Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China; Department of Metabolic Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China.
Department of Metabolic Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China; National Metabolic Management Center, Shanghai, P.R. China.
Surg Obes Relat Dis. 2021 Jun;17(6):1175-1181. doi: 10.1016/j.soard.2021.02.012. Epub 2021 Feb 17.
Thyroid dysfunction in patients with morbid obesity usually resolves after bariatric surgery. However, the role of diverse types of adipose tissue in the process remains unknown.
We aim to investigate the effects of visceral and subcutaneous fat on thyroid function in a Chinese population with morbid obesity who underwent sleeve gastrectomy (SG).
University hospital, Shanghai, China METHODS: Repeated measurement data of thyroid hormone and body fat were collected at 0, 3, 6, 12, 24, and 36 months after sleeve gastrectomy. Dual-energy X-ray absorptiometer and quantitative computerized tomography (CT) were used to compute visceral fat and subcutaneous fat. Repeated measures correlation (rmmcorr) package was employed for correlation analysis with generalized additive mixed model (GAMM) determining the independent factors.
Thyroid stimulating-hormone (TSH) showed notable decrease at 36 months after surgery, coupled with reduction of BMI (38.08 kg/cm versus 24.28 kg/cm), C-reactive protein (CRP), visceral adipose tissue (786.74 cm versus 367.44 cm), body fat rate, and waistline (118.13 cm versus 100.87 cm). Only visceral fat, diabetes, and CRP proved to be independent variables for TSH decline, without correlation with subcutaneous fat.
The present study is first to report the effects of different types of body fat on thyroid function in a Chinese population with morbid obesity, revealing that loss of visceral fat is the key to improving endocrine and metabolic activity after bariatric surgery.
病态肥胖患者的甲状腺功能障碍通常在减重手术后会得到解决。然而，不同类型脂肪组织在这个过程中的作用尚不清楚。
我们旨在研究中国病态肥胖患者在接受袖状胃切除术（SG）后内脏和皮下脂肪对甲状腺功能的影响。
中国上海的一家大学医院。
在袖状胃切除术后 0、3、6、12、24 和 36 个月时，收集甲状腺激素和体脂肪的重复测量数据。双能 X 射线吸收仪和定量计算机断层扫描（CT）用于计算内脏脂肪和皮下脂肪。采用重复测量相关（rmmcorr）包进行相关分析，广义加性混合模型（GAMM）确定独立因素。
术后 36 个月时，促甲状腺激素（TSH）明显下降，同时 BMI（38.08kg/cm 至 24.28kg/cm）、C 反应蛋白（CRP）、内脏脂肪组织（786.74cm 至 367.44cm）、体脂率和腰围（118.13cm 至 100.87cm）均下降。只有内脏脂肪、糖尿病和 CRP 被证明是 TSH 下降的独立变量，与皮下脂肪无关。
本研究首次报道了不同类型的体脂对中国病态肥胖人群甲状腺功能的影响，表明内脏脂肪的丢失是减重手术后改善内分泌和代谢活动的关键。
