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

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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.

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Funding

None. (Authors confirm they did not receive any funding to do this work.)

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Authors and Affiliations

  1. General Surgery Department, Kasralainy School of Medicine, Cairo University, Giza, Egypt

    Mohamed AbdAlla Salman, Mahmoud A.Ameen & Haitham S. E. Omar

  2. Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Giza, Egypt

    Ahmed Rabiee & Ahmed Salman

  3. General Surgery Department, Ain Shams University, Cairo, Egypt

    Mohamed G.Qassem

  4. General Surgery Department Faculty of Medicine, AlAzhar University, Asiut, Egypt

    Ahmed M. Hassan

  5. Senior Clinical Fellow, Endocrinology, Lancashire Teaching Hospital, NHS Foundation, Preston, UK

    Ahmed Soliman

  6. National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt

    Hossam Shaaban

  7. Medical Biochemistry Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt

    Ghada M. K. GabAllah

  8. Anaesthesia and Pain Management Department, Kasralainy School of Medicine, Cairo University, Giza, Egypt

    Ahmed A.Ismail

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  1. Mohamed AbdAlla Salman
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Correspondence to Mohamed AbdAlla Salman.

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Salman, M.A., Rabiee, A., Salman, A. et al. Laparoscopic Sleeve Gastrectomy has A Positive Impact on Subclinical Hypothyroidism Among Obese Patients: A Prospective Study. World J Surg 45, 3130–3137 (2021). https://doi.org/10.1007/s00268-021-06201-5

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