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Changes in Thyroid Replacement Therapy after Bariatric Surgery: Differences between Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy

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Abstract

Introduction

Levothyroxine (LT4) requirements can presumably be modified differently after laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). The present study compared changes in LT4 dose in hypothyroid subjects undergoing LRYGB or LSG 2 years after the procedure.

Material and Methods

A 2-year follow-up observational study was conducted in a prospective cohort of obese patients who had undergone bariatric surgery and were receiving LT4. Indication for the type of surgical procedure was based on clinical criteria. Repeated measures ANOVA models were used to examine differences within and between groups.

Results

Thirty-five consecutive patients were included for analysis: 22 LRYGB and 13 LSG. Total daily LT4 dosage decreased in the LSG group (133.7 ± 50.3 mcg/day at baseline to 104.3 ± 43.3 mcg/day at 2 years; p = 0.047) whereas it remained stable in the LRYGB group (129.5 ± 46.1 mcg/day at baseline to 125.2 ± 55.7 mcg/day at 2 years; p = 1.000). Differences between groups became significant at 24 months. Daily weight-based LT4 dose increased in the LRYGB group (1.11 ± 0.38 mcg/kg day at baseline to 1.57 ± 0.74 mcg/kg day at 2 years; p = 0.005) with no significant changes in the LSG group (1.15 ± 0.35 mcg/kg day at baseline vs 1.11 ± 0.49 mcg/kg day at 2 years; p = 1.000).

Conclusion

LRYGB and LSG showed different changes in LT4 requirements 2 years after surgery. There was an early decrease in daily total LT4 dose requirements after LSG, which suggests an early preventive reduction to be validated in future studies.

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Acknowledgements

We thank Miss Christine O’Hara for the review of the English version of the manuscript. CIBEROBN and CIBERESP are an initiative of the Instituto de Salud Carlos III (ISCIII).

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Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital del Mar, Paseo Marítimo, 25-29, E-08003, Barcelona, Spain

    Helena Julià, David Benaiges, Juan Pedro-Botet, Montserrat Villatoro, Laia Fontané, Elisenda Climent, Juana A. Flores Le Roux & Alberto Goday

  2. Department of Medicine, Universitat Autònoma de Barcelona, Campus Universitari Mar. Dr. Aiguader, 80, E-08003, Barcelona, Spain

    Helena Julià, David Benaiges, Paula Mollà, Juan Pedro-Botet, Elisenda Climent, Juana A. Flores Le Roux & Alberto Goday

  3. Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Dr Aiguader, 80, E-08003, Barcelona, Spain

    David Benaiges, Juan Pedro-Botet, Jose M. Ramon, Juana A. Flores Le Roux & Alberto Goday

  4. Unit of Gastrointestinal Surgery, Hospital del Mar, Institut de Recerca IMIM-Hospital del Mar, Barcelona, Spain

    Jose M. Ramon

  5. CiberOBN, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0, E-28029, Madrid, Spain

    Alberto Goday

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  1. Helena Julià
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Correspondence to David Benaiges.

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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 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Julià, H., Benaiges, D., Mollà, P. et al. Changes in Thyroid Replacement Therapy after Bariatric Surgery: Differences between Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy. OBES SURG 29, 2593–2599 (2019). https://doi.org/10.1007/s11695-019-03890-9

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