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Thyroid Hormone Changes After Sleeve Gastrectomy With and Without Antral Preservation

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Abstract

Background

The effect of bariatric surgery on thyroid hormone changes yielded inconsistent results. The aim of the present study was to assess the change of thyroid hormone levels following laparoscopic sleeve gastrectomy (LSG), with or without antral preservation (AP).

Methods

Thyroid hormones (TSH, FT3, FT4) were examined preoperatively, at the end of the first postoperative month, and first postoperative year. Secondly, antral resection (AR) and AP were compared at inducing weight loss and thereby affecting thyroid hormone levels.

Results

Euthyroid obese patients (86 female/20 male) underwent LSG. Of these, 58 patients underwent AR and 48 patients AP. The mean FT3 levels significantly decreased both in the first postoperative month and the first year (P < 0.001), whereas mean TSH levels decreased significantly in the first postoperative year (P < 0.001). FT4 levels remained nearly unchanged (P = 0.517). Postoperative first year body mass index (BMI) loss, excess BMI loss percentile (%EBMIL), and total body weight loss percentile (%TWL) were significantly higher in AR group than the AP group (P ≤ 0.01). When the change in thyroid hormone levels was analyzed by pyloric distance according to time periods, no significant difference was found in TSH and FT4 levels (P > 0.05); however, reduction in FT3 levels was significantly greater in patients with AR than in AP patients (P = 0.028).

Conclusion

LSG promotes significant reduction in TSH and FT3 levels, whereas FT4 levels remain unchanged. LSG with AR provides more weight loss in short term and appears to be more effective at lowering FT3 levels.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Sakarya University Teaching and Research Hospital, Adnan Menderes Cad. Sağlık Sok No:195, Genel Cerrahi Klinigi, 54100, Adapazarı, Sakarya, Turkey

    Kerem Karaman, Kaan Mansıroglu, Ozkan Subasi, Aytac Biricik, Hakan Yirgin & Metin Ercan

  2. Department of Public Health, Sakarya University Teaching and Research Hospital, Adapazarı, Sakarya, Turkey

    Elif Kose

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  1. Kerem Karaman
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  2. Kaan Mansıroglu
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Contributions

Kerem Karaman: conceived and designed the experiment, performed the experiments, and wrote the paper.

Kaan Mansıroğlu, Ozkan Subasi, Aytac Biricik, and Hakan Yirgin: contributed reagents, materials, analysis tools, or data.

Elif Kose: statistical calculation.

Metin Ercan: review and editing, supervision, and project administration.

Corresponding author

Correspondence to Kerem Karaman.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Karaman, K., Mansıroglu, K., Subasi, O. et al. Thyroid Hormone Changes After Sleeve Gastrectomy With and Without Antral Preservation. OBES SURG 31, 224–231 (2021). https://doi.org/10.1007/s11695-020-04896-4

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  • DOI: https://doi.org/10.1007/s11695-020-04896-4

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