Skip to main content
SpringerLink
Log in

Thyroid Homeostasis After Bariatric Surgery in Obese Cases

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Silva JE. Thermogenic mechanisms and thyroid hormonal regulation. Physiol Rev. 2006;86(2):435–64.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

Download references

Acknowledgments

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

Author information

Authors and Affiliations

  1. Department of Endocrinology, Medical Park Hospital, Ordu, Turkey

    Feyzi Gokosmanoglu

  2. Department of General Surgery, Medical Park Hospital, Ordu, Turkey

    Erkan Aksoy

  3. Department of Internal Medicine, Medical Faculty, Duzce University, Duzce, Turkey

    Attila Onmez

  4. Department of Internal Medicine, Sinop Ayancık State Hospital, Sinop, Turkey

    Hasan Ergenç

  5. Department of Internal Medicine, Ordu State Hospital, Sinop, Turkey

    Sibel Topkaya

Authors
  1. Feyzi Gokosmanoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erkan Aksoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Attila Onmez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hasan Ergenç
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sibel Topkaya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Attila Onmez.

Ethics declarations

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.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gokosmanoglu, F., Aksoy, E., Onmez, A. et al. Thyroid Homeostasis After Bariatric Surgery in Obese Cases. OBES SURG 30, 274–278 (2020). https://doi.org/10.1007/s11695-019-04151-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-019-04151-5

Keywords

Search

Navigation