Karmisholt Jesper, Carlé Allan, Andersen Stig
Department of Medical Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
Clinical Institute, Aalborg University, Aalborg, Denmark.
Eur Thyroid J. 2021 Jun;10(3):208-214. doi: 10.1159/000512078. Epub 2020 Dec 2.
Weight gain during treatment of hyperthyroidism is a frequent and for many patients unwanted outcome. With this repeated measurement study, we explored the timing of weight changes during the first year of antithyroid drug (ATD) treatment and assessed the correlation between body weight changes and changes in thyroid hormones, resting energy expenditure (REE), physical activity level, and energy efficiency.
Patients with new onset hyperthyroidism were investigated every second month during the first year of ATD treatment. At each investigation, the following were measured: body weight, thyroid hormone concentrations, physical activity level, and daily number of steps, REE, and exercise performance.
Two men and eleven women, all sedentary, mean age 49(SD: 9.3) years were included. Significant changes after 1 year occurred for body weight (68.9-74.1 kg), thyroid hormones (free T3 [fT3] 17.5 to 4.42 pmol/L), REE (1,630-1,484 kcal/24 h), and energy efficiency at lower (50 W) workloads (16.0-17.6%). In individual patients, only REE and fT3 correlated to changes in body weight. Physical activity level did not change during treatment.
In this study, treatment of hyperthyroidism was associated with marked increase in body weight in the patients. This increase correlated to a decrease in REE and only to a negligible extent to changes in energy efficiency and not at all to changes in physical activity level of daily living.
甲状腺功能亢进症治疗期间体重增加是常见现象,且许多患者对此并不期望。通过这项重复测量研究,我们探究了抗甲状腺药物(ATD)治疗第一年体重变化的时间,并评估了体重变化与甲状腺激素、静息能量消耗(REE)、身体活动水平和能量效率变化之间的相关性。
新诊断为甲状腺功能亢进症的患者在接受ATD治疗的第一年每两个月接受一次调查。每次调查时,测量以下指标:体重、甲状腺激素浓度、身体活动水平、每日步数、REE和运动表现。
纳入了2名男性和11名女性,均为久坐不动者,平均年龄49(标准差:9.3)岁。1年后,体重(68.9 - 74.1千克)、甲状腺激素(游离T3 [fT3]从17.5降至4.42皮摩尔/升)、REE(从1630千卡/24小时降至1484千卡/24小时)以及较低(50瓦)工作负荷下的能量效率(从16.0%升至17.6%)均发生了显著变化。在个体患者中,只有REE和fT3与体重变化相关。治疗期间身体活动水平未发生变化。
在本研究中,甲状腺功能亢进症的治疗与患者体重显著增加有关。这种增加与REE降低相关,与能量效率变化的相关性可忽略不计,与日常生活身体活动水平变化则完全无关。