甲状腺毒症的严重程度是治疗后甲亢患者体重过度增加的一个风险因素。

Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism.

作者信息

Kyriacou Angelos, Vryza Paraskevi, Kyriacou Alexis, Picolos Michalis, Lamnisos Demetris, Panayiotis Economides, Syed Akheel A

出版信息

Eur Thyroid J. 2025 May 2;14(3). doi: 10.1530/ETJ-24-0373. Print 2025 Jun 1.

DOI:10.1530/ETJ-24-0373

PMID:40238086

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12060850/

Abstract

OBJECTIVE

Hyperthyroidism is characterized by weight fluctuations and overshoot of weight regain following treatment. We aimed to identify parameters predicting peak percentage weight gain (PWG) in the post-treatment period.

METHODS

We included 110 patients (73 (66.4%) women) with hyperthyroidism 6-36 months after treatment initiation. The primary outcome was PWG of ≥10% (group A) or <10% (group B). We performed adjusted analyses by logistic regression with age, sex, disease-related weight loss, hypothyroidism occurrence, free T4 at diagnosis (fT4-t0) and disease duration as independent variables.

RESULTS

Post-treatment mean (SD) weight gain was 7.4 (5.22) kg, whereas disease-related weight loss was 5.3 (5.15) kg. Group A (52.7% participants) compared to group B had significantly higher median (IQR) fT4-t0 at 47.4 (36.2, 97.2) vs 29.3 (22.8, 40.4) ng/dL (P < 0.001) and disease-related weight loss at 6.8 (3, 10) vs 2.5 (0, 4.8) kg (P < 0.001) and non-significantly higher presentation free triiodothyronine at 19.6 (10.4, 44.1) vs 11.8 (8.7, 22.9) pg/mL (P = 0.078) and TRAb at 6.3 (3, 16.1) vs 4.2 (2.4, 8.7) IU/L (P = 0.093), respectively. Significant predictor variables of post-treatment PWG in logistic regression were disease-related weight loss (OR = 1.23, P = 0.002) and fT4-t0 (OR = 1.04, P = 0.008).

CONCLUSION

More than half the patients with hyperthyroidism had ≥10% PWG post-treatment. Indicators of disease severity, namely disease-related weight loss and baseline thyroid hormones, were predictive of excessive weight gain post-treatment and could be utilized for risk stratification and early intervention.

摘要

目的

甲状腺功能亢进症的特征是体重波动以及治疗后体重反弹过度。我们旨在确定预测治疗后体重增加峰值百分比（PWG）的参数。

方法

我们纳入了110例在开始治疗6至36个月后的甲状腺功能亢进症患者（73例（66.4%）为女性）。主要结局是PWG≥10%（A组）或<10%（B组）。我们以年龄、性别、疾病相关体重减轻、甲状腺功能减退症的发生、诊断时的游离T4（fT4-t0）和病程作为自变量，通过逻辑回归进行校正分析。

结果

治疗后的平均（标准差）体重增加为7.4（5.22）kg，而疾病相关体重减轻为5.3（5.15）kg。与B组相比，A组（52.7%的参与者）的fT4-t0中位数（四分位间距）显著更高，分别为47.4（36.2，97.2）与29.3（22.8，40.4）ng/dL（P<0.001），疾病相关体重减轻分别为6.8（3，10）与2.5（0，4.8）kg（P<0.001），诊断时的游离三碘甲状腺原氨酸略高，分别为19.6（10.4，44.1）与11.8（8.7，22.9）pg/mL（P=0.078），促甲状腺素受体抗体分别为6.3（3，16.1）与4.2（2.4，8.7）IU/L（P=0.093）。逻辑回归中治疗后PWG的显著预测变量是疾病相关体重减轻（比值比=1.23，P=0.002）和fT4-t0（比值比=1.04，P=0.008）。