Prevalence of Endocrine Disorders in Morbidly Obese Patients and the Effects of Bariatric Surgery on Endocrine and Metabolic Parameters

Janković, Draženka; Wolf, Peter; Anderwald, Christian; Winhofer, Yvonne; Promintzer-Schifferl, Miriam; Hofer, Astrid; Langer, Felix B.; Prager, Gerhard; Ludvik, Bernhard; Gessl, Alois; Luger, Anton; Krebs, Michael

doi:10.1007/s11695-011-0545-4

Cited by 57 publications

(50 citation statements)

References 50 publications

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“…Most [12][13][14][15][16], but not all [17][18][19], studies evaluating the variation of TSH after bariatric surgery have also shown a decrease of TSH after the procedure. Moulin de Moraes et al [13] reported that in 54 euthyroid patients submitted to RYGB there was a significant decrease in TSH that was not correlated to percent change in BMI and a significant decrease in FT3 but not in FT4.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism and the clinical implications of this alteration remains uncertain. Furthermore, the effect of bariatric surgery on postoperative thyroid function remains incompletely understood with previous studies showing contradictory results regarding the variation of TSH after bariatric surgery and the relation of TSH variation with postoperative weight loss [12][13][14][15][16][17][18][19]. Therefore, our aim was to evaluate the effect of weight loss after bariatric surgery on TSH variation in patients with morbid obesity and normal thyroid function.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

et al. 2017

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Background Several studies have reported that morbid obesity is associated with increased thyroid-stimulating hormone (TSH) levels. However, it is not clear what is the impact of bariatric surgery on postoperative thyroid function. The aim of this study was to evaluate the effect of weight loss after bariatric surgery on TSH levels in euthyroid patients with morbid obesity. TSH, free thyroxine (FT4), free triiodothyronine (FT3), type of surgery, and excessive body weight loss (EBWL) on TSH variation 12 months after surgery was evaluated. MethodsResults The high-normal TSH group (24.3% of patients) included more women, presented a higher BMI, higher systolic blood pressure, and higher FT3 levels. There was a significant decrease of TSH 12 months after surgery that was more marked in the high-normal TSH group (normal TSH group: 1.57 ± 0.49 to 1.53 ± 0.69 mIU/L, p = 0.063; high-normal TSH group: 3.23 ± 0.59 to 2.38 ± 0.86 mIU/L, p < 0.001). In a multivariate analysis, after adjusting for relevant covariates, EBWL, baseline BMI, and baseline FT3 were significantly associated with TSH decrease 12 months after bariatric surgery.Conclusion Bariatric surgery promotes a decrease of TSH that is significantly greater in patients with high-normal TSH and is independently associated with EBWL after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

et al. 2017

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“…In study by Janković et al [20], which included 44 patients with clinical hypothyroidism and 32 with subclinical hypothyroidism, they found normalization of the TSH levels after weight loss by bariatric surgery; they did not specify the type of surgery or change in thyroxin requirements.…”

Section: Discussionmentioning

confidence: 99%

Effect of Laparoscopic Sleeve Gastrectomy on Clinical Hypothyroidism in Morbidly Obese Patients

Elnabil¹,

Ahmed²,

Mostafa³

2017

Thyroid Disorders Ther

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“…Screening studies for obese populations usually revealed a low prevalence of CS except for one study that found a prevalence of 9% (6,31,32,33). Moreover, false-positivity rate was found to be 25%, which resulted in unnecessary further investigations (6).…”

Section: Discussionmentioning

confidence: 99%

Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

Karaca

Acmaz

Açmaz

et al. 2013

European Journal of Endocrinology

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Context: Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. Objective: Screening of CS in patients with hirsutism. Setting: Referral hospital. Patients and other participants: This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. Intervention: All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. Main outcome measure: Response to LDDST in patients presenting with hirsutism. Results: All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. Conclusion: Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.

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Prevalence of Endocrine Disorders in Morbidly Obese Patients and the Effects of Bariatric Surgery on Endocrine and Metabolic Parameters

Abstract: CS appears to be a rare cause of morbid obesity. Normalization of slightly elevated thyrotropin after weight loss suggests that obesity causes TSH elevation rather than the reverse.

Cited by 57 publications

References 50 publications

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obesity and Normal Thyroid Function

Effect of Laparoscopic Sleeve Gastrectomy on Clinical Hypothyroidism in Morbidly Obese Patients

Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

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