The effect of body weight and weight loss on thyroid volume and function in obese women

Sarı, Ramazan; Balcı, Mustafa Kemal; Altunbaş, Hasan; Karayalçın, Ümit

doi:10.1046/j.1365-2265.2003.01836.x

Cited by 167 publications

(153 citation statements)

References 31 publications

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“…Interestingly, the BMI of patients with subclinical hypothyroidism was significantly higher than euthyroid patients. The serum levels of TSH were higher in obese patients in some studies [37][38][39][40][41] but not in others [42,43]. The reason is still unclear because the BMI of patients with overt hypothyroidism was not different from the others also in our study.…”

Section: Discussionsupporting

confidence: 30%

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

et al. 2011

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abstract. Hypercholesterolemia is one of the most representative disorders of the common diseases. To evaluate the prevalence of hypothyroidism in the population of adult hypercholesterolemia, we prospectively examined the thyroid function in patients with untreated or treated hypercholesterolemia as a multi-center survey. Subjects were the patients who were treated with some antilipemic agents or the untreated patients whose total cholesterol (TC) was over 220 mg/dL and/or LDL-cholesterol (LDL-C) over 140 mg/dL. Among 737 cases recruited, 725 cases (300 males and 425 females) participated in the survey including the thyroid function test. The patient's backgrounds include hypertension (51%), diabetes mellitus (49%), fatty liver (17%), smoking (15%), and habitual drinking (10%). The 72% of the patients were treated with some antilipemic agents and the mean values of TC, LDL-C, triglyceride (TG), HDL-cholesterol (HDL-C), and LDL-C/HDL-C ratio were 204.5 mg/dL, 119.6 mg/dL, 144.4 mg/dL, 60.7 mg/dL and 2.25, respectively. The primary hypothyroidism was seen in 27 cases (3.7%) (11 males, 16 females) with subclinical hypothyroidism in 17 cases (2.4%) and overt hypothyroidism in 10 cases (1.4%). The central hypothyroidism was seen in 4 cases (0.6%). The prevalence of hypothyroidism was 4.3% in patients with hypercholesterolemia. Taking account of the large number of patients with dyslipidemia and importance of avoiding unnecessary administration and associated adverse effects, evaluation of the thyroid function could be warranted in patients with dyslipidemia although cost-benefit issues waits further investigation.Key words: Hypercholesterolemia, Dyslipidemia, Subclinical hypothyroidism strongly related to atherosclerotic cardiovascular disease. Recently, new therapeutic reagents such as fibrates and statins have been created and primary dyslipidemia is effectively treated with these reagents [1]. However, they are not low priced and may induce rare but serious side effects such as rhabdomyolysis [1]. Hypothyroidism induces secondary hypercholesterolemia that increases the incidence of atherosclerotic cardiovascular events [2], and replacement of low-

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Section: Discussionsupporting

confidence: 30%

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

et al. 2011

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“…This difference was related to the amount of lean body mass rather than to body weight by itself (59). After weight loss, a reduction in thyroid volume was also observed (60). Studies on children and adults also demonstrated that obesity is associated with a thyroid hypo-echogenic pattern at US, which occurs independently from thyroid autoimmunity (77,78).…”

Section: Thyroid Function and Structure In Obese Subjectsmentioning

confidence: 88%

“…Data regarding the circulating concentrations of thyroid hormones are less univocal because the serum levels of FT 3 were reported as increased, unchanged, or decreased. On the other hand, most studies reported a general trend toward low/normal levels of FT 4 in obese subjects (59,60,61,62,63,64,65,66). Lately, the relation between adiposity and serum TSH, FT 3 , and FT 4 was evaluated in a large, representative sample of the adult population from the National Health and Nutrition Examination Survey 2007-2008 (67).…”

Section: Thyroid Function and Structure In Obese Subjectsmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: The crosstalk between thyroid gland and adipose tissue: signal integration in health and disease

Santini

Marzullo

Rotondi

et al. 2014

European Journal of Endocrinology

204

185

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Obesity and thyroid diseases are common disorders in the general population and they frequently occur in single individuals. Alongside a chance association, a direct relationship between 'thyroid and obesity' has been hypothesized. Thyroid hormone is an important determinant of energy expenditure and contributes to appetite regulation, while hormones and cytokines from the adipose tissue act on the CNS to inform on the quantity of energy stores. A continuous interaction between the thyroid hormone and regulatory mechanisms localized in adipose tissue and brain is important for human body weight control and maintenance of optimal energy balance. Whether obesity has a pathogenic role in thyroid disease remains largely a matter of investigation. This review highlights the complexity in the identification of thyroid hormone deficiency in obese patients. Regardless of the importance of treating subclinical and overt hypothyroidism, at present there is no evidence to recommend pharmacological correction of the isolated hyperthyrotropinemia often encountered in obese patients. While thyroid hormones are not indicated as anti-obesity drugs, preclinical studies suggest that thyromimetic drugs, by targeting selected receptors, might be useful in the treatment of obesity and dyslipidemia.

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“…A recent study from our group questioned whether an elevated serum TSH alone provides sufficient evidence for a diagnosis of subclinical hypothyroidism in patients with morbid obesity (19). Little has been reported on the morphology of the thyroid gland in adults with morbid obesity (20,21). A recent study, performed in obese children, showed for the first time that obesity is associated with structural changes in thyroid morphology, as assessed by US, which are unrelated to thyroid autoimmunity (22).…”

Section: Introductionmentioning

confidence: 99%

“…Isolated hyperthyrotropinemia (a condition frequently encountered in patients with morbid obesity) (20) was defined as a raised serum level of TSH with normal FT 4 and FT 3 levels, in the absence of circulating thyroid Ab.…”

Section: Subjectsmentioning

confidence: 99%

A hypoechoic pattern of the thyroid at ultrasound does not indicate autoimmune thyroid diseases in patients with morbid obesity

Rotondi¹,

Cappelli²,

Leporati³

et al. 2010

European Journal of Endocrinology

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Objective: Thyroid ultrasound (US) scan is a valuable tool for diagnosing thyroid diseases. In autoimmune thyroid disease (AITD), an hypoechoic pattern of the thyroid at US is related to circulating thyroid antibodies (Abs). The aim of this study was to evaluate the diagnostic accuracy of thyroid US for the detection of AITD in patients with morbid obesity. Design: Thyroid US scans showing an hypoechoic pattern of the thyroid were collected from 105 morbid obese patients (body mass index (BMI) O40 kg/m 2 ) and 105 non-obese patients (BMI%30 kg/m 2 ). Results: A thyroid hypoechoic pattern at US was consistent with clinical/biochemical features of AITD in 90/105 (85.7%) non-obese patients and in 22/105 (20.9%) morbid-obese patients (P!0.0001). By performing a complete thyroid work-up, including clinical examination, thyroid morphology, serum hormones, and auto-Ab measurements, the discrepancy between the US pattern and the results of the thyroid Ab tests was justified in 6/15 non-obese patients, and only in 1/83 morbid obese patients. Thus, an unexplained hypoechoic pattern of the thyroid at US, defined as negative tests for thyroid Ab and absence of justifying thyroid disturbances, was found in 2/105 (1.9%) non-obese patients and in 68/105 (64.8%) morbid obese patients (P!0.0001). Conclusions: Our results suggest that i) morbid obesity may affect thyroid morphology, and ii) an hypoechoic pattern of the thyroid at US, a well-established parameter for diagnosing AITD, has a poor diagnostic accuracy when patients with morbid obesity are taken into account.

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The effect of body weight and weight loss on thyroid volume and function in obese women

Abstract: Our study suggests that thyroid volume and function may vary in obese women in association with body weight and fat mass; > 10% weight loss may affect thyroid volume and function, which however, is clinically insignificant.

Cited by 167 publications

References 31 publications

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

MECHANISMS IN ENDOCRINOLOGY: The crosstalk between thyroid gland and adipose tissue: signal integration in health and disease

A hypoechoic pattern of the thyroid at ultrasound does not indicate autoimmune thyroid diseases in patients with morbid obesity

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