RAI combined with lithium is safe and more effective than RAI alone in the cure of hyperthyroidism due to Graves' disease.

BackgroundRegulating thermogenesis is a major task of thyroid hormones (THs), and involves TH-responsive energetic processes at the central and peripheral level. In severe obesity, little is known on the relationship between THs and resting energy expenditure (REE) before and after weight loss.MethodsWe enrolled 100 euthyroid subjects with severe obesity who were equally distributed between genders. Each was examined before and after completion of a 4-wk inpatient multidisciplinary dieting program and subjected to measurement of thyroid function, REE, fat-free mass (FFM, kg) and percent fat mass (FM).ResultsBaseline REE was lower than predicted in 70 obese patients, and overall associated with BMI, FFM and FM but not thyroid-related parameters. By the study end, both BMI and REE decreased (5.5% and 4.1%, p<0.001 vs. baseline) and their percent changes were significantly associated (p<0.05), while no association related percent changes of REE and FFM or FM. Individually, REE decreased in 66 and increased in 34 patients irrespective of gender, BMI and body composition. Weight loss significantly impacted TSH (-6.3%), FT3 (-3.3%) and FT4 levels (3.9%; p<0.001 for all). By the study end, a significant correlation became evident between REE and FT4 (r = 0.42, p<0.001) as well as FT3 (r = 0.24, p<0.05). In stepwise multivariable regression analysis, however, neither THs nor body composition entered the regression equation for REE response to weight loss.ConclusionsIn severe obesity, short-term weight loss discloses a positive relationship between REE and THs.

We investigated the relationship between mechanical and energy cost of transport and body mass in running humans. Ten severely obese (body mass ranging from 108.5 to 172.0 kg) and 15 normal-weighted (52.0-89.0 kg) boys and men, aged 16.0-45.8 years, participated in this study. The rate of O(2) consumption was measured and the subjects were filmed with four cameras for kinematic analysis, while running on a treadmill at 8 km h(-1). Mass specific energy cost (C (r)) and external mechanical work (W (ext)) per unit distance were calculated and expressed in joules per kilogram per meter, efficiency (η) was then calculated as W (ext) × C (r) (-1)  × 100. Both mass-specific C (r) and W (ext) were found to be independent of body mass (M) (C (r) = 0.002 M + 3.729, n = 25, R (2) = 0.05; W (ext) = -0.001 M + 1.963, n = 25, R (2) = 0.01). It necessarily follows that the efficiency is also independent of M (η = -0.062 M + 53.3298, n = 25, R (2) = 0.05). The results strongly suggest that the elastic tissues of obese subjects can adapt (e.g., thickening) to the increased mass of the body thus maintaining their ability to store elastic energy, at least at 8 km h(-1) speed, at the same level as the normal-weighted subjects.

In morbidly obese women, NAFLD severity is inversely associated with insulin sensitivity and beta-cell function. The association of NAFLD severity with beta-cell dysfunction is stronger than that with insulin resistance.