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韩国人群甲状腺切除术后肥胖:手术范围重要吗?

Postthyroidectomy obesity in a Korean population: does the extent of surgery matter?

作者信息

Park Min-Young, Nam Sang Eun, Park Kyoung Sik, Saindane Madhuri, Yoo Young-Bum, Yang Jung-Hyun, Ahn Ah-Leum, Choi Jae-Kyung, Park Won Seo

机构信息

Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.

Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2019 Sep;97(3):119-123. doi: 10.4174/astr.2019.97.3.119. Epub 2019 Aug 29.

Abstract

PURPOSE

The purpose of this study was to investigate the prevalence of postthyroidectomy obesity, and the relationship between the extent of thyroidectomy and obesity.

METHODS

A survey conducted at an outpatient clinic from June to October 2014 and retrospective charts for patients undergoing thyroidectomy at Konkuk University Medical Centers from June 2009 to December 2013 were reviewed. We compared clinical characteristics and pre- and postoperative obesity-related factors in 227 patients who underwent total thyroidectomy or lobectomy.

RESULTS

Patients included 39 males and 188 females with a mean age of 46.0 ± 11.0 years; the mean follow-up period was 23.9 ± 16.7 months, and 90 of the 227 patients showed postthyroidectomy obesity. In effect of operative extent on postoperative obesity, patients who underwent TT (48.2 years) than those who underwent lobectomy (43.4 years). TT group had longer follow-up and the frequency of menopause was higher than in the lobectomy group. No differences in postthyroidectomy obesity, body weight change, or body mass index (BMI), change among 2 groups. The predictors of postthyroidectomy obesity were older age, female, heavy alcohol consumption (P = 0.029), higher preoperative BMI (P < 0.001), larger postoperative weight gain (P = 0.024), and larger BMI change. However, the extent of thyroidectomy did not affect postthyroidectomy obesity. Preoperative BMI (P < 0.001) and heavy alcohol consumption (P = 0.03) were independent factors of postthyroidectomy obesity.

CONCLUSION

The extent of thyroidectomy does not affect postthyroidectomy obesity. Preoperative BMI and heavy alcohol consumption are risk factors for postthyroidectomy obesity. Studies are needed to suggest preoperative life style modification to prevent postthyroidectomy obesity.

摘要

目的

本研究旨在调查甲状腺切除术后肥胖的患病率,以及甲状腺切除范围与肥胖之间的关系。

方法

对2014年6月至10月在门诊进行的一项调查以及2009年6月至2013年12月在建国大学医学中心接受甲状腺切除术患者的回顾性病历进行了审查。我们比较了227例行全甲状腺切除术或叶切除术患者的临床特征以及术前和术后与肥胖相关的因素。

结果

患者包括39名男性和188名女性,平均年龄为46.0±11.0岁;平均随访期为23.9±16.7个月,227例患者中有90例出现甲状腺切除术后肥胖。在手术范围对术后肥胖的影响方面,行全甲状腺切除术(TT)的患者(48.2岁)比行叶切除术的患者(43.4岁)年龄更大。TT组随访时间更长,绝经频率高于叶切除术组。两组在甲状腺切除术后肥胖、体重变化或体重指数(BMI)变化方面无差异。甲状腺切除术后肥胖的预测因素为年龄较大、女性、大量饮酒(P = 0.029)、术前BMI较高(P < 0.001)、术后体重增加较多(P = 0.024)以及BMI变化较大。然而,甲状腺切除范围并未影响甲状腺切除术后肥胖。术前BMI(P < 0.001)和大量饮酒(P = 0.03)是甲状腺切除术后肥胖的独立因素。

结论

甲状腺切除范围不影响甲状腺切除术后肥胖。术前BMI和大量饮酒是甲状腺切除术后肥胖的危险因素。需要开展研究以建议术前进行生活方式调整,以预防甲状腺切除术后肥胖。

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