Abstract
Obesity is associated with several endocrine abnormalities, including thyroid dysfunction. The objective of this study was to investigate the effect of weight loss after bariatric surgery on thyroid-stimulating hormone (TSH) levels in euthyroid patients with morbid obesity. We performed an observational study, evaluating patients with morbid obesity submitted to bariatric surgery. We included 129 patients (92 women) and 31 controls (21 women). Clinical, anthropometric, biochemical, and hormonal parameters were evaluated. The primary endpoint was circulating TSH (µU/mL). Fasting TSH levels were higher in the obese group (3.3 ± 0.2) than in the control group (2.1 ± 0.2). The mean excessive body mass index (BMI) loss (EBMIL) 12 months after bariatric surgery was 72.7 ± 2.1%. TSH levels significantly decreased in the obese patients after surgery; 3.3 ± 0.2 vs. 2.1 ± 0.2 before and 12 months after surgery, respectively. Free thyroxine (T4) (ng/dL) levels significantly decreased in the obese patients after surgery; 1.47 ± 0.02 vs. 1.12 ± 0.02 before and 12 months after surgery, respectively. TSH decreased significantly over time, and the decrement was associated with the EBMIL. In euthyroid patients with morbid obesity, weight loss induced by bariatric surgery promotes a significant decline of the increased TSH levels. This decrement of TSH is progressive over time after surgery and significantly associated with excess BMI loss.
Highlights
IntroductionSince 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries
Obesity is a major public health problem
Fasting thyroid-stimulating hormone (TSH) levels significantly decreased in the obese patients after surgery induced weight loss; 3.3 ± 0.2 vs. 2.1 ± 0.2 for the obese patients before and 12 months after surgery, respectively
Summary
Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. A high body mass index (BMI) accounts for some 4.0 million deaths globally. Nutrients 2019, 11, 1121 related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990 [1]. The age-adjusted prevalence of obesity in the United States in 2013–2014 was 35.0% among men and 40.4% among women. The corresponding values for class three obesity were 5.5% for men and 9.9% for women [2]. Bariatric surgery (BS) using laparoscopic banding, gastric bypass, or laparoscopic sleeve gastrectomy, compared with usual care nonsurgical obesity management, was associated with more marked improvement in several comorbidities and lower all-cause mortality [6]
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