Kedia Rohit, Lowes Alicia, Gillis Sarah, Markert Ronald, Koroscil Thomas
From the Department of Internal Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, and the Department of Internal Medicine, University of Nebraska Medical Center, Omaha.
South Med J. 2016 Feb;109(2):97-100. doi: 10.14423/SMJ.0000000000000415.
Among patients who have undergone total thyroidectomy, do those with thyroid cancer being kept iatrogenically subclinical hyperthyroid (SCH) differ from euthyroid patients in long-term weight change?
In a retrospective study, medical records identified 291 patients who had undergone a thyroidectomy for differentiated thyroid cancer or benign thyroid disease. Weight, thyroid-stimulating hormone, and levothyroxine dose were measured presurgery and 1, 2, and 3 years postsurgery.
Of 291 patients, 147 were in the SCH group and 144 were in the euthyroid group. At all 3 years both groups gained weight from baseline, but the two groups did not differ in weight change from baseline at any time period: year 1 (SCH mean 0.4% ± 6.2% weight gain vs euthyroid group mean 2.2% ± 6.6% weight gain; P = 0.12), year 2 (SCH mean 1.1% ± 9.1% weight gain vs euthyroid mean 2.9% ± 7.8% weight gain; P = 0.22), and year 3 (SCH mean 2.6% ± 9.2% weight gain vs euthyroid mean 3.1% ± 11.1% weight gain; P = 0.49).
Among total thyroidectomy patients, weight change did not differ between SCH patients and euthyroid patients at years 1 through 3. As such, the use of levothyroxine to induce SCH did not lead to long-term weight change when compared with euthyroid patients.
在接受全甲状腺切除术的患者中,因医源性原因维持亚临床甲状腺功能亢进(SCH)的甲状腺癌患者与甲状腺功能正常的患者在长期体重变化方面是否存在差异?
在一项回顾性研究中,通过病历识别出291例因分化型甲状腺癌或良性甲状腺疾病接受甲状腺切除术的患者。在术前以及术后1年、2年和3年测量体重、促甲状腺激素和左甲状腺素剂量。
291例患者中,147例属于SCH组,144例属于甲状腺功能正常组。在所有3年中,两组体重均较基线增加,但在任何时间段两组体重较基线的变化均无差异:第1年(SCH组平均体重增加0.4%±6.2%,甲状腺功能正常组平均体重增加2.2%±6.6%;P = 0.12),第2年(SCH组平均体重增加1.1%±9.1%,甲状腺功能正常组平均体重增加2.9%±7.8%;P = 0.22),第3年(SCH组平均体重增加2.6%±9.2%,甲状腺功能正常组平均体重增加3.1%±11.1%;P = 0.49)。
在接受全甲状腺切除术的患者中,SCH患者与甲状腺功能正常的患者在1至3年的体重变化无差异。因此,与甲状腺功能正常的患者相比,使用左甲状腺素诱导SCH并未导致长期体重变化。