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评估因良性非毒性结节性甲状腺肿接受甲状腺切除术患者的围手术期体重变化。

Assessing perioperative body weight changes in patients thyroidectomized for a benign nontoxic nodular goitre.

作者信息

Lang Brian H-H, Zhi Helen, Cowling Benjamin J

机构信息

Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

Biostatistics and Clinical Research Methodology Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

出版信息

Clin Endocrinol (Oxf). 2016 Jun;84(6):882-8. doi: 10.1111/cen.12945. Epub 2015 Oct 19.

Abstract

BACKGROUND

Following thyroidectomy, patients often complain of weight gain. Our study aimed to evaluate the extent of weight change in patients thyroidectomized for a nontoxic benign goitre after adjusting for patient demographics and pre-operative weight changes.

METHODS

Three different patient groups were studied. The first comprised 898 patients who underwent thyroidectomy for benign nontoxic nodular goitre (group I). The second comprised 179 patients who had benign nontoxic goitre but did not undergo thyroidectomy (group II), and the third comprised 80 patients who underwent a simple excision of a parathyroid adenoma (group III). All patients were weighed 12 months preceding baseline, at baseline and 6 months after baseline.

RESULTS

Baseline characteristics were comparable between groups. Patients in Group I who gained the least weight in the year leading to surgery gained the most weight 12 months after surgery (P = 0·030). After adjusting for demographics and pre-operative weight changes, Group I gained significantly more weight at post 6 and 12 months (0·71 (95% CI=0·46-0·95) kg and 1·21 (95% CI = 0·96-1·46) kg, respectively). Weight gain at post 12 months appeared similar between hemithyroidectomy and total thyroidectomy (1·32 vs 1·16 kg, P = 0·197). Younger age (ß coefficient -0·100, 95% CI = -0·030 to 0·003, P = 0·015) and higher baseline thyroid stimulating hormone (ß coefficient -0·315, 95% CI = -1·468 to 0·134, P = 0·020) were significant factors for weight gain at post 12 months.

CONCLUSIONS

Compared to nonthyroidectomized patients, thyroidectomized patients experienced significant weight increases at post 6 and 12 months. The extent of thyroidectomy did not affect the extent of weight gain. Younger age and higher baseline thyroid stimulating hormone were significant factors of weight gain at post 12 months.

摘要

背景

甲状腺切除术后,患者常抱怨体重增加。我们的研究旨在评估因非毒性良性甲状腺肿接受甲状腺切除术的患者在调整患者人口统计学和术前体重变化后体重改变的程度。

方法

研究了三个不同的患者组。第一组包括898例因良性非毒性结节性甲状腺肿接受甲状腺切除术的患者(第一组)。第二组包括179例患有良性非毒性甲状腺肿但未接受甲状腺切除术的患者(第二组),第三组包括80例接受甲状旁腺腺瘤单纯切除术的患者(第三组)。所有患者在基线前12个月、基线时和基线后6个月称重。

结果

各组间基线特征具有可比性。在手术前一年体重增加最少的第一组患者在术后12个月体重增加最多(P = 0.030)。在调整人口统计学和术前体重变化后,第一组在术后6个月和12个月体重增加显著更多(分别为0.71(95%CI = 0.46 - 0.95)kg和1.21(95%CI = 0.96 - 1.46)kg)。半甲状腺切除术和全甲状腺切除术术后12个月的体重增加似乎相似(1.32对1.16 kg,P = 0.197)。年龄较小(β系数 -0.100,95%CI = -0.030至0.003,P = 0.015)和基线促甲状腺激素较高(β系数 -0.315,95%CI = -1.468至0.134,P = 0.020)是术后12个月体重增加的重要因素。

结论

与未接受甲状腺切除术的患者相比,接受甲状腺切除术的患者在术后6个月和12个月体重显著增加。甲状腺切除的范围不影响体重增加的程度。年龄较小和基线促甲状腺激素较高是术后12个月体重增加的重要因素。

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