Chukir Tariq, Yaghmour Mohammad, Almutairi Turki, Chagoury Odette, Taheri Shahrad
Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar.
National Obesity Treatment Center, Hamad Medical Corporation, Doha, Qatar.
PLoS One. 2025 Sep 11;20(9):e0332091. doi: 10.1371/journal.pone.0332091. eCollection 2025.
Hypothyroidism is associated with weight gain. Although levothyroxine therapy restores thyroid hormone levels, its impact on weight loss is modest. Whether individuals with appropriately treated hypothyroidism respond differently to obesity pharmacotherapy remains relative unexplored. This study aimed to evaluate weight and body composition responses to liraglutide in patients with obesity and levothyroxine-treated hypothyroidism compared to matched controls without thyroid disease.
In this retrospective case-control study, we included adults with overweight or obesity who were treated with liraglutide between 2017 and 2022 at an academic weight management center. Participants with hypothyroidism on stable levothyroxine therapy were compared to age-, gender-, and BMI-matched controls without thyroid disease. Outcomes include percentage weight change, categorical weight loss thresholds and changes in body composition assessed via bioelectrical impedance. Univariate and multivariate regression were used to identify predictors of weight loss.
Fifty-three patients with hypothyroidism were compared to 145 controls. After a mean follow-up of 10 months, the percent weight change was similar between groups (-10.8% vs. -8.9%, P = 0.940), as was the proportion of weight reduction from fat-free mass loss (29.9% vs. 33.3%, P = 0.729). A significant proportion in both groups achieved ≥5% weight loss (79.2% vs. 71.0%, P = 0.248). Baseline thyroid stimulating hormone (TSH) levels within the normal range did not correlate with weight outcomes. In univariate analysis, baseline metformin use was associated with greater weight loss (P = 0.042), but this was not significant in multivariate models.
Liraglutide leads to clinically meaningful and comparable weight loss in individuals with well-treated hypothyroidism and those without thyroid disease. Body composition changes were also similar between groups. These findings help clinicians address a frequently asked question among patients with hypothyroidism about their ability to effectively lose weight.
甲状腺功能减退与体重增加有关。虽然左甲状腺素治疗可恢复甲状腺激素水平，但其对体重减轻的影响不大。经过适当治疗的甲状腺功能减退患者对肥胖药物治疗的反应是否不同仍相对未被探索。本研究旨在评估与无甲状腺疾病的匹配对照组相比，肥胖且接受左甲状腺素治疗的甲状腺功能减退患者使用利拉鲁肽后的体重和身体成分反应。
在这项回顾性病例对照研究中，我们纳入了2017年至2022年期间在一家学术体重管理中心接受利拉鲁肽治疗的超重或肥胖成年人。将接受稳定左甲状腺素治疗的甲状腺功能减退患者与年龄、性别和BMI匹配的无甲状腺疾病对照组进行比较。结局包括体重变化百分比、分类体重减轻阈值以及通过生物电阻抗评估的身体成分变化。使用单变量和多变量回归来确定体重减轻的预测因素。
53例甲状腺功能减退患者与145例对照组进行了比较。平均随访10个月后，两组之间的体重变化百分比相似（-10.8%对-8.9%，P = 0.940），无脂肪质量损失导致的体重减轻比例也相似（29.9%对33.3%，P = 0.729）。两组中相当大比例的患者体重减轻≥5%（79.2%对71.0%，P = 0.248）。正常范围内的基线促甲状腺激素（TSH）水平与体重结局无关。在单变量分析中，基线使用二甲双胍与更大的体重减轻相关（P = 0.042），但在多变量模型中不显著。
利拉鲁肽在治疗良好的甲状腺功能减退患者和无甲状腺疾病的患者中导致具有临床意义且相当的体重减轻。两组之间的身体成分变化也相似。这些发现有助于临床医生回答甲状腺功能减退患者关于其有效减肥能力的常见问题。
