Laparoscopic Sleeve Gastrectomy has A Positive Impact on Subclinical Hypothyroidism Among Obese Patients: A Prospective Study

Abstract

Background The effect of bariatric surgery on postoperative thyroid function remains incompletely understood. In this study, we aimed to evaluate the changes in thyroid functions after gastric sleeve operation for morbidly obese Egyptian patients. Methods This was a prospective study that recruited 128 patients who underwent sleeve gastrectomy through the period from December 2016 to April 2020. We measured thyroid-stimulating hormone (TSH), free thyroxin (FT4), and free triiodothyronine. Subclinical hypothyroidism was defined by a TSH level [ 4.5 mIU/L but a normal FT4 level. All patients were followed for 12 months after the procedure. Results Preoperatively, 30 (23.4%) patients had subclinical hypothyroidism. The prevalence of subclinical hypothyroidism decreased significantly to reach 7.8% at the end of follow-up (p \ 0.001). None of the patients developed de novo hypothyroidism at the end of follow-up. Patients with subclinical hypothyroidism were more likely to be females (p = 0.037) and had significantly higher waist circumference (p \ 0.001), DBP (p = 0.02), serum cholesterol (p \ 0.001), and serum triglyceride (p \ 0.001). However, patients with subclinical hypothyroidism at the end of follow-up had significantly higher BMI at the end of the sixth month (p = 0.048). Similarly, patients with subclinical hypothyroidism at the end of follow-up had significantly higher serum cholesterol (p = 0.002), LDL, (p = 0.038), and serum triglyceride (p \ 0.001) at the end of the sixth months of follow-up. A similar trend was noted at the end of the 12th month. The preoperative value of serum TSH correlated significantly with serum cholesterol and triglyceride levels. Conclusion The positive effect of the LSG procedure on the hypothyroid bariatric population, including enhanced thyroid function, was demonstrated.

Sex dimorphism in the effect and predictors of weight loss after sleeve gastrectomy

“…Female patients with higher preoperative TSH levels achieved better weight-loss outcomes. Clinical studies have demonstrated a positive correlation between obesity and plasma TSH levels ( 32 , 33 ). A previous study initially reported that the TSH level decreased significantly after SG in euthyroid patients.…”

Total weight loss induces the alteration in thyroid function after bariatric surgery

“…However, changes in thyroid-stimulating hormone (TSH) after bariatric surgery reported by different studies varied dramatically. TSH levels were found to decline significantly following bariatric surgery in the majority of studies involving patients with subclinical or overt hypothyroidism ( 10 – 12 ). Similar results have been noted in a number of researches involving patients with normal thyroid function ( 13 – 15 ).…”

Targeting Thyroid Hormone/Thyroid Hormone Receptor Axis: An Attractive Therapy Strategy in Liver Diseases

“…Dysfunction of the TH/TR axis leads to numerous pathologies, especially including growth, skeletal development, heart diseases, cognitive dissonance, gastrointestinal function, obesity, dysmetabolism, and cancers ( Brent, 2012 ; Ortiga-Carvalho et al, 2014 ; Ajdukovic et al, 2021 ; Moutzouri et al, 2021 ; Niedowicz et al, 2021 ; Salman et al, 2021 ). Therefore, the abnormity of the TH/TR axis elicits a series of diseases, the most common of which is metabolic disease ( Malm, 2004 ).…”