IRCCS Istituto Auxologico Italiano, Division of General Medicine, Piancavallo, Verbania, Italy.
Università del Piemonte Orientale, Department of Translational Medicine, Novara, Italy.
PLoS One. 2018 Oct 19;13(10):e0205293. doi: 10.1371/journal.pone.0205293. eCollection 2018.
Regulating thermogenesis is a major task of thyroid hormones (THs), and involves TH-responsive energetic processes at the central and peripheral level. In severe obesity, little is known on the relationship between THs and resting energy expenditure (REE) before and after weight loss.
We enrolled 100 euthyroid subjects with severe obesity who were equally distributed between genders. Each was examined before and after completion of a 4-wk inpatient multidisciplinary dieting program and subjected to measurement of thyroid function, REE, fat-free mass (FFM, kg) and percent fat mass (FM).
Baseline REE was lower than predicted in 70 obese patients, and overall associated with BMI, FFM and FM but not thyroid-related parameters. By the study end, both BMI and REE decreased (5.5% and 4.1%, p<0.001 vs. baseline) and their percent changes were significantly associated (p<0.05), while no association related percent changes of REE and FFM or FM. Individually, REE decreased in 66 and increased in 34 patients irrespective of gender, BMI and body composition. Weight loss significantly impacted TSH (-6.3%), FT3 (-3.3%) and FT4 levels (3.9%; p<0.001 for all). By the study end, a significant correlation became evident between REE and FT4 (r = 0.42, p<0.001) as well as FT3 (r = 0.24, p<0.05). In stepwise multivariable regression analysis, however, neither THs nor body composition entered the regression equation for REE response to weight loss.
In severe obesity, short-term weight loss discloses a positive relationship between REE and THs.
调节产热是甲状腺激素（TH）的主要任务，涉及到中枢和外周水平的 TH 反应性能量过程。在严重肥胖中，对于减肥前后 THs 与静息能量消耗（REE）之间的关系知之甚少。
我们招募了 100 名甲状腺功能正常的严重肥胖患者，男女各占一半。每位患者在完成 4 周住院多学科节食计划前后都接受了甲状腺功能、REE、去脂体重（FFM，kg）和体脂百分比（FM）的测量。
70 名肥胖患者的基础 REE 低于预测值，总体上与 BMI、FFM 和 FM 相关，但与甲状腺相关参数无关。研究结束时，BMI 和 REE 均下降（分别下降 5.5%和 4.1%，p<0.001 与基线相比），其变化百分比呈显著相关性（p<0.05），而 REE 和 FFM 或 FM 的变化百分比之间无相关性。单独来看，无论性别、BMI 和身体成分如何，REE 下降的患者有 66 例，REE 增加的患者有 34 例。体重减轻显著影响 TSH（-6.3%）、FT3（-3.3%）和 FT4 水平（均为 p<0.001）。研究结束时，REE 与 FT4（r = 0.42，p<0.001）和 FT3（r = 0.24，p<0.05）之间出现了显著相关性。然而，在逐步多元回归分析中，THs 或身体成分均未进入 REE 对体重减轻反应的回归方程。
在严重肥胖中，短期体重减轻揭示了 REE 与 TH 之间的正相关关系。
