Decreased Leptin Is Associated with Alterations in Thyroid-Stimulating Hormone Levels after Roux-en-Y Gastric Bypass Surgery in Obese Euthyroid Patients with Type 2 Diabetes

Yu, Haoyong; Li, Qing; Zhang, Mingliang; Liu, Fangyuan; Pan, Jiemin; Tu, Ya; Lu, Junxi; Zhang, Pin; Han, Junfeng; Jia, Weiping; Bao, Yuqian

doi:10.1159/000499385

Cited by 25 publications

(13 citation statements)

References 28 publications

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“…Leptin regulates appetite and food intake and stimulates the secretion of hypothalamic hormones, such as TRH. Yu et al demonstrated that TSH was significantly positively related with BMI, CRP, and leptin, reasoning that leptin might mediate change in thyroid function via cross talk between adipose tissue and hypothalamic pituitary thyroid axis [123]. To conclude, it is noteworthy that most studies revealed a beneficial effect of bariatric surgery on hypothyroid patients, considering thyroid function and a decrease of drug requirements.…”

Section: Bariatric Surgerymentioning

confidence: 99%

Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?

et al. 2020

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A healthy gut microbiota not only has beneficial effects on the activity of the immune system, but also on thyroid function. Thyroid and intestinal diseases prevalently coexist—Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are the most common autoimmune thyroid diseases (AITD) and often co-occur with Celiac Disease (CD) and Non-celiac wheat sensitivity (NCWS). This can be explained by the damaged intestinal barrier and the following increase of intestinal permeability, allowing antigens to pass more easily and activate the immune system or cross-react with extraintestinal tissues, respectively. Dysbiosis has not only been found in AITDs, but has also been reported in thyroid carcinoma, in which an increased number of carcinogenic and inflammatory bacterial strains were observed. Additionally, the composition of the gut microbiota has an influence on the availability of essential micronutrients for the thyroid gland. Iodine, iron, and copper are crucial for thyroid hormone synthesis, selenium and zinc are needed for converting T4 to T3, and vitamin D assists in regulating the immune response. Those micronutrients are often found to be deficient in AITDs, resulting in malfunctioning of the thyroid. Bariatric surgery can lead to an inadequate absorption of these nutrients and further implicates changes in thyroid stimulating hormone (TSH) and T3 levels. Supplementation of probiotics showed beneficial effects on thyroid hormones and thyroid function in general. A literature research was performed to examine the interplay between gut microbiota and thyroid disorders that should be considered when treating patients suffering from thyroid diseases. Multifactorial therapeutic and preventive management strategies could be established and more specifically adjusted to patients, depending on their gut bacteria composition. Future well-powered human studies are warranted to evaluate the impact of alterations in gut microbiota on thyroid function and diseases.

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Section: Bariatric Surgerymentioning

confidence: 99%

Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?

et al. 2020

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“…Mean free thyroxine levels decreased from 16.26 pmol/L to 14.59 pmol/L ( P < 0.01) and thyroid-stimulating hormone (TSH) levels decreased significantly (2.19 ± 1.09 mIU/L vs. 1.97 ± 1.12 mIU/L, P = 0.027) at 6 months after RYGB ( Liu et al, 2017a ). In other studies, thyroid hormones including free triiodothyronine, free thyroxine, and TSH declined in parallel at 12 months after RYGB and SG ( Yu et al, 2019 ; Zhu et al, 2019a ). However, weight loss after SG is accompanied by a significant decrease in serum TSH level, but no change in serum free thyroxine or free triiodothyronine levels ( Yang et al, 2017 ).…”

Section: Evaluation Of Metabolic Surgery Efficacy For Obesity and T2dmmentioning

confidence: 70%

“…However, weight loss after SG is accompanied by a significant decrease in serum TSH level, but no change in serum free thyroxine or free triiodothyronine levels ( Yang et al, 2017 ). Decreased TSH levels after weight loss induced by RYGB might be mediated by a decline in leptin ( Yu et al, 2019 ). However, patients after RYGB have a potential risk of thyroid nodule progression ( Zhang et al, 2017b ).…”

Section: Evaluation Of Metabolic Surgery Efficacy For Obesity and T2dmmentioning

confidence: 99%

Metabolic surgery in China: present and future

Bao

2021

Journal of Molecular Cell Biology

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Obesity and its related complications comprise a serious public health problem worldwide, and obesity is increasing in China. Metabolic surgery is a new type of treatment with unique advantages in weight loss and obesity-related metabolic complications. The pathogenesis of obesity is complex and not yet fully understood. Here, we review the current efficacy and safety of metabolic surgery, as well as recent progress in mechanistic studies and surgical procedures in China. The exciting and rapid advances in this field provide new opportunities for patients with obesity and strike a balance between long-term effectiveness and safety.

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“…It is believed to play a relevant role in the hypothalamic-pituitary-thyroid (HPT) axis by regulating the TRH gene expression. A positive correlation between the decrease in leptin levels after bariatric surgery and the reduction in TSH has been observed in euthyroid patients [19]. However, a retrospective study did not found a signi cant association between the decrease in plasma leptin level and the decrease in levothyroxine dose [8].…”

Section: Discussionmentioning

confidence: 99%

Change in Levothyroxine Requirements After Bariatric Surgery in Patients With Hypothyroidism.

García-Moreno

Blanco

Viñuela

et al. 2021

Preprint

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PurposeThis study aims to evaluate the need to modify the levothyroxine dose after surgery. Additional goals are to estimate the increase or decrease of total dose and weight-adjusted dose, assess the influence of weight loss on the levothyroxine requirements, and identify predictors.Material and methodsRetrospective study in patients with treated hypothyroidism that underwent bariatric surgery. The required levothyroxine dose was evaluated before the surgery and at 6, 12, and 24 months post-surgery. Dose modification during follow-up and its association with weight loss and other potential predictors were assessed. ResultsOf the 63 patients included, 82.54% needed an adjustment of dose during the follow-up. The total dose of levothyroxine decreased significantly at 6 months post-surgery (-49.1 µg/week; 95%CI= -93.7 to -4.5; p=0.031) and 12 months (-54.9 µg/week; 95%CI= -102 to -7.8; p=0.022), with no significant change at 24 months (p=0.114). The weight-adjusted dose increased at 6 months (1.37 µg/kg/week; 95%CI=0.91 to 1.83; p<0.001), 12 months (2.05 µg/kg/week; 95%CI=1.43 to 2.67; p<0.001), and 24 months (2.52 µg/kg/week; 95%CI=1.74 to 3.30; p<0.001). Weight loss showed significant association with weight-adjusted dose (OR=1.07; 95%CI=1.02 to 1.12; p=0.004) and did not with the total dose (p=0.320).ConclusionsIt is expected that the levothyroxine requirements change in the firsts years after bariatric surgery. This study shows a significant decrease in the total dose during the first year of follow-up and an increase in the weight-adjusted dose over the two first years. No predictors for the modification in the total dose of levothyroxine have been identified.

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Decreased Leptin Is Associated with Alterations in Thyroid-Stimulating Hormone Levels after Roux-en-Y Gastric Bypass Surgery in Obese Euthyroid Patients with Type 2 Diabetes

Cited by 25 publications

References 28 publications

Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?

Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?

Metabolic surgery in China: present and future

Change in Levothyroxine Requirements After Bariatric Surgery in Patients With Hypothyroidism.

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