Thyroid function before and after Roux-en-Y gastric bypass: an observational study

Granzotto, Paula Carolina Dambros; Mesa, Cléo Otaviano; Strobel, Rodrigo; Radominski, Rosana Bento; Graf, Hans; Carvalho, Gisah Amaral de

doi:10.1016/j.soard.2019.11.011

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…A meta-analysis confirmed that a high-normal serum TSH was associated with a high BMI [24]. It has been observed that TSH normalization after weightlessness was caused by a low-calorie diet or weight loss surgery [4][5][6][7], suggesting that TSH elevation in obese patients is an adaptive response by the hypothalamus-pituitary-thyroid axis to weight gain. e alterations in body weight associated with overt hypothyroidism may reflect both the accumulation of body fat, due to decreased resting energy expenditure (REE) and reduced physical activity, and the increased water content of the body, consequent to a reduced capacity to excrete free water [19].…”

Section: Discussionmentioning

confidence: 89%

“…Previous studies have evaluated a possible association between SCH and obesity [2,3]. SCH has been shown to have an increased prevalence in morbidly obese patients and is mostly corrected after weight loss (due to dieting or bariatric surgery); therefore, it has been speculated that SCH may be a consequence of abnormal fat accumulation and not a true hypothyroid state in morbidly obese subjects [4][5][6][7]. In addition, obesity complicated by SCH manifests higher insulin levels and lowgrade inflammation in patients compared with obesity alone with normal TSH [8].…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Thyroid Homeostasis and Obesity in Subclinical Hypothyroidism: Community-Based Cross-Sectional Research

Zhou

et al. 2021

International Journal of Endocrinology

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Objective. It remains unknown whether obesity has an effect on the pituitary-thyroid feedback control axis in subclinical hypothyroidism (SCH). We aimed to investigate the association of thyroid homeostasis with obesity in a SCH population. Methods. Our study consisted of a community-based and cross-sectional study from the Epidemiological Survey of Thyroid Diseases in Fujian Province, China. A total of 193 subjects with SCH (90 males and 103 females) without a history of treatment of thyroid disease, such as surgery, radiation, and thyroid hormone or antithyroid medication, were included in the present study. Indices of obesity, including body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) were measured. Results. Our results showed that the secretory capacity of the thyroid gland (SPINA-GT) and Jostel’s thyrotropin index (TSHI) were negatively correlated with BMI, WC, and WHtR, whereas the reciprocal of the thyrotroph thyroid hormone resistance index (TTSI-1) was positively correlated with BMI (all p < 0.05 ). After adjustment for age, sex, smoking, iodine status, and glucolipid metabolism, the associations between TSHI, TTSI (reciprocal transformation), and BMI still persisted (all p < 0.05 ). Conclusions. These results suggest that low levels of thyroid homeostasis indexes may be associated with overall obesity in SCH, rather than central adiposity.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Correlation between Thyroid Homeostasis and Obesity in Subclinical Hypothyroidism: Community-Based Cross-Sectional Research

Zhou

et al. 2021

International Journal of Endocrinology

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“…In addition, the accumulation of fat in the body and the increase in free fatty acids in circulation may also lead to the steatosis and infiltration of the thyroid gland, resulting in changes in thyroid morphology and function [ 17 ]. By comparing thyroxine levels of patients before and after bariatric surgery, several studies found that TSH levels significantly decreased after bariatric surgery, which was maintained for long periods without L-T4 therapy, indicating that SHO tends to spontaneously improve after weight loss [ 18 – 20 ]. Since many weight loss operations are performed by gastrectomy, obesity-mediated SHO is more likely to be affected by some intestinal hormones [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The association between BMI, smoking, drinking and thyroid disease: a cross-sectional study in Wuhan, China

et al. 2021

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Background There is no clear conclusion on the relationship between thyroid disease and obesity and lifestyle factors such as smoking and drinking. In this study, we analysed the association of body mass index (BMI), smoking and drinking with subclinical hypothyroidism (SHO) and thyroid nodules (TNs) with the results of a cross-sectional survey of urban residents in central China and discussed the potential mechanism linking these predictive factors and the two diseases. Methods This study included 1279 participants who were recruited from a Chinese community in 2011 and 2012. A questionnaire, laboratory examination and ultrasound diagnosis were conducted on these participants. Binary logistic regression analysis was used to analyse these factors. Results Overweight (BMI ≥ 25 kg/m2) was closely related to SHO and TNs in univariate and multivariate logistic regression analyses. Smoking had a protective effect on SHO and TNs, while drinking had a protective effect on TNs in univariate logistic regression and multivariate logistic regression with some covariates, but there was no significant difference between smoking and drinking and the two kinds of thyroid diseases in multivariate logistic regression analysis with all the covariates. In subgroup analysis, BMI ≥ 25 kg/m2 was significantly associated with SHO in people with positive thyroid antibodies (odds ratio (OR) = 2.221, 95 % confidence interval (CI): 1.168–4.184, P = 0.015) and smokers (OR = 2.179, 95 % CI: 1.041–4.561, P = 0.039). BMI ≥ 25 kg/m2 was significantly associated with TNs in people over 60 years old (OR = 2.069, 95 % CI: 1.149–3.724, P = 0.015) and drinkers (OR = 3.065, 95 % CI: 1.413–6.648, P = 0.005). Drinking alcohol had a protective effect on TNs in smokers (OR = 0.456, 95 % CI: 0.240–0.865, P = 0.016) and people with BMI ≥ 25 kg/m2 (OR = 0.467, 95 % CI: 0.236–0.925, P = 0.029). No significant association was found between smoking and the two thyroid diseases in different subgroups. Conclusions Obesity is a risk factor for both TNs and SHO, especially in elderly individuals and people with positive thyroid autoantibodies. Obesity and metabolic syndrome may be more associated with TNs than SHO. Smoking may have a protective effect on thyroid disease, while drinking may have a protective effect only on TNs.

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“…In addition, the accumulation of fat in the body and the increase of free fatty acids in circulation may also lead to steatosis and in ltration of the thyroid gland, resulting in changes in thyroid morphology and function [17]. By comparing the thyroxine levels of patients before and after bariatric surgery, several studies found that TSH levels decreased signi cantly after bariatric surgery, and lasted for a long time without taking L-T4, indicating that subclinical hypothyroidism tends to be improved spontaneously after weight loss [18][19][20]. Since many weight loss operations are performed by gastrectomy, obesity-mediated subclinical hypothyroidism is more likely to be affected by some intestinal hormones [21].…”

Section: Discussionmentioning

confidence: 99%

The Association between BMI, Smoking, Drinking and Thyroid Disease: A Cross-sectional Study in Wuhan, China

Chen

Wang

Liu

et al. 2021

Preprint

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Background: There is no clear conclusion on the relationship between thyroid disease and obesity and living habits such as smoking and drinking. In this study, a cross-sectional survey of urban residents in central China was conducted to analyze the association of body mass index (BMI), smoking and drinking with subclinical hypothyroidism (SHO) and thyroid nodules (TNs), and to discuss the potential mechanism between these risk or protective factors and the two diseases.Methods: This study included 1279 participants in 2011 and 2012. Questionnaire survey, laboratory examination and ultrasonic diagnosis were conducted on these participants. Binary logistics regression analysis was used to analyze these factors.Results: Overweight (BMI ≥25kg/m2) was closely related to subclinical hypothyroidism and thyroid nodules in univariate and multivariate logistics regression analysis. Smoking had protective effect on subclinical hypothyroidism and thyroid nodules in univariate logistics regression, while drinking had protective effect on thyroid nodules in univariate logistics regression, but there was no significant difference between smoking and drinking and two kinds of thyroid diseases in multivariate logistics regression analysis. In subgroup analysis, BMI ≥ 25kg/m2 was significantly associated with subclinical hypothyroidism in people with positive thyroid antibodies (OR= 2.221, 95%CI: 1.168-4.184, P=0.015) and smokers (OR= 2.179, 95%CI: 1.041-4.561, P=0.039). Thyroid nodules were significantly associated with thyroid nodules in people over 60 years old (OR= 2.069, 95%CI: 1.149-3.724, P=0.015) and drinkers (OR=3.065, 95%CI: 1.413-6.648, P=0.005). Drinking alcohol has a protective effect on thyroid nodules in smokers (OR=0.456, 95%CI: 0.240-0.865, P=0.016) and people with BMI ≥ 25kg/m2 (OR=0.467, 95%CI: 0.236-0.925, P=0.029). No statistical association was found between smoking and the two thyroid diseases in different subgroups.Conclusion: Obesity is a risk factor for thyroid disease, especially in the elderly and people with positive thyroid autoantibodies. Obesity and metabolic syndrome may be more associated with thyroid nodules than subclinical hypothyroidism. Smoking may be a protective factor for thyroid disease, while drinking is a protective factor for thyroid nodules.

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Thyroid function before and after Roux-en-Y gastric bypass: an observational study

Cited by 8 publications

References 43 publications

Correlation between Thyroid Homeostasis and Obesity in Subclinical Hypothyroidism: Community-Based Cross-Sectional Research

Correlation between Thyroid Homeostasis and Obesity in Subclinical Hypothyroidism: Community-Based Cross-Sectional Research

The association between BMI, smoking, drinking and thyroid disease: a cross-sectional study in Wuhan, China

The Association between BMI, Smoking, Drinking and Thyroid Disease: A Cross-sectional Study in Wuhan, China

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