Skip to main content
SpringerLink
Log in

Evolution of Subclinical Hypothyroidism and its Relation with Glucose and Triglycerides Levels in Morbidly Obese Patients After Undergoing Sleeve Gastrectomy as Bariatric Procedure

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Background

There is an increased prevalence of subclinical hypothyroidism (SCH) in patients with obesity. It is unclear if this biochemical abnormality may be a secondary phenomenon of obesity or a real hypothyroid state.

Methods

A retrospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and November 2012 was performed. Weight loss, body mass index (BMI) and excess weight loss, baseline glucose, lipid profiles, and TSH levels were obtained before operation and postoperative determinations at 3, 6, and 12 months after surgery.

Results

Sixty patients were included. Prevalence of subclinical hypothyroidism was 16.7 % preoperatively, 10 % at 3 months, 3.3 % at 6 months, and 1.7 % at 12 months. A significant correlation could be established between TSH decrease and weight loss at 12 months (Pearson 0.603; p = 0.007). TSH decrease showed a significant correlation with glucose and glycated hemoglobin decrease from 6th month onwards. Referring to lipid profile, an association of TSH decrease with total cholesterol, LDL cholesterol, or HDL cholesterol could not be determined. A significant association between TSH decrease and triglycerides and cardiovascular risk index triglycerides/HDL cholesterol reductions could also be established 12 months after surgery.

Conclusions

SCH is usually corrected after bariatric surgery, while there are no significant changes in total or LDL cholesterol. This suggests that, in morbidly obese subjects, SCH is, in most patients, just a consequence of the abnormal fat accumulation and not a real hypothyroid state.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tuzcu A, Bahceci M, Gokalp D, et al. Subclinical hypothyroidism may be associated with elevated high-sensitive C-reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocrine J. 2005;52:89–94.

    Article  CAS  Google Scholar 

  2. Vanderpump M. Subclinical hypothyroidism: the case against treatment. Trends Endocrinol Metab. 2003;14:262–6.

    Article  CAS  PubMed  Google Scholar 

  3. Diaz-Olmos R, Nogueira AC, Penalva DQF, et al. Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace. Sao Paulo Med J. 2010;128:18–23.

    Article  PubMed  Google Scholar 

  4. De Pergola G, Ciampolillo A, Paolotti S, et al. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrino (Oxf). 2007;67:265–9.

    Article  Google Scholar 

  5. Biondi B, Palmieri EA, Lombardi G, et al. Effects of subclinical thyroid dysfunction on the heart. Ann Intern Med. 2002;137:904–14.

    Article  PubMed  Google Scholar 

  6. Gaziano JM, Hennekens CH, O’Donnell CJ, et al. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation. 1997;96:2520–5.

    Article  CAS  PubMed  Google Scholar 

  7. Mehta S, Mathur D, Chaturvedi M, et al. Thyroid hormone profile in obese subjects—a clinical study. J Indian Med Assoc. 2001;99:260–72.

    CAS  PubMed  Google Scholar 

  8. Roelfsema F, Veldhuis JD. Thyrotropin secretion patterns in health and disease. Endocrine Rev 2013. doi:10.1210/er.2012-1076.

  9. Nyrnes A, Jorde R, Sundsfjord J. Serum TSH is positively associated with BMI. Int J Obes (Lond). 2006;30:100–5.

    Article  CAS  Google Scholar 

  10. Fox CS, Pencina MJ, D’Agostino RB, et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med. 2008;168:587–92.

    Article  PubMed  Google Scholar 

  11. Chikunguwo S, Brethauer S, Nirujogi V, et al. Influence of obesity and surgical weight loss on thyroid hormone levels. Surg Obes Relat Dis. 2007;3:631–5.

    Article  PubMed  Google Scholar 

  12. Marzullo P, Minocci A, Tagliaferri MA, et al. Investigations of thyroid hormones and antibodies in obesity: leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal and weight-related determinants. J Clin Endocrinol Metab. 2010;95:3965–72.

    Article  CAS  PubMed  Google Scholar 

  13. Rotondi M, Leporati P, Rizza MI, et al. Raised serum TSH in morbid-obese and non-obese patients: effect of the circulating lipid profile. Endocrine 2013. doi:10.1007/S12020-013-9928-8.

  14. Frias Lopez MC, Tárraga Lopez PJ, Rodriguez Montes JA, et al. Hipotiroidismo subclínico y factores de riesgo cardiovascular. Nutr Hosp. 2011;26:1355–62.

    Google Scholar 

  15. Velkoska Nakova V, Krstevska B, Bosevski M, et al. Dyslipidemia and hypertension in patients with hypothyroidism. Prilozi. 2009;30:93–102.

    CAS  PubMed  Google Scholar 

  16. Vierhapper H, Nardi A, Grosser P. Prevalence of paradoxically normal serum cholesterol in morbidly obese women. Metabolism. 2000;49:607–10.

    Article  CAS  PubMed  Google Scholar 

  17. Ruiz-Tovar J, Oller I, Tomas A, et al. Midterm impact of sleeve gastrectomy, calibrated with a 50-Fr bougie, on weight loss, glucose hemostasis, lipid profiles and comorbidities in morbidly obese patients. Am Surg. 2012;78:969–74.

    PubMed  Google Scholar 

  18. Galofre JC, Pujante P, Abreu C, et al. Relationship between thyroid-stimulating hormone and insulin in euthyroid obese men. Ann Nutr Metab. 2008;53:188–94.

    Article  CAS  PubMed  Google Scholar 

  19. Kouidhi S, Berhouma R, Ammar M, et al. Relationship of thyroid function with obesity and type 2 diabetes in euthyroid Tunisian subjects. Endocr Res. 2013;38:15–23.

    Article  CAS  PubMed  Google Scholar 

  20. Celik C, Abali R, Tasdemir N, et al. Is subclinical hypothyroidism contributing dyslipidemia and insulin resistance in women with polycystic ovary syndrome? Gynecol Endocrinol. 2012;28:615–8.

    Article  CAS  PubMed  Google Scholar 

  21. Proces S, Delgrange E, Vander Borght TV, et al. Minor alterations in thyroid-function tests associated with diabetes mellitus and obesity in outpatients without known thyroid illness. Acta Clin Belg. 2001;56:86–90.

    Article  CAS  PubMed  Google Scholar 

  22. Velija-Asimi Z, Karamehic J. The effects of treatment of subclinical hypothyroidism on metabolic control and hyperinsulinemia. Med Arh. 2007;61:20–1.

    PubMed  Google Scholar 

Download references

Conflict of Interest

All authors (Jaime Ruiz-Tovar, MD, PhD; Evangelina Boix, MD, PhD; Isabel Galindo, MD; Lorea Zubiaga, MD; María Diez, MD; Antonio Arroyo, MD, PhD; and Rafael Calpena, MD, PhD) declare that they have no conflict of interests in the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Bariatric Surgery Unit, Department of Surgery, General University Hospital Elche, Elche, Alicante, Spain

    Jaime Ruiz-Tovar, Isabel Galindo, Lorea Zubiaga, María Diez, Antonio Arroyo & Rafael Calpena

  2. Bariatric Surgery Unit, Department of Endocrinology, General University Hospital Elche, Elche, Alicante, Spain

    Evangelina Boix

  3. Corazon de Maria, 64, 7º J, 28002, Madrid, Spain

    Jaime Ruiz-Tovar

Authors
  1. Jaime Ruiz-Tovar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Evangelina Boix
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Isabel Galindo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lorea Zubiaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. María Diez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonio Arroyo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rafael Calpena
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jaime Ruiz-Tovar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ruiz-Tovar, J., Boix, E., Galindo, I. et al. Evolution of Subclinical Hypothyroidism and its Relation with Glucose and Triglycerides Levels in Morbidly Obese Patients After Undergoing Sleeve Gastrectomy as Bariatric Procedure. OBES SURG 24, 791–795 (2014). https://doi.org/10.1007/s11695-013-1150-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-013-1150-5

Keywords

Search

Navigation