Ankara Numune Education and Research Hospital, Department of Endocrinology and Metabolic Diseases, TC. Sağlık Bakanlığı, Ankara, Turkey.
Ankara Gülhane Education and Research Hospital, Department of Endocrinology and Metabolic Diseases, TC. Sağlık Bakanlığı, Ankara, Turkey.
Obes Surg. 2019 Feb;29(2):705-712. doi: 10.1007/s11695-018-3595-z.
Bariatric surgery may modulate the hormones and elements which maintain thyroid and calcium homeostasis. These adaptations in hormonal and elemental aspects have previously been determined via some studies with variations in their findings. Thyroid volume and 24-h urinary calcium are two parameters which have not been investigated regarding whether they change during the bariatric postsurgical period. This study planned to examine the changes in calcium metabolism and thyroid gland functioning after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).
Seventy-three morbidly obese patients with planned bariatric surgery were enrolled in the study. Before and 12 months after the operation, parathormone (PTH), 25-OH-vitamin D3(25vitD3), TSH, free triiodothyronine (fT3), free thyroxine (fT4), calcium (Ca), 24-h urinary Ca and ultrasonography-guided thyroid volume were measured.
In the beginning, 73 patients were examined and 12 months after surgery out of 25 patients continuing follow-up, 20 (80%) had undergone sleeve gastrectomy (SG) while five (20%) had undergone Roux-en-Y gastric bypass (RYGB). Accompanied by significant BMI decrease, 24-h urinary Ca and thyroid volume did not significantly increase in RYGB, SG, and the whole group after 12 months. The SG group showed a significant drop in TSH (p 0.03) level, while the RYGB group showed significant decreases in fT4 (p 0.00) and fT3 (p 0.00); and significant fT3 decrease (p 0.01) was recorded for the whole group.
Bariatric surgery may modify Ca homeostasis and thyroid gland functional status. We documented that these were not statistically significant increases in 24-h urinary Ca level and thyroid volume after 1 year. Further studies are needed to understand the issue, enrolling more patients who underwent the same bariatric procedure and after accounting for the inhibition of supplementary vitamin and mineral effects.
减重手术可能会调节维持甲状腺和钙稳态的激素和元素。这些激素和元素方面的适应性之前已经通过一些发现存在差异的研究确定。甲状腺体积和 24 小时尿钙是两个尚未研究其在减重术后期间是否发生变化的参数。本研究旨在检查袖状胃切除术（SG）和 Roux-en-Y 胃旁路术（RYGB）后钙代谢和甲状腺功能的变化。
本研究纳入了 73 名计划接受减重手术的病态肥胖患者。在手术前和手术后 12 个月，测量了甲状旁腺激素（PTH）、25-羟维生素 D3（25vitD3）、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、钙（Ca）、24 小时尿钙和超声引导下的甲状腺体积。
最初检查了 73 名患者，术后 12 个月，25 名继续随访的患者中有 20 名（80%）接受了袖状胃切除术（SG），5 名（20%）接受了 Roux-en-Y 胃旁路术（RYGB）。随着 BMI 的显著下降，RYGB、SG 和整个组在 12 个月后 24 小时尿钙和甲状腺体积没有显著增加。SG 组 TSH（p 0.03）水平显著下降，而 RYGB 组 fT4（p 0.00）和 fT3（p 0.00）水平显著下降；整个组的 fT3 也显著下降（p 0.01）。
减重手术可能会改变钙稳态和甲状腺功能状态。我们记录到，1 年后 24 小时尿钙水平和甲状腺体积没有统计学意义上的增加。需要进一步的研究来了解这个问题，招募更多接受相同减重手术的患者，并考虑到补充维生素和矿物质的抑制作用。
