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Thyroid function before and after Roux-en-Y gastric bypass: an observational study

Thyroid function before and after Roux-en-Y gastric bypass: an observational study

Authors :
Paula Carolina Dambros Granzotto
Gisah Amaral de Carvalho
Hans Graf
Rodrigo Strobel
Cleo Otaviano Mesa Junior
Rosana Bento Radominski
Source :
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 16(2)
Publication Year :
2019

Abstract

Background Population studies have shown a positive association between thyroid-stimulating hormone (TSH) and body mass index. Recent studies have shown a significant increase in the prevalence of subclinical hypothyroidism (SCH) in obesity. Weight reduction after Roux-en-Y gastric bypass (RYGB) seems to significantly decrease TSH levels. Objectives The purpose of this study was to evaluate the prevalence of SCH in obese patients (class II and III) and to observe the behavior of thyroid hormones (TSH, hormone triiodothyronine, thyroxine, free thyroxine) with significant weight loss after RYGB. Setting Hospital Nossa Senhora das Gracas, Curitiba, Parana, Brazil. Methods We retrospectively reviewed the medical records of 215 obese patients who underwent RYGB between 2005 and 2012 with a follow-up of at least 2 years. The study was observational and descriptive. The selected times for clinical and laboratory evaluations were preoperative, 3, 6, 12, and 24 months after the procedure. Association, correlation, and variance analyses were performed. Results The prevalence of SCH preoperatively was 9.3%. SCH was corrected in 89.5% of patients 12 months after RYGB. We did not find an association between TSH and BMI (r = .002, P = .971). There was a positive impact of bariatric surgery on all metabolic variables. We showed that serum TSH level had no positive correlation with the presence or absence of metabolic syndrome. Conclusions Weight loss after bariatric surgery leads to normalization of TSH levels in most patients and none developed overt hypothyroidism. Obese patients with SCH should not be treated with thyroid hormone replacement. Serial monitoring of thyroid function after obesity therapy seems to be a reasonable approach.

Details

ISSN :
18787533
Volume :
16
Issue :
2
Database :
OpenAIRE
Journal :
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Accession number :
edsair.doi.dedup.....a268ebe0f0c7c6908c4fcb476e8e0483