Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Av. Prof. Rodolfo Rocco 255, Rio de Janeiro, RJ, 21941-617, Brazil.
Instituto de Biofísica Carlos Chagas Filho, Av. Carlos Chagas Filho, 373, Cidade Universitária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-170, Brazil.
Obes Surg. 2023 Oct;33(10):3193-3197. doi: 10.1007/s11695-023-06779-w. Epub 2023 Aug 17.
Few studies have evaluated the impact of bariatric surgery (BS) on thyroid function and morphology, and how it correlates to inflammatory and metabolic markers. We aimed to evaluate all those parameters together.
A longitudinal study included 70 patients with severe obesity. The bariatric group (BG) enrolled 40 patients who underwent BS, and the control group (CG) enrolled 30 patients who did not undergo BS. Both were submitted (pre- and 2nd-year) to thyroid ultrasound and laboratory analyses to determine the levels of thyroid hormones, inflammatory, and metabolic markers.
Thyroid volume (TV) decreased after BS (-1.5 cm), differing significantly from the CG (+0.6 cm; p = 0.003). ΔTV was independently and positively correlated with ΔHOMA-IR (0.41 (0.11/7.16) p = 0.007) and ΔIL6 (0.02 (0.01/0.3) p = 0.016). A nonsignificant correlation between ΔTV and ΔBMI was detected (0.38 (-0.01/0.09) p = 0.152). We also observed a negative correlation between ΔTV and ΔTSH (-2.03 (-2.87/-1.19) p = 0.000) and ΔT3/T4 ratio (-0.06 (-0.09/-0.02) p = 0.001). TSH had a nonsignificant reduction with BS (-0.3872 vs. -0.2483 p = 0.128). The conversion of T4 to T3 had a significant increase after BS, as demonstrated by the T3/T4 ratio (+5.16 p = 0.01). Despite an increase in the prevalence of thyroid nodules in the BG, it was not statistically significant (p = 0.340).
BS was associated with a reduction in TV and a nonstatistically significant reduction in TSH. The variations in TV were related to the metabolic markers and inflammatory changes. An increase in the conversion of T4 to T3 with BS was detected, possibly related to inflammatory improvement.
很少有研究评估减重手术（BS）对甲状腺功能和形态的影响，以及它与炎症和代谢标志物的相关性。我们旨在一起评估所有这些参数。
一项纵向研究纳入了 70 名严重肥胖患者。减重组（BG）纳入了 40 名接受 BS 的患者，对照组（CG）纳入了 30 名未接受 BS 的患者。两组均进行了甲状腺超声和实验室分析，以确定甲状腺激素、炎症和代谢标志物的水平。
BS 后甲状腺体积（TV）减小（-1.5cm），与 CG 相比差异显著（+0.6cm；p=0.003）。ΔTV 与 ΔHOMA-IR（0.41（0.11/7.16），p=0.007）和 ΔIL6（0.02（0.01/0.3），p=0.016）呈独立正相关。ΔTV 与 ΔBMI 之间未检测到显著相关性（0.38（-0.01/0.09），p=0.152）。我们还观察到 ΔTV 与 ΔTSH（-2.03（-2.87/-1.19），p=0.000）和 ΔT3/T4 比值（-0.06（-0.09/-0.02），p=0.001）呈负相关。BS 后 TSH 水平有一定程度的降低（-0.3872 比-0.2483，p=0.128）。BS 后 T4 向 T3 的转化明显增加，T3/T4 比值升高（+5.16，p=0.01）。尽管 BG 中甲状腺结节的患病率增加，但无统计学意义（p=0.340）。
BS 与 TV 减小和 TSH 非统计学显著降低相关。TV 的变化与代谢标志物和炎症变化有关。BS 后 T4 向 T3 的转化增加，可能与炎症改善有关。
