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2015, Number S1

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Rev Med Inst Mex Seguro Soc 2015; 53 (S1)

Alterationsof the thyroid functionin patients withmorbid obesity

Montoya-Morales DS, Tapia-González MÁ, Alamilla-Lugo L, Sosa-Caballero A, Muñoz-Solís A, Jiménez- Sánchez M

Language: Spanish
References: 22
Page: 18-23
PDF size: 72.68 Kb.


ABSTRACT

Introduction: The morbid obesity (BMI ≥ 40 kg/m2) is associated with dysfunction of the hypothalamus-pituitary-thyroid axis, showing high levels of thyrotropin (TSH), triiodothyronine (T3) total and free, suspecting a real thyroid condition.
Objetive: Describe the alterations in thyroid function in patients with morbid obesity, determining serum levels of TSH, total T3, free T4 and thyroid peroxidase antibodies (TPO).
Methods: Prospective, descriptive, observational, cross-sectional study, we enrolled 52 patients with morbid obesity, at the obesity clinic, from department of Endocrinology, since January 2009 to July 2011. All patients signed a letter of informed consent. Patients with known thyroid disorders and/or under the use of levothyroxine or other medication that causes alteration in thyroid function were excluded. Statistical analysis was performed using measures of central tendency, simple frequencies, percentages and Spearman’s correlation.
Results: The prevalence of primary hypothyroidism was 8 %, 6 % subclinical hypothyroidism and thyroid function alterations secondary to obesity of 23 % (elevated TSH and/or free T4 Total T3 with normal and TPO antibody negative).
Conclusions: Most morbidly obese patients haven’t autoimmune thyroid dysfunction; the alterations in thyroid function are caused by an effect of homeostasis against obesity and can be corrected by reducing weight.


REFERENCES

  1. Verma A, Jayaraman M; Kumar HK, Modi KD. Hipothyroidism and obesity. Cause of effect?. Saudi Med J. 2008;29:1135-38.

  2. Liu YY, Brent GA. Thyroid hormone crosstalk with nuclear receptor signaling in metabolic regulation. Trends Endocrinol Metab. 2009;21:166-73.

  3. Muscogiuri G, Sorice G, Mezza T, Prioletta A, Lassandro A, et al. High-Normal TSH values in obesity: Is it insulin resistence or adipose tissue´s guilt?. Obesity. 2013;101-06.

  4. Iglesias P, Diez JJ. Infl uence of thyroid dysfunction on serum concentrations of adipocytokines. Cytokine. 2007;40:61-70.

  5. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol. 2005;62:487-91.

  6. Rotondi M, Magri F, Chiovato L. Thyroid and obesity: not a one-way interaction. J Clin Endocrinol Metab. 2011;96:344-46.

  7. Mechanick J, Kushner R, Sugerman H, Gonzalez- Campoy M, Collazo-Clavell M, Spitz A, et al. American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional Metabolic and Nonsurgical Support of the Bariatric Surgery Patient. 2009.

  8. Bergoglio L, Mestman J. NACB: Guía de Consenso para el Diagnóstico y Seguimiento de la Enfermedad Tiroidea. Thyroid. 2003;13:4-126.

  9. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol. 2010;316:165-171.

  10. Krotkiewski M. Thyroid hormones in the pathogenesis and treatment of obesity. Eur J Pharmacol. 2002; 440:85-98.

  11. Longhi S, Radetti G. Thyroid Function and Obesity. J CLin Res Pediatr Endocrinol. 2013;5:40-44.

  12. Michalaki M, Vagenakis A, Leonardou A, Argentou M, Habeos I, Makri M, et al. Thyroid function in humans con morbid obesity. Thyroid. 2006;16:73-77.

  13. Marzullo P, Minocci A, Tagliaferri MA, Guzzaloni G, Di Blasio A, De Medici C, et al. Investigations of Thyroid Hormones and Antibodies in Obesity: leptin levels are associated with thyroid autoinmunity independent of bioanthropometric, hormonal and weight-related determinants. J Clin Endocrinol Metab. 2010;95:3965-72.

  14. Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39-51.

  15. Duntas L, Biondi B. The interconnections between obesity, thyroid function, and autoimmunity: the multifold role of leptin. Thyroid. 2013;23:646-53.

  16. Ohtaki S, Nakagawa H, Nakamura M, Kotani T. Thyroid Peroxidase: Experimental and Clinical Integration. Endocrine Journal.1996;43:1-14.

  17. Sari R, Kemal M, Altunbas H, Karayalcin U. The effect of body weight and weight loss on thyroid volume and function in obese women. Clinical Endocrinology. 2003;59:258-62.

  18. Nannipieri M, Cecchetti F, Anselmo M, Camastra S, Niccolini P, Lammacchia M et al. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with moprbid obesoty and/or type 2 diabetes: effects of weight loss. International Journal of Obesity.2009;33:1001-06.

  19. Kouidhi S, Berhouma R, Ammar M, Rouissi K, Jarboui S, et al. Relationship of thyroid function with obesity and type 2 diabetes in euthyroid Tunisian subjects. Endocrine Research. 2013;38:15-23.

  20. Cappelli C, Rotondi M, Pirola I, Agosti B, Gandossi E, et al. TSH-Lowering effect of metformin in type 2 diabetic patients. Diabetes Care. 2009;32: 1589-90.

  21. Vigersky R, Filmore-Nassar A, Glass A. Thyrotropin suppression by metformin. J Clin Endocrinol Metab. 2006;91:225-27.

  22. Rotondi M, Leporatti P, La Manna A, Pirali B, Mondello B, Fonte R et al. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?. European Journal of Endocrinology. 2009;160:403-408.




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