Abstract
BackgroundBariatric surgery (BS) was shown to promote a decline in thyroid-stimulating hormone (TSH) in euthyroid patients with severe obesity in the short-term. Aim of the present study was to assess the effect of weight loss on thyroid function in euthyroid patients in the long-term following different bariatric procedures.MethodsIn a retrospective cohort study including 135 patients at baseline, thyroid function was assessed at six time points up to 8 years after surgery. Patients were stratified by TSH levels at baseline and divided into two groups to compare the change in TSH at long-time. We used log-linear regression to assess the relation between thyroid hormones and TSH and linear regression analyses to identify variables that were thought to determine TSH and fT3/fT4-ratio as well as their change long-term.ResultsOver a mean follow-up of 8 years, TSH and fT3/fT4-ratio declined (both p < 0.001). Patients with high-normal TSH showed a greater decline in TSH than those with normal TSH compared to baseline. Thyroid hormones and TSH displayed a negative log-linear correlation at long-term follow-up. Change in TSH at long-time showed a negative correlation with TSH at baseline (B = −0.55; p < 0.001). With regard to type of surgery, there were no significant differences in TSH.ConclusionBS promotes a decline of TSH in euthyroid patients up to 8 years after intervention despite weight regain. The greatest change in TSH was seen among patients with high-normal baseline-TSH. Results of log-linear regression suggest recovery of the pituitary-thyroid axis. Type of surgery did not affect the change in TSH levels over time.
Highlights
In the last few decades the prevalence of obesity constantly increased reaching pandemic levels
Patients with severe obesity may have transient hypothyroidism caused by an increase in leptin-levels that resolves following Roux-en-Y gastric bypass (RYGB) [8]
Data on cardiovascular comorbidities were recorded at baseline and data on post-surgical complications were recorded over the follow-up period. fT3 and fT4 were measured by a sandwich chemiluminescence homogeneous immunoassay (LOCI-technology, Dimension Vista 1500 Analyzer, Siemens Healthineers)
Summary
In the last few decades the prevalence of obesity constantly increased reaching pandemic levels. Severe obesity has previously shown to be associated with high-normal serum levels of thyroid stimulating hormone (TSH) and free triiodothyronine (fT3) in euthyroid adults [3]. Bariatric surgery (BS) was shown to promote a decline in thyroid-stimulating hormone (TSH) in euthyroid patients with severe obesity in the short-term. Aim of the present study was to assess the effect of weight loss on thyroid function in euthyroid patients in the long-term following different bariatric procedures. METHODS: In a retrospective cohort study including 135 patients at baseline, thyroid function was assessed at six time points up to 8 years after surgery. Patients were stratified by TSH levels at baseline and divided into two groups to compare the change in TSH at long-time.
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