降低。似乎碘在剩余的胃肠道中能被充分吸收。