Thyroid Function Alteration in Obesity and the Effect of Bariatric Surgery

被引:15
作者
Cordido, Maria [1 ,2 ,3 ]
Juiz-Valina, Paula [1 ,2 ]
Urones, Paula [1 ,2 ]
Sangiao-Alvarellos, Susana [1 ,2 ]
Cordido, Fernando [1 ,2 ,4 ]
机构
[1] Univ A Coruna, Fac Ciencias Salud, Grp Fisiopatol Endocrina Nutr & Med FENM, La Coruna 15006, Spain
[2] Univ A Coruna, Ctr Invest Cient Avanzadas CICA, Inst Invest Biomed INIB, La Coruna 15006, Spain
[3] Hosp Univ Coruna, Serv Urgencias, La Coruna 15006, Spain
[4] Hosp Univ Coruna, Serv Endocrinol & Nutr, La Coruna 15006, Spain
关键词
obesity; endocrine abnormalities; bariatric surgery; hypothyroidism; Y GASTRIC BYPASS; LAPAROSCOPIC SLEEVE GASTRECTOMY; WEIGHT-LOSS; ADIPOSE-TISSUE; REDUCED SENSITIVITY; GROWTH-HORMONE; MORBID-OBESITY; SUBCLINICAL HYPOTHYROIDISM; REPLACEMENT THERAPY; JEJUNOILEAL BYPASS;
D O I
10.3390/jcm11051340
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The most common endocrine disease in obesity is hypothyroidism and secondary endocrine alterations, including abnormal thyroid function, are frequent in obesity. It is unclear whether impaired thyroid function is the cause or the consequence of increased adiposity; furthermore, there are no clear data regarding the best way to dose levothyroxine for patients with both hypothyroidism and obesity, and the effect of bariatric surgery (BS). The aim of the present article is to review some controversial aspects of the relation between obesity and the thyroid: (1) Thyroid function in obesity and the effect of BS (2) Thyroid hormone treatment (THT) in obese patients with hypothyroidism and the effect of BS. In summary: In morbidly obese patients, TSH is moderately increased. Morbid obesity has a mild central resistance to the thyroid hormone, reversible with weight loss. In morbidly obese hypothyroid patients, following weight loss, the levothyroxine dose/kg of ideal weight did not change, albeit there was an increment in the levothyroxine dose/kg of actual weight. From a clinical practice perspective, in morbid obesity, diagnosing mild hypothyroidism is difficult, BS improves the altered thyroid function and THT can be adapted better if it is based on ideal weight.
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页数:13
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