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Thyroid Function Before and After Laparoscopic Sleeve Gastrectomy in Patients with Obesity

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Abstract

Background

Effect of laparoscopic sleeve gastrectomy (LSG) on thyroid function of patients with obesity remains unclear. The aim of this study was to evaluate the changes in thyroid function before and after LSG in patients with obesity.

Methods

Data was retrieved from a retrospectively collected database of patients with morbid obesity and normal thyroid function who received LSG. At 12 months after surgery, changes of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and intact parathyroid hormone (iPTH) were evaluated. In addition, the correlation between thyroid hormone levels and body mass index (BMI) and other metabolic indicators and anthropometric parameters were analyzed.

Results

Eighty-five patients were included in the study. The concentrations of FT3 (5.7 ± 0.7 vs 5.1 ± 0.6, p < 0.001) and TSH (2.2 ± 1.0 vs 1.9 ± 0.9, p = 0.002) significantly decreased 12 months postsurgery, while mean FT4 levels increased from12.0 ± 1.9 vs 12.4 ± 2.0 pmol/L (p = 0.013). Furthermore, mean iPTH decreased from 53.3 ± 48.3 to 38.7 ± 13.2 pg/mL (p = 0.011). Multiple stepwise regression analysis showed that changes in LDL levels were an independent factor contributing to changes in TSH levels (β = 0.362, p = 0.001). Moreover, TSH did not correlate with BMI.

Conclusions

In this study, FT3, TSH, and iPTH were decreased in euthyroid patients with obesity after LSG, while FT4 was significantly increased. Changes in TSH were positively correlated with LDL, but no statistically significant correlation was found with BMI. Additionally, FT3, FT4, and iPTH were correlated with VB12, age, and BMI, respectively.

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Abbreviations

BMI:

Body mass index

FT3:

Free triiodothyronine

FT4:

Free thyroxine

HbA1c:

Glycated hemoglobin

LSG:

Laparoscopic sleeve gastrectomy

TSH:

Thyroid-stimulating hormone

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

ANTI-TG:

Anti-thyroglobulin antibody

ANTI-TPO:

Peroxidase antibody

iPTH:

Parathyroid hormone

T0:

Preoperative

T12:

Follow-up 1 year

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Funding

This study was supported by Medical Research Foundation of Guangdong Province (A2019190) and Guangzhou Science and Technology Plan Project (202102010120).

Author information

Authors and Affiliations

  1. Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China

    Yuan Chen, Cunchuan Wang & Wah Yang

  2. Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China

    Yuan Chen, Cunchuan Wang & Wah Yang

  3. Joint Institute of Metabolic Medicine Between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China

    Yuan Chen, Cunchuan Wang & Wah Yang

  4. School of Nursing, Jinan University, Guangzhou, Guangdong, China

    Wen Zhang & Weiju Chen

  5. Department of Thyroid Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China

    Yongqin Pan

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  1. Yuan Chen
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on behalf of Chinese Obesity, Metabolic Surgery Collaborative

Corresponding authors

Correspondence to Cunchuan Wang or Wah Yang.

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Ethical Approval

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. The study was approved by the institutional review boards of the hospital.

Informed Consent

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

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The authors declare no competing interests.

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Yuan Chen and Wen Zhang are co-first authors.

Key Points

1. FT3, TSH, and iPTH were decreased in euthyroid patients with obesity after LSG, while FT4 was significantly increased.

2. The changes in TSH were positively correlated with LDL after LSG, but no statistically significant correlation was found with BMI.

3. FT3, FT4, and iPTH were correlated with VB12, age, and BMI, respectively.

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Chen, Y., Zhang, W., Pan, Y. et al. Thyroid Function Before and After Laparoscopic Sleeve Gastrectomy in Patients with Obesity. OBES SURG 32, 1954–1961 (2022). https://doi.org/10.1007/s11695-022-06035-7

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  • DOI: https://doi.org/10.1007/s11695-022-06035-7

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