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腹腔镜袖状胃切除术对埃及肥胖症患者甲状腺功能的影响。

The Impact of Laparoscopic Sleeve Gastrectomy on Thyroid Functions in Egyptian Patients with Obesity.

机构信息

El Warraq Central Hospital, Ministry of Health, Giza, Egypt.

General Surgery Department, Faculty of Medicine, Cairo University, Giza, Egypt.

出版信息

J Gastrointest Surg. 2023 Jul;27(7):1345-1352. doi: 10.1007/s11605-023-05662-4. Epub 2023 Apr 5.

Abstract

BACKGROUND

Sleeve gastrectomy (SG) continues to be one of the most popular bariatric procedures all over the world. Thyroid-stimulating hormone (TSH) frequently shows a slight elevation in patients with obesity. The effect of SG on thyroid hormones has been rarely investigated.

AIM OF THE STUDY

This study aimed to assess the short-term effect of SG on thyroid functions in Egyptian patients with morbid obesity and the potential predictors of the postoperative thyroid functions.

PATIENTS AND METHODS

This study included patients undergoing SG at kasr al ainy hospitals. The patients underwent preoperative 3-, 6-, and 12-month postoperative analyses of the thyroid functions and other biochemical markers.

RESULTS

The study included 106 patients who showed significant improvement in thyroid functions at the follow-up assessment. Twelve-month TSH positively correlated with the 12-month measures of LDL and HbA1c. TSH change at 12-month follow-up (TSH) was inversely correlated to 12-month BMI and positively correlated to preoperative TSH and 12-month percentage of total weight loss (TWL%). Univariable linear regression analysis demonstrated that preoperative TSH (p < 0.001), 12-month TWL% (p = 0.042), 12-month HbA1c (p = 0.001), and 12-month LDL (p = 0.049) were significant predictors for the 12-month TSH levels. Multivariable analysis showed that only preoperative TSH levels (p < 0.001) and 12-month HbA1c levels (p = 0.021) could affect the 12-month TSH levels.

CONCLUSION

The current study supports the evidence of thyroid function improvement after sleeve gastrectomy. This improvement was affected by the amount of weight loss after surgery.

摘要

背景

袖状胃切除术(SG)仍然是全世界最受欢迎的减肥手术之一。肥胖患者的促甲状腺激素(TSH)经常略有升高。SG 对甲状腺激素的影响很少被研究。

目的

本研究旨在评估 SG 对埃及肥胖症患者甲状腺功能的短期影响,以及术后甲状腺功能的潜在预测因素。

患者和方法

本研究纳入了在 kasr al ainy 医院接受 SG 的患者。患者在术前、术后 3、6 和 12 个月进行了甲状腺功能和其他生化标志物的分析。

结果

本研究纳入了 106 例患者,这些患者在随访评估中甲状腺功能显著改善。12 个月 TSH 与 12 个月 LDL 和 HbA1c 呈正相关。12 个月 TSH 变化(TSH)与 12 个月 BMI 呈负相关,与术前 TSH 和 12 个月总体重减轻百分比(TWL%)呈正相关。单变量线性回归分析表明,术前 TSH(p<0.001)、12 个月 TWL%(p=0.042)、12 个月 HbA1c(p=0.001)和 12 个月 LDL(p=0.049)是 12 个月 TSH 水平的显著预测因素。多变量分析表明,只有术前 TSH 水平(p<0.001)和 12 个月 HbA1c 水平(p=0.021)会影响 12 个月 TSH 水平。

结论

本研究支持袖状胃切除术后甲状腺功能改善的证据。这种改善受手术后体重减轻量的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e226/10366286/57c1316b8faa/11605_2023_5662_Fig1_HTML.jpg

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