Glick Ron, Chang Paula, Michail Peter, Serpell Jonathan W, Grodski Simon, Lee James C
Monash University Endocrine Surgery Unit, The Alfred Hospital, Melbourne, Victoria, Australia.
Department of Surgery, Monash University, Melbourne, Victoria, Australia.
ANZ J Surg. 2018 Mar;88(3):162-166. doi: 10.1111/ans.14421. Epub 2018 Feb 14.
There is a common perception that total thyroidectomy causes weight gain beyond expected age-related changes, even when thyroid replacement therapy induces a euthyroid state. The aim of this study was to determine whether patients who underwent total thyroidectomy for a wide spectrum of conditions experienced weight gain following surgery.
We retrospectively studied 107 consecutive total thyroidectomy patients treated between January 2013 and June 2014. Medical records were reviewed to determine underlying pathology, thyroid status, use of antithyroid drugs and preoperative weight. Follow-up data were obtained from 79 patients at least 10 months post-operatively to determine current weight, the type of clinician managing thyroid replacement therapy and patient satisfaction with post-thyroidectomy management.
The cohort was 73% female, with a mean age of 55.8 ± 15.7 years and a mean preoperative weight of 78.8 ± 17.5 kg. Commonest pathologies were multinodular goitre, Graves' disease, thyroid cancer and Hashimoto's thyroiditis. Preoperatively, 63.2% of patients were hyperthyroid. Mean weight change at follow-up was a non-significant increase of 0.06 ± 6.9 kg (P = 0.094). Weight change was not significant regardless of preoperative thyroid function status. This study did not demonstrate any significant differences in clinical characteristics (including post-operative thyroid-stimulating hormone) between the group with >2% weight gain and those who did not.
This study did not reveal significant weight gain following thyroidectomy for a wide spectrum of pathologies. Specifically, preoperative hyperthyroidism, female gender and use of antithyroid medications do not predict weight gain after thyroid surgery.
人们普遍认为，即使甲状腺替代疗法能使患者处于甲状腺功能正常状态，全甲状腺切除术仍会导致体重增加，且超出与年龄相关的预期变化。本研究旨在确定因多种病症接受全甲状腺切除术的患者术后是否会出现体重增加。
我们回顾性研究了2013年1月至2014年6月期间连续接受全甲状腺切除术的107例患者。查阅病历以确定潜在病理、甲状腺状态、抗甲状腺药物的使用情况和术前体重。从79例术后至少10个月的患者处获取随访数据，以确定当前体重、管理甲状腺替代疗法的临床医生类型以及患者对甲状腺切除术后管理的满意度。
该队列中73%为女性，平均年龄为55.8±15.7岁，术前平均体重为78.8±17.5千克。最常见的病理情况为多结节性甲状腺肿、格雷夫斯病、甲状腺癌和桥本甲状腺炎。术前，63.2%的患者甲状腺功能亢进。随访时的平均体重变化为非显著性增加0.06±6.9千克（P = 0.094）。无论术前甲状腺功能状态如何，体重变化均无显著性差异。本研究未显示体重增加超过2%的组与未增加的组在临床特征（包括术后促甲状腺激素）上有任何显著差异。
本研究未发现因多种病理情况接受甲状腺切除术后有显著的体重增加。具体而言，术前甲状腺功能亢进、女性性别和抗甲状腺药物的使用并不能预测甲状腺手术后的体重增加。
