Short-term Change in Resting Energy Expenditure and Body Compositions in Therapeutic Process for Graves' Disease

Abstract

Objective In the medical treatment of Graves' disease, we sometimes encounter patients who gain weight after the onset of the disease. To estimate the energy required during the course of treatment when hyperthyroidism ameliorates, we measured the resting energy expenditure (REE) and body composition in patients with Graves' disease before and during treatment in the short-term. Methods Twenty patients with newly diagnosed Graves' disease were enrolled, and our REE data of 19 healthy volunteers were used. The REE was measured by a metabolic analyzer, and the basal energy expenditure (BEE) was estimated by the Harris-Benedict formula. The body composition, including body weight, fat mass (FM), muscle mass (MM) and lean body mass (LBM), were measured by a multi-frequency body composition analyzer. We tailored the nutritional guidance based on the measured REE. Results Serum thyrotropin levels were significantly increased at three and six months. Serum free thyroxine, free triiodothyronine and REE values were significantly decreased at one, three and six months. The REE/BEE ratio was 1.58±0.28 at the onset and significantly declined to 1.34±0.34, 1.06±0.19 and 1.01±0.16 at 1, 3 and 6 months, respectively. Body weight, MM and LBM significantly increased at three and six months. Conclusion The REE significantly decreased during treatment of Graves' disease. The decline was evident as early as one month after treatment. The REE after treatment was lower than in healthy volunteers, which may lead to weight gain. These data suggest that appropriate nutritional guidance is necessary with shortterm treatment before the body weight normalizes in order to prevent an overweight condition and the emergence of metabolic disorders.

Dysthyroidism in dermato/polymyositis patients: A case‐control study

“…We would, anyway, expect a significant change in the clinical features of the original disease after starting treatment of the thyroid impairments, based on what it is currently known from the scholarly. 30,31 Clinical trials should be conducted to confirm our hypothesis.…”

“…However, being the present study a retrospective investigation based on a health claims database, we do not have data concerning patients' global functionality after and during management of the thyroid disturbances. We would, anyway, expect a significant change in the clinical features of the original disease after starting treatment of the thyroid impairments, based on what it is currently known from the scholarly 30,31 . Clinical trials should be conducted to confirm our hypothesis.…”

Resting Energy Expenditure and Cold-induced Thermogenesis in Patients With Overt Hyperthyroidism

“…Lower capacity of CIT has recently been shown to be associated with a higher propensity to weight gain underscoring a potential role of BAT and CIT in the prevention of obesity ( 34 ). Weight loss is common in hyperthyroidism, but a significant proportion of patients treated for hyperthyroidism quickly regains weight when returning to the euthyroid state, sometimes even exceeding predisease body weight ( 35 , 36 ). We wondered whether weight regain was associated with changes in thermogenesis during hyperthyroidism.…”

Alterations of Serum Leptin Levels in Patients with Autoimmune Thyroid Disorders

“…However, today, it is known to signal a switch from the fed to starved state, suggesting an important interplay between thyroid hormones and leptin ( 33 ). Patients with thyroid dysfunction usually return to a normal thyroid state within the first 2 to 3 months after treatment, although changes in the body composition continue for months ( 34 , 35 ). Nevertheless, it is not clear whether leptin contributes to this complication.…”