Effect of Sleeve Gastrectomy on Thyroid Function in Chinese Euthyroid Obese Patients

Yang, Jingge; Gao, Zhiguang; Yang, Wah; Zhou, Xiangmao; Lee, Joe; Wang, Cunchuan

doi:10.1097/sle.0000000000000432

Cited by 17 publications

(18 citation statements)

References 17 publications

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“…Several studies have found different results regarding the variation of TSH after weight loss surgery and the relationship between TSH variation and weight loss [15,16,17,18,19,20]. Most [16,17,19], but not all [15,20], studies evaluating the evolution of TSH after weight loss surgery have also found a decrease in circulating TSH after the intervention. In agreement with our results, Guan et al [16] performed a systematic review and meta-analysis of the effect of BS on thyroid function in obese patients and found that BS was associated with a significant decrease in circulating TSH levels.…”

Section: Discussionmentioning

confidence: 99%

“…The alteration of thyroid function and the effect of BS on postoperative thyroid function evolution are still not completely understood. There are several previous studies showing different results regarding the variation of thyroid-stimulating hormone (TSH) after BS and the relation of TSH variation with weight loss [15,16,17,18,19,20]. In addition, the mechanism and the clinical implications of this hormonal alteration remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

et al. 2019

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Obesity is associated with several endocrine abnormalities, including thyroid dysfunction. The objective of this study was to investigate the effect of weight loss after bariatric surgery on thyroid-stimulating hormone (TSH) levels in euthyroid patients with morbid obesity. We performed an observational study, evaluating patients with morbid obesity submitted to bariatric surgery. We included 129 patients (92 women) and 31 controls (21 women). Clinical, anthropometric, biochemical, and hormonal parameters were evaluated. The primary endpoint was circulating TSH (µU/mL). Fasting TSH levels were higher in the obese group (3.3 ± 0.2) than in the control group (2.1 ± 0.2). The mean excessive body mass index (BMI) loss (EBMIL) 12 months after bariatric surgery was 72.7 ± 2.1%. TSH levels significantly decreased in the obese patients after surgery; 3.3 ± 0.2 vs. 2.1 ± 0.2 before and 12 months after surgery, respectively. Free thyroxine (T4) (ng/dL) levels significantly decreased in the obese patients after surgery; 1.47 ± 0.02 vs. 1.12 ± 0.02 before and 12 months after surgery, respectively. TSH decreased significantly over time, and the decrement was associated with the EBMIL. In euthyroid patients with morbid obesity, weight loss induced by bariatric surgery promotes a significant decline of the increased TSH levels. This decrement of TSH is progressive over time after surgery and significantly associated with excess BMI loss.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

et al. 2019

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“…Research has shown that severely obese individuals may require higher L-T4suppressing or replacement therapy than normal weight subjects in association with impairment of the L-T4 pharmacokinetic parameters [8]. Decreased thyroid gene expression (particularly TSH-receptors) has been reported in visceral adipose tissue and subcutaneous in obese patients [9]. The decrease in adipose tissue in parallel with weight loss following obesity surgery results in corresponding changes in serum TSH and thyroid hormone levels.…”

Section: Discussionmentioning

confidence: 99%

Changes in levothyroxine pharmacokinetics following bariatric surgery in obese hypothyroid patients

Gökosmanoğlu

Önmez

2021

j-ebr

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Levothyroxine (L-T4) requirements in obese hypothyroid patients receiving L-T4 therapy decrease following bariatric surgery. L-T4 absorption is also thought to decrease after surgery. The purpose of this study was to evaluate L-T4 requirements in hypothyroidism cases before and after weight loss through bariatric surgery. Methods: Seventy-six cases of hypothyroidism receiving L-T4 replacement therapy and with a body mass index over 40 kg/m2 were included in the study. Patients losing at least 10% of basal body weight following bariatric surgery were assessed in terms of thyroid hormone levels and L-T4 requirements over follow-up of at least one year. The L-T4 requirements of patients in whom euthyroidism was achieved were compared in terms of bariatric surgery procedures and hypothyroidism etiology. Results: Seventy-six patients (56 women, 20 men) with a mean age of 38 years (18-51) were included in the study. Mean weight before bariatric surgery was 121.6 ± 6.8 kg, and mean body mass index was 49.5 ± 1.6 kg/m 2 . Euthyroidism was confirmed at pre-and post-bariatric surgery evaluation. No statistically significant postoperative changes were determined in thyroid-stimulating hormone or free thyroxine-3 and -4 (p > 0.05). A statistically insignificant decrease was observed in L-T4 dosages after surgery in cases of Hashimoto's thyroiditis (p = 0.064). A statistically significant decrease was determined in L-T4 dosages in cases of non-Hashimoto hypothyroidism (p = 0.001). L-T4 requirements decreased in both surgical procedures (p = 0.001) Conclusion: Postoperative L-T4 requirements decrease with weight loss. In addition, no decrease appeared to occur in L-T4 absorption following the surgical procedures in this study.

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“…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 ). Decreased TSH levels after weight loss induced by RYGB might be mediated by a decline in leptin ( Yu et al, 2019 ).…”

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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Effect of Sleeve Gastrectomy on Thyroid Function in Chinese Euthyroid Obese Patients

Abstract: Weight loss after LSG is accompanied by significant decrease in serum TSH level but no change in serum FT4 and FT3 levels. However, further work is required to elucidate the mechanism.

Cited by 17 publications

References 17 publications

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

Changes in levothyroxine pharmacokinetics following bariatric surgery in obese hypothyroid patients

Metabolic surgery in China: present and future

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