scholarly journals Thyroid-stimulating hormone, leptin and insulin resistance in patients with obesity after bariatric surgery

2020 ◽  
Vol 17 (2) ◽  
pp. 187-192
Author(s):  
Anna R. Volkova ◽  
Michael B. Fishman ◽  
Galina V. Semikova
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Body Weight ◽  
Thyroid Gland ◽  
Resistance Index ◽  
Thyroid Stimulating Hormone ◽  
Obese Patients ◽  
Free T4 ◽  
Spontaneous Reduction ◽  
Stimulating Hormone

BACKGROUND: The function of the thyroid gland effects on obesity and comorbidities. It has been proven for bariatric surgery to be the most effective in obesity treatment. AIM: to evaluate the dynamics of body weight, thyroid status, leptin and insulin resistance in obese patients after bariatric surgery. MATERIALS AND METHODS: 74 obese patients were observed after bariatric surgery (sleeve gastrectomy 42, gastric bypass - 32); initial body mass index (BMI), thyroid stimulating hormone, free T4, fasting plasma leptin, insulin and glucose were estimated; the insulin resistance index HOMA-IR was calculated. The dynamics of body weight was estimated by BMI and the excess BMI loss (% EBMIL). After 3 years of follow-up, 48 patients were examined. RESULTS: Subclinical hypothyroidism (SH) was detected in 36.5% of patients with high degrees of obesity. A correlation was found between BMI and TSH level (R=0.5; p=0.01). HOMA-IR was increased in most patients with obesity of the II and III degree (4.81.9 ng / ml). In the SH group, the leptin level was significantly higher than in the group with a normal TSH level of 43.07.3 ng / ml and 33.24.6 ng / ml (p=0.004). Among patients with initial SH, spontaneous reduction of TSH levels occurred in 45% patients 3 years after surgery. CONCLUSIONS: Postoperatively, the BMI decrease was associated with the decrease of TSH, leptin and HOMA-IR. The data obtained may reflect the effect of adipose tissue on the functional state of the thyroid gland in patients with high degrees of obesity after bariatric surgery. This seems to be extremely important for maintaining body weight.

scholarly journals Obese patients with higher TSH levels had an obvious metabolic improvement after bariatric surgery

2021 ◽  
Vol 10 (10) ◽  
pp. 1326-1336
Author(s):  
Nannan Bian ◽  
Xiaomeng Sun ◽  
Biao Zhou ◽  
Lin Zhang ◽  
Qiu Wang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Thyroid Function ◽  
Fasting Blood Glucose ◽  
Thyroid Stimulating Hormone ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Free Triiodothyronine ◽  
The Relationship ◽  
Tsh Levels

Objective Bariatric surgery has become the most effective treatment for morbid obesity. Increasing evidence showed that bariatric surgery can alleviate insulin resistance and influence thyroid function. This study aimed to investigate the relationship between changes in thyroid function and adipose tissue insulin resistance (adipo-IR) after bariatric surgery. Methods A total of 287 non-diabetic participants with regular thyroid function were recruited and divided into the lean, overweight and obese groups. Among them, 50 morbidly obese patients submitted to bariatric surgery. Results The obese group had a higher level of adipo-IR, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), FT3/free thyroxine (FT4) and metabolism disorders than the lean and overweight groups. BMI was correlated with TSH, FT3, FT3/FT4 and adipo-IR (r = 0.309, 0.315, 0.322 and 0.651, respectively, all P < 0.001). Adipo-IR was significantly correlated with TSH (r = 0.402, P < 0.001), FT3 (r = 0.309, P < 0.001), and FT3/FT4 (r = 0.228, P < 0.05). Bariatric surgery resulted in a sharp decline in BMI, adipo-IR, TSH, FT3 and FT3/FT4 levels, meanwhile, metabolic disorders improved. The decrease in BMI after bariatric surgery was significantly correlated with reductions in adipo-IR (r = 0.577, P < 0.001) and TSH (r = 0.401, P = 0.005). Interestingly, the fasting blood glucose, fasting insulin, adipo-IR and TSH in the higher TSH group decreased more remarkably than in the lower TSH group. Conclusion Obese individuals with higher TSH levels had an obvious metabolic improvement after bariatric surgery.

scholarly journals Plasma Osteopontin Increases After Bariatric Surgery and Correlates with Markers of Bone Turnover But Not with Insulin Resistance

2008 ◽  
Vol 93 (6) ◽  
pp. 2307-2312 ◽  
Author(s):  
Michaela Riedl ◽  
Greisa Vila ◽  
Christina Maier ◽  
Ammon Handisurya ◽  
Soheila Shakeri-Manesch ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Resistance Index ◽  
Model Assessment ◽  
Obese Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Insulin Resistance Index ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Abstract Context: Osteopontin (OPN) is a multifunctional protein involved in bone metabolism, cardiovascular disease, diabetes, and obesity. OPN levels are elevated in the plasma and adipose tissue of obese subjects, and are decreased with diet-induced weight loss. Objective: We investigated the effect of bariatric surgery on plasma OPN concentrations in morbidly obese patients. Setting: The study was performed at a university hospital. Subjects: We investigated 40 obese patients aged 43.1 ± 1.8 yr, scheduled to undergo bariatric surgery. Roux-en-Y gastric bypass (RYGB) was performed in 30 subjects (27 females, three males), and laparoscopic adjustable gastric banding (LAGB) in 10 subjects (eight females, two males). Study Design: All patients were studied before and 1 yr (10.3–14.8 months) after the intervention. Main Outcome Measures: OPN, leptin, C-reactive protein, insulin, the homeostatic model assessment insulin resistance index, calcium, 25-hydroxyvitamin D, C telopeptide, and osteocalcin were determined. Results: Both bariatric procedures significantly reduced body weight, body mass index, insulin, leptin, and C-reactive protein 1 yr after surgery. Plasma OPN increased from 31.4 ± 3.8 to 52.8 ± 3.7 ng/ml after RYGB (P &lt; 0.001) and from 29.8 ± 6.9 to 46.4 ± 10.6 ng/ml after LAGB (P = 0.042). Preoperative OPN correlated with age, insulin, the homeostatic model assessment insulin resistance index, and postoperative OPN. Postoperative OPN correlated with C telopeptide and osteocalcin. Conclusions: One year after RYGB and LAGB, plasma OPN levels significantly increased and correlated with biomarkers of bone turnover. Unlike other proinflammatory cytokines, OPN does not normalize but increases further after bariatric surgery.

scholarly journals Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1121 ◽  
Author(s):  
Paula Juiz-Valiña ◽  
Elena Outeiriño-Blanco ◽  
Sonia Pértega ◽  
Bárbara María Varela-Rodriguez ◽  
María García-Brao ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Obese Patients ◽  
Excess Bmi Loss ◽  
Tsh Levels ◽  
Over Time ◽  
Stimulating Hormone

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.

POSTOPERATIVE COMPLIANCE OF BARIATRIC SURGERY PATIENTS REGARDING THE ASSESSMENT OF SERUM LEPTIN LEVELS AND INSULIN RESISTANCE

2019 ◽  
Vol 49 (1/2019) ◽  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Serum Levels ◽  
Medical Laboratory ◽  
Leptin Resistance ◽  
Obese Patients ◽  
Laboratory Assessment ◽  
Serum Leptin ◽  
Before And After ◽  
Bariatric Patients

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance

Infants Diagnosed with Athyreosis on Scintigraphy May Have a Gland Present on Ultrasound and Have Transient Congenital Hypothyroidism

2021 ◽  
pp. 1-8
Author(s):  
Niamh McGrath ◽  
Colin Patrick Hawkes ◽  
Stephanie Ryan ◽  
Philip Mayne ◽  
Nuala Murphy
Keyword(s):  
Thyroid Gland ◽  
Congenital Hypothyroidism ◽  
Thyroid Tissue ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Ultrasound ◽  
Free T4 ◽  
Median Serum ◽  
Thyroid Glands ◽  
Rule Out

Scintigraphy using technetium-99m (<sup>99m</sup>Tc) is the gold standard for imaging the thyroid gland in infants with congenital hypothyroidism (CHT) and is the most reliable method of diagnosing an ectopic thyroid gland. One of the limitations of scintigraphy is the possibility that no uptake is detected despite the presence of thyroid tissue, leading to the spurious diagnosis of athyreosis. Thyroid ultrasound is a useful adjunct to detect thyroid tissue in the absence of <sup>99m</sup>Tc uptake. <b><i>Aims:</i></b> We aimed to describe the incidence of sonographically detectable in situ thyroid glands in infants scintigraphically diagnosed with athyreosis using <sup>99m</sup>Tc and to describe the clinical characteristics and natural history in these infants. <b><i>Methods:</i></b> The newborn screening records of all infants diagnosed with CHT between 2007 and 2016 were reviewed. Those diagnosed with CHT and athyreosis confirmed on scintigraphy were invited to attend a thyroid ultrasound. <b><i>Results:</i></b> Of the 488 infants diagnosed with CHT during the study period, 18/73 (24.6%) infants with absent uptake on scintigraphy had thyroid tissue visualised on ultrasound (3 hypoplastic thyroid glands and 15 eutopic glands). The median serum thyroid-stimulating hormone (TSH) concentration at diagnosis was significantly lower than that in infants with confirmed athyreosis (no gland on ultrasound and no uptake on scintigraphy) (74 vs. 270 mU/L), and median free T4 concentration at diagnosis was higher (11.9 vs. 3.9 pmol/L). Six of 10 (60%) infants with no uptake on scintigraphy but a eutopic gland on ultrasound had transient CHT. <b><i>Conclusion:</i></b> Absent uptake on scintigraphy in infants with CHT does not rule out a eutopic gland, especially in infants with less elevated TSH concentrations. Clinically, adding thyroid ultrasound to the diagnostic evaluation of infants who have athyreosis on scintigraphy may avoid committing some infants with presumed athyreosis to lifelong levothyroxine treatment.

Genetic thyroid stimulating hormone regulation of atrial fibrillation risk is mediated through an effect on height

2021 ◽  
Author(s):  
Mingjian Shi ◽  
Ali M Manouchehri ◽  
Christian M Shaffer ◽  
Nataraja Sarma Vaitinadin ◽  
Jacklyn N Hellwege ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Genetic Association ◽  
Multiple Testing ◽  
Mendelian Randomization ◽  
Later Life ◽  
Thyroid Stimulating Hormone ◽  
Hormone Regulation ◽  
Nucleotide Polymorphisms ◽  
Free T4 ◽  
Stimulating Hormone

Abstract Background A genetic predisposition to lower thyroid stimulating hormone (TSH) levels associates with increased atrial fibrillation (AF) risk through undefined mechanisms. Defining the genetic mediating mechanisms could lead to improved targeted therapies to mitigate AF risk. Methods We used two-sample Mendelian randomization (MR) to test associations between TSH-associated single nucleotide polymorphisms (SNPs) and 16 candidate mediators. We then performed multivariable Mendelian randomization (MVMR) to test for a significant attenuation of the genetic association between TSH and AF, after adjusting for each mediator significantly associated with TSH. Results Four candidate mediators (free T4, systolic blood pressure, heart rate, and height) were significantly inversely associated with genetically predicted TSH after adjusting for multiple testing. In MVMR analyses, adjusting for height significantly decreased the magnitude of the association between TSH and AF from -0.12 (s.e. 0.02) occurrences of AF per standard deviation change in height to -0.06 (0.02) (p=0.005). Adjusting for the other candidate mediators did not significantly attenuate the association. Conclusions The genetic association between TSH and increased AF risk is mediated, in part, by taller stature. Thus, some genetic mechanisms underlying TSH variability may contribute to AF risk through mechanisms determining height occurring early in life that differ from those driven by thyroid hormone level elevations in later life.

Thyroid Volume and Thyroid Function Parameters Are Independently Associated with Weight Status in Overweight Children

2020 ◽  
Vol 93 (5) ◽  
pp. 279-286
Author(s):  
Nina Lass ◽  
Andre Barth ◽  
Thomas Reinehr
Keyword(s):  
Insulin Resistance ◽  
Thyroid Function ◽  
Weight Status ◽  
Resistance Index ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Normal Weight ◽  
Function Parameter ◽  
Overweight Children ◽  
Cross Sectional

<b><i>Background:</i></b> A relation between thyroid-stimulating hormone (TSH), insulin resistance – both of which are related to obesity – and thyroid volume has been suggested. Therefore, we analyzed thyroid volume and structure in relation to thyroid function parameters, weight status, and insulin resistance. <b><i>Methods:</i></b>This is a cross-sectional study in which weight status (BMI-SDS), thyroid function parameters (TSH, free tri-iodothyronine [fT3], and free thyroxine [fT4]), insulin resistance index (HOMA-IR), and thyroid volume (ultrasound) were determined in 617 overweight children (aged 10.4 ± 2.2 years, 50% male, BMI-SDS 2.5 ± 0.6) and in 27 normal-weight children of a similar age and gender. Furthermore, changes in thyroid volume and structure, and thyroid function parameters were analyzed in 83 obese children (51% male, mean age 10.3 ± 2.2) at baseline and at the end of a 1-year lifestyle intervention. <b><i>Results:</i></b> Overweight children had a significant greater thyroid volume (4.2 ± 1.8 vs. 4.1 ± 0.5 mL) and higher TSH (3.1 ± 1.5 vs. 2.4 ± 1.1 mU/L) and fT3 (4.4 ± 0.7 vs. 4.1 ± 0.5 pg/mL) concentrations compared to normal-weight children. In multiple linear regression analyses adjusted to multiple confounders, thyroid volume was significantly related to BMI-SDS (<i>b</i> coefficient 0.44 ± 0.10, <i>r</i><sup>2</sup> = 0.41) but not to any thyroid function parameter or HOMA-IR. Changes in BMI-SDS were significantly associated with changes in thyroid volume (<i>r</i> = 0.22). The changes in thyroid volume were not correlated to changes of any thyroid function parameter or HOMA-IR. <b><i>Conclusions:</i></b> Thyroid volume is positively correlated to weight status in childhood obesity and the change is reversible after weight loss independently of thyroid function parameters and insulin resistance. Further studies are needed to understand why thyroid volume is increased reversibly in overweight children.

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