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. 2021 Oct 13;10(10):1326-1336.
doi: 10.1530/EC-21-0360.

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

Nannan Bian  1 , Xiaomeng Sun  1 , Biao Zhou  2 , Lin Zhang  1 , Qiu Wang  1 , Yu An  1 , Xiaohui Li  1 , Yinhui Li  1 , Jia Liu  1 , Hua Meng  2 , Guang Wang  1
Affiliations

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

Nannan Bian et al. Endocr Connect. .

Abstract

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.

Keywords: adipose tissue insulin resistance; bariatric surgery; obesity; thyroid-stimulating hormone.

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Figures

Figure 1
Figure 1
Relationships among BMI, TSH, FT3, FT3/FT4 and adipo-IR in non-diabetic patients. (A) BMI was positively correlated with TSH. (B) BMI was positively correlated with FT3. (C) BMI was positively correlated with FT3/FT4. (D) BMI was positively associated with Adipo-IR. (E) Adipo-IR was positively associated with TSH. (F) Adipo-IR was positively correlated with FT3. (G) Adipo-IR was positively correlated with FT3/FT4.
Figure 2
Figure 2
Effects of bariatric surgery on glucose homeostasis and insulin sensitivity in non-diabetic patients. (A) Glucose tolerance improved 6 months after surgery. (B) The AUC of plasma glucose was significantly declined 6 months after surgery. (C) DI was elevated 6 months after surgery. (D) Insulin release was significantly decreased after surgery. (E) There was no difference in AUC of insulin secretion (F) EISI was elevated after surgery but was not significant. (G) HOMA-IR improved after surgery.
Figure 3
Figure 3
Changes in adipo-IR after bariatric surgery were positively correlated with changes in BMI and TSH. (A) The change of BMI was correlated with the change of Adipo-IR. (B) The change of BMI was associated with the change of TSH.
Figure 4
Figure 4
Serum adipo-IR levels of lower TSH group and higher TSH group before and 6 months after bariatric surgery. (A) Adipo-IR level of lower TSH group and higher TSH group at baseline and 6 months after surgery. (B) The change of Adipo-IR in the lower and higher TSH groups.
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References

    1. Roberto CA, Swinburn B, Hawkes C, Huang TT, Costa SA, Ashe M, Zwicker L, Cawley JH, Brownell KD. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet 20153852400–2409. ( 10.1016/S0140-6736(1461744-X) - DOI - PubMed
    1. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 20163152284–2291. ( 10.1001/jama.2016.6458) - DOI - PMC - PubMed
    1. English WJ, DeMaria EJ, Brethauer SA, Mattar SG, Rosenthal RJ, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surgery for Obesity and Related Diseases 201814259–263. ( 10.1016/j.soard.2017.12.013) - DOI - PubMed
    1. Kim JY, Bacha F, Tfayli H, Michaliszyn SF, Yousuf S, Arslanian S. Adipose tissue insulin resistance in youth on the spectrum from normal weight to obese and from normal glucose tolerance to impaired glucose tolerance to type 2 diabetes. Diabetes Care 201942265–272. ( 10.2337/dc18-1178) - DOI - PMC - PubMed
    1. Li X, Liu J, Zhou B, Li Y, Wu Z, Meng H, Wang G. Sex differences in the effect of testosterone on adipose tissue insulin resistance from overweight to obese adults. Journal of Clinical Endocrinology and Metabolism 20211062252–2263. ( 10.1210/clinem/dgab325) - DOI - PubMed

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