Endocrine, Nutritional and Metabolic Diseases Group, Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain.
Instituto de Investigación Biomedica (INIBIC), University Hospital A Coruña, 15006 A Coruña, Spain.
Nutrients. 2019 May 20;11(5):1121. doi: 10.3390/nu11051121.
Obesity is associated with several endocrine abnormalities, including thyroid dysfunction. The objective of this study was to investigate the effect of weight loss after bariatric surgery on thyroid-stimulating hormone (TSH) levels in euthyroid patients with morbid obesity. We performed an observational study, evaluating patients with morbid obesity submitted to bariatric surgery. We included 129 patients (92 women) and 31 controls (21 women). Clinical, anthropometric, biochemical, and hormonal parameters were evaluated. The primary endpoint was circulating TSH (µU/mL). Fasting TSH levels were higher in the obese group (3.3 ± 0.2) than in the control group (2.1 ± 0.2). The mean excessive body mass index (BMI) loss (EBMIL) 12 months after bariatric surgery was 72.7 ± 2.1%. TSH levels significantly decreased in the obese patients after surgery; 3.3 ± 0.2 vs. 2.1 ± 0.2 before and 12 months after surgery, respectively. Free thyroxine (T4) (ng/dL) levels significantly decreased in the obese patients after surgery; 1.47 ± 0.02 vs. 1.12 ± 0.02 before and 12 months after surgery, respectively. TSH decreased significantly over time, and the decrement was associated with the EBMIL. In euthyroid patients with morbid obesity, weight loss induced by bariatric surgery promotes a significant decline of the increased TSH levels. This decrement of TSH is progressive over time after surgery and significantly associated with excess BMI loss.
肥胖与多种内分泌异常有关,包括甲状腺功能障碍。本研究旨在探讨肥胖症患者行减重手术后对甲状腺刺激激素(TSH)水平的影响。我们进行了一项观察性研究,评估了接受减重手术的病态肥胖患者。共纳入 129 名患者(92 名女性)和 31 名对照者(21 名女性)。评估了临床、人体测量学、生化和激素参数。主要终点为循环 TSH(µU/mL)。肥胖组患者的空腹 TSH 水平(3.3±0.2)高于对照组(2.1±0.2)。减重手术后 12 个月的平均多余体重指数(BMI)丢失(EBMIL)为 72.7±2.1%。肥胖患者手术后 TSH 水平显著下降;分别为 3.3±0.2 与术前和术后 12 个月的 2.1±0.2。肥胖患者手术后游离甲状腺素(T4)(ng/dL)水平显著下降;分别为 1.47±0.02 与术前和术后 12 个月的 1.12±0.02。TSH 随时间显著下降,其降低与 EBMIL 相关。在肥胖症的甲状腺功能正常患者中,减重手术引起的体重减轻可显著降低升高的 TSH 水平。这种 TSH 的降低是手术治疗后逐渐发生的,与多余 BMI 丢失有显著相关性。