Advertisement

Obesity Surgery

, Volume 30, Issue 1, pp 274–278 | Cite as

Thyroid Homeostasis After Bariatric Surgery in Obese Cases

  • Feyzi Gokosmanoglu
  • Erkan Aksoy
  • Attila OnmezEmail author
  • Hasan Ergenç
  • Sibel Topkaya
Original Contributions
  • 93 Downloads

Abstract

Background

The aim of this study was to determine changes in thyroid hormones and morphology with weight loss after bariatric surgery in obese patients.

Methods

This prospective study was performed in our endocrinology and surgery clinic. Pre- and post-bariatric surgery thyroid function tests and thyroid ultrasonography parameters were compared.

Results

Four hundred seventy-two patients were included in the study. Mean weight loss after surgery was 30.7 ± 5.1 kg. TSH levels decreased statistically significantly parallel with weight loss and decreased BMI (p = 0.025) after bariatric surgery. However, no statistically significant change was observed in fT4 or fT3 levels (p > 0.05). A significant increase in thyroid parenchyma echogenicity, correlated with weight loss and time elapsed since surgery, was detected at ultrasonography (US) grayscale histogram analysis compared with muscle echogenicity (p = 0.032). An increase in echogenicity was even detected in patients with isoechoic thyroid parenchyma before surgery. Fasting insulin and HOMA-IR levels decreased after surgery (p = 0.010 and p = 0.001, respectively). Patients were divided into three groups based on weight loss. In group 3, preoperative TSH of 4.1 ± 0.7 decreased to 1.6 ± 0.7 postoperatively (p = 0.001), while preoperative HOMA-IR of 4.9 ± 1.9 decreased to 2.4 ± 0.8 postoperatively (p = 0.001).

Conclusions

Obesity causes thyroid hormone resistance through a mechanism similar to insulin resistance and leads to an increase in TSH similar to hyperinsulinemia. Our findings show that echogenicity at thyroid US increases in line with weight loss following bariatric surgery.

Keywords

Obesity Bariatric surgery Thyroid Thyroid echogenicity 

Notes

Acknowledgments

The authors would like to thank the biostatisticians for their assistance.

Compliance with Ethical Standards

Conflicts of Interest and Source of Funding

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed 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.

Informed Consent Statement

After receiving detailed information about the study, all subjects provided informed written consent to participate.

References

  1. 1.
    Silva JE. Thermogenic mechanisms and thyroid hormonal regulation. Physiol Rev. 2006;86(2):435–64.CrossRefGoogle Scholar
  2. 2.
    Longhi S, Radetti G. Thyroid function and obesity. J Clin Res Pediatr Endocrinol. 2013;5(Suppl 1):40–4.  https://doi.org/10.4274/jcrpe.856.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Radetti G, Longhi S, Baiocchi M, et al. Changes in lifestyle improve body composition, thyroid function, and structure in obese children. J Endocrinol Investig. 2012;35(3):281–5.Google Scholar
  4. 4.
    Santini F, Marzullo P, Rotondi M, et al. Mechanisms in endocrinology: the crosstalk between thyroid gland and adipose tissue: signal integration in health and disease. Eur J Endocrinol. 2014;171(4):R137–52.CrossRefGoogle Scholar
  5. 5.
    Abu-Ghanem Y, Inbar R, Tyomkin V, et al. Effect of sleeve gastrectomy on thyroid hormone levels. Obes Surg. 2015;25(3):452–6.  https://doi.org/10.1007/s11695-014-1415-7.CrossRefPubMedGoogle Scholar
  6. 6.
    Schauer PR, Nor Hanipah Z, Rubino F. Metabolic surgery for treating type 2 diabetes mellitus: now supported by the world’s leading diabetes organizations. Cleve Clin J Med. 2017;84(7 Suppl 1):S47–56.  https://doi.org/10.3949/ccjm.84.s1.06.CrossRefPubMedGoogle Scholar
  7. 7.
    Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149(3):275–87.CrossRefGoogle Scholar
  8. 8.
    Ashrafian H, Toma T, Rowland SP, et al. Bariatric surgery or non-surgical weight loss for obstructive sleep apnoea? A systematic review and comparison of meta-analyses. Obes Surg. 2015;25(7):1239–50.  https://doi.org/10.1007/s11695-014-1533-2.CrossRefPubMedGoogle Scholar
  9. 9.
    Guan B, Chen Y, Yang J, et al. Effect of bariatric surgery on thyroid function in obese patients: a systematic review and meta-analysis. Obes Surg. 2017;27(12):3292–305.  https://doi.org/10.1007/s11695-017-2965-2.CrossRefPubMedGoogle Scholar
  10. 10.
    Yang J, Gao Z, Yang W, et al. Effect of sleeve gastrectomy on thyroid function in chinese euthyroid obese patients. Surg Laparosc Endosc Percutan Tech. 2017;27(4):e66–8.  https://doi.org/10.1097/SLE.0000000000000432.CrossRefPubMedGoogle Scholar
  11. 11.
    Gutch M, Rungta S, Kumar S, et al. Thyroid functions and serum lipid profile in metabolic syndrome. Biom J. 2017;40(3):147–53.  https://doi.org/10.1016/j.bj.2016.12.006.CrossRefGoogle Scholar
  12. 12.
    Agnihothri RV, Courville AB, Linderman JD, et al. Moderate weight loss is sufficient to affect thyroid hormone homeostasis and inhibit its peripheral conversion. Thyroid. 2014;24(1):19–26.  https://doi.org/10.1089/thy.2013.0055.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Neves JS, Castro Oliveira S, Souteiro P, et al. Effect of weight loss after bariatric surgery on thyroid-stimulating hormone levels in patients with morbid obesity and normal thyroid function. Obes Surg. 2018;28(1):97–103.  https://doi.org/10.1007/s11695-017-2792-5.CrossRefPubMedGoogle Scholar
  14. 14.
    Nannipieri M, Cecchetti F, Anselmino M, et al. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss. Int J Obes. 2009;33(9):1001–6.  https://doi.org/10.1038/ijo.2009.140.CrossRefGoogle Scholar
  15. 15.
    Legradi G, Emerson CH, Ahima RS, et al. Leptin prevents fasting-induced suppression of prothyrotropin-releasing hormone messenger ribonucleic acid in neurons of the hypothalamic paraventricular nucleus. Endocrinology. 1997;138(6):2569–76.CrossRefGoogle Scholar
  16. 16.
    Camastra S, Manco M, Frascerra S, et al. Pituitary hormones in morbid obesity: effects of bariatric surgery. Int J Obes. 2009;33(1):166–72.CrossRefGoogle Scholar
  17. 17.
    Seon HC, Eun-KK, Jk S, et al. Thyroid ultrasonography: pitfalls and techniques. Korean J Radiol. 2014;15(2):267–76. Published online 2014 Mar 7.  https://doi.org/10.3348/kjr.2014.15.2.267.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of EndocrinologyMedical Park HospitalOrduTurkey
  2. 2.Department of General SurgeryMedical Park HospitalOrduTurkey
  3. 3.Department of Internal Medicine, Medical FacultyDuzce UniversityDuzceTurkey
  4. 4.Department of Internal MedicineSinop Ayancık State HospitalSinopTurkey
  5. 5.Department of Internal MedicineOrdu State HospitalSinopTurkey

Personalised recommendations