Total thyroidectomy: a clue to understanding the metabolic changes induced by subclinical hyperthyroidism?

Lassen, Pierre Bel; Kyrilli, Aglaia; Lytrivi, Maria; Patino, Maria Jose Ruiz; Corvilain, Bernard

doi:10.1111/cen.13237

Cited by 10 publications

(13 citation statements)

References 33 publications

(54 reference statements)

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“…3 We acknowledge the concerns raised by Bel Lassen et al 1 regarding patient numbers and heterogeneity (both surgical indication and treatment status). 2 We also congratulate them for their work on this topic.…”

Section: Re: Body Weight Change Is Unpredictable After Total Thyroidementioning

confidence: 87%

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Re: Body weight change is unpredictable after total thyroidectomy

Lassen

Lytrivi

Patino

et al. 2018

ANZ Journal of Surgery

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Re: Body weight change is unpredictable after total thyroidectomyWe read with interest the article by Glick et al. 1 assessing predictors for body weight change after total thyroidectomy in 79 patients. They found no predictors and in particular preoperative thyroid status did not predict weight gain after surgery. This observation is in contradiction with a larger study performed by Bel Lassen et al. 2 comparing weight gain after total thyroidectomy for multi-nodular goitre between patients with preoperative euthyroidism (n = 151) and with subclinical hyperthyroidism (n = 74). Body mass index gain was significantly greater in the subclinical hyperthyroid group than in the euthyroid group (1.11 AE 0.17 versus 0.33 AE 0.16 kg/ m 2 ; P = 0.003) and in the multivariate analysis, the preoperative serum TSH value was the main predictive factor for the increase in body weight.Methodological factors may explain why TSH or thyroid status did not predict weight change in the study of Glick et al.(1) The low number of patients and the heterogeneity of the preoperative diagnosis: patients with Graves' disease have probably been treated by antithyroid drugs preoperatively which makes it difficult to interpret thyroid status; patients with a diagnosis of thyroid cancer may have been psychologically affected and may have modified their diet. In our study, we included only patients with benign multi-nodular goitre free of treatment (antithyroid drug or thyroxine). (2) The definition of preoperative hyperthyroidism: TSH <0.3 mU/L is a consensual definition but patients treated with antithyroid drugs means that patients treated with antithyroid drug have been classified as hyperthyroid even with normal TSH value. (3) In the post-operative period, patients have been largely undertreated (mean TSH >5 mU/L). Therefore, we believe that the data presented in the article by Glick et al. do not allow to draw conclusions on possible predictors for weight change after thyroidectomy. References 1. Glick R, Chang P, Michail P, Serpell JW, Grodski S, Lee JC. Body weight change is unpredictable after total thyroidectomy. ANZ J. Surg. 2018; 88: 162-6. 2. Bel Lassen P, Kyrilli A, Lytrivi M, Ruiz Patino M, Corvilain B. Total thyroidectomy: a clue to understanding the metabolic changes induced by subclinical hyperthyroidism?Response to Re: Body weight change is unpredictable after total thyroidectomyWe thank Bel Lassen et al. 1 for their interest in our publication. 2 We also congratulate them for their work on this topic. 3 We acknowledge the concerns raised by Bel Lassen et al. 1 regarding patient numbers and heterogeneity (both surgical indication and treatment status). These limitations have been acknowledged within the manuscript.We appreciate Bel Lassen et al. pointing out the finding that post-operatively, on average, patients seemed to have been undertreated with thyroxine. In fact, patients without postoperative weight gain were far more undertreated (mean TSH: 5.9) than those who gained weight (mean TSH: 2.9). This finding is counteri...

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Section: Re: Body Weight Change Is Unpredictable After Total Thyroidementioning

confidence: 87%

“…3 We acknowledge the concerns raised by Bel Lassen et al 1 regarding patient numbers and heterogeneity (both surgical indication and treatment status). They found no predictors and in particular preoperative thyroid status did not predict weight gain after surgery.…”

mentioning

confidence: 87%

Re: Body weight change is unpredictable after total thyroidectomy

Lassen

Lytrivi

Patino

et al. 2018

ANZ Journal of Surgery

Self Cite

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“…A few studies on the impact of thyroid function on lipid metabolism are available. Bel Lassen et al [19] proposed that endogenous subclinical hyperthyroidism after thyroidectomy may directly affect lipid profiles after thyroidectomy. Jung et al [20] suggested that changes in thyroid function after thyroidectomy can be associated with changes in the concentration and functions of lipid profiles.…”

Section: Discussionmentioning

confidence: 99%

Postthyroidectomy obesity in a Korean population: does the extent of surgery matter?

et al. 2019

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Purpose The purpose of this study was to investigate the prevalence of postthyroidectomy obesity, and the relationship between the extent of thyroidectomy and obesity. Methods A survey conducted at an outpatient clinic from June to October 2014 and retrospective charts for patients undergoing thyroidectomy at Konkuk University Medical Centers from June 2009 to December 2013 were reviewed. We compared clinical characteristics and pre- and postoperative obesity-related factors in 227 patients who underwent total thyroidectomy or lobectomy. Results Patients included 39 males and 188 females with a mean age of 46.0 ± 11.0 years; the mean follow-up period was 23.9 ± 16.7 months, and 90 of the 227 patients showed postthyroidectomy obesity. In effect of operative extent on postoperative obesity, patients who underwent TT (48.2 years) than those who underwent lobectomy (43.4 years). TT group had longer follow-up and the frequency of menopause was higher than in the lobectomy group. No differences in postthyroidectomy obesity, body weight change, or body mass index (BMI), change among 2 groups. The predictors of postthyroidectomy obesity were older age, female, heavy alcohol consumption (P = 0.029), higher preoperative BMI (P < 0.001), larger postoperative weight gain (P = 0.024), and larger BMI change. However, the extent of thyroidectomy did not affect postthyroidectomy obesity. Preoperative BMI (P < 0.001) and heavy alcohol consumption (P = 0.03) were independent factors of postthyroidectomy obesity. Conclusion The extent of thyroidectomy does not affect postthyroidectomy obesity. Preoperative BMI and heavy alcohol consumption are risk factors for postthyroidectomy obesity. Studies are needed to suggest preoperative life style modification to prevent postthyroidectomy obesity.

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“…2 We also congratulate them for their work on this topic. 3 We acknowledge the concerns raised by Bel Lassen et al 1 regarding patient numbers and heterogeneity (both surgical indication and treatment status). These limitations have been acknowledged within the manuscript.We appreciate Bel Lassen et al pointing out the finding that post-operatively, on average, patients seemed to have been undertreated with thyroxine.…”

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confidence: 87%