Abstract
Background: Obesity may affect both biochemical thyroid function tests; and thyroid morphology, as assessed using ultrasound scans (US). The aim of the present pilot study was to explore whether weight loss achieved by bariatric surgery alters thyroid US morphology including gray-scale measurements; and/or function in euthyroid adults with severe obesity.Methods: Euthyroid adults (>18 years) with body mass index (BMI) ≥40 kg/m2 and negative thyroid peroxidase antibodies were assessed at baseline (pre-surgery) and after achieving at least 5% weight loss of their baseline body weight following bariatric surgery. Anthropometric assessments, biochemical/hormonal measurements (TSH, free-T4, free-T3, reverse-T3, and leptin) and thyroid US with gray-scale histogram analysis were performed at the baseline and post-surgery follow-up.Results: Ten Caucasian, euthyroid patients (women/men: 8/2; age: 48.6 ± 3.1 years; BMI: 51.4 ± 1.8 kg/m2) successfully completed this study with significantly decreased body weight (>5% weight loss), waist circumference and serum leptin levels post-surgery (mean post-surgery follow-up duration: 16.5 ± 2.5 months). In parallel to the observed bariatric-induced weight loss, thyroid US echogenicity increased by 25% (p = 0.03), without significant changes in thyroid volume. No significant changes in thyroid function tests were detected. No significant correlations were observed between the increase in thyroid echogenicity and the decreases in anthropometric parameters and circulating leptin.Conclusion: Our results indicate that in euthyroid adults with severe obesity, marked weight loss achieved by bariatric surgery is associated with a parallel significant increase in the thyroid US echogenicity, suggesting that morphological changes of the thyroid in obesity are reversible with weight loss.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03048708
Highlights
By 2025, the global prevalence of obesity is expected to reach 18 and 21% in men and women, respectively, with a progressively increasing burden of obesity-related disease [1, 2]
Representative thyroid ultrasound scanning images before and after bariatric surgery for a study participant who achieved 18% body weight loss following bariatric surgery is presented in Supplementary Figure S1
To the best of our knowledge, this is the first study in euthyroid adults with severe obesity showing that marked weight loss achieved by bariatric surgery is followed by a parallel significant increase in the thyroid ultrasound scanning (US) echogenicity
Summary
By 2025, the global prevalence of obesity is expected to reach 18 and 21% in men and women, respectively, with a progressively increasing burden of obesity-related disease [1, 2]. The aim of the present pilot study was to explore whether weight loss achieved by bariatric surgery may result in changes of the thyroid morphology and/or function in euthyroid adults with severe obesity. Obesity may affect both biochemical thyroid function tests; and thyroid morphology, as assessed using ultrasound scans (US). The aim of the present pilot study was to explore whether weight loss achieved by bariatric surgery alters thyroid US morphology including gray-scale measurements; and/or function in euthyroid adults with severe obesity
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