Cho Hae-Ryong, Song Ra-Yeong, Kang Kyung Ho
Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Korean J Clin Oncol. 2020 Dec;16(2):127-130. doi: 10.14216/kjco.20019. Epub 2020 Dec 31.
Thyroid hormone is an important hormone in maintaining metabolism and homeostasis in the body. There exists a common perception among patients that thyroid surgery will cause weight gain. Prevention of any undesired weight gain could be important for the maintenance of well-being in most patients. Our study compares changes in body mass index (BMI) and weight after total thyroidectomy or lobectomy in thyroid cancer patients.
A total of 967 patients with differentiated thyroid carcinoma were enrolled in the study, from March 2011 to July 2016 at Chung-Ang University Hospital. Exclusion criteria were less than lobectomy, modified radical neck dissection, recurred operation, and combined operation for other causes. Primary endpoints were change in body weight and BMI at 2 years after surgery. A subgroup analysis was performed for patients with significant weight change.
There were no differences between both groups in BMI after 2 years of thyroid operation. Thyroid stimulating hormone (TSH) levels were not significantly different. Fifteen percent of patients showed significant change in body weight after 2 years of operation. The subgroup analysis of these patients showed no significant differences in gender, age, or extent of operation between those who had gained weight compared to those who had lost weight. There were also no differences in postoperative TSH levels, levothyroxine supplementation, or radioactive iodine treatment.
There was a minimal postoperative increase in mean BMI over the years in patients undergoing thyroidectomy for differentiated thyroid cancer. However, weight change did not differ in those undergoing thyroid lobectomy or total thyroidectomy.
甲状腺激素是维持机体新陈代谢和内环境稳定的重要激素。患者中普遍存在一种观念，即甲状腺手术会导致体重增加。对大多数患者而言，预防任何不必要的体重增加对于维持健康可能很重要。我们的研究比较了甲状腺癌患者行全甲状腺切除或甲状腺叶切除术后体重指数（BMI）和体重的变化。
2011年3月至2016年7月，共有967例分化型甲状腺癌患者纳入 Chung-Ang 大学医院的这项研究。排除标准为甲状腺叶切除范围不足、改良根治性颈清扫术、再次手术以及因其他原因进行的联合手术。主要终点是术后2年体重和BMI的变化。对体重有显著变化的患者进行亚组分析。
甲状腺手术后2年，两组患者的BMI无差异。促甲状腺激素（TSH）水平无显著差异。15%的患者术后2年体重有显著变化。对这些患者的亚组分析显示，体重增加者与体重减轻者在性别、年龄或手术范围方面无显著差异。术后TSH水平、左甲状腺素补充或放射性碘治疗也无差异。
分化型甲状腺癌患者行甲状腺切除术后，多年来平均BMI的术后增加幅度极小。然而，甲状腺叶切除术或全甲状腺切除术患者的体重变化并无差异。
