减肥手术对改善甲状腺功能和减少肥胖和过度甲状腺功能低下的患者的levothyroxine剂量的有效性
Hanan H Alfaifi1, Manar A Altowairgi1, Rawan G Algethami1
1Medicine and Surgery, College of Medicine, Taif University, Taif, SAU.
Cureus
|June 12, 2023
概括
腹部外科手术显著改善甲状腺功能在患有甲状腺功能低下症的患者,导致甲状腺刺激激素减少和较低的levothyroxine剂量. 这项研究强调了减肥手术对管理这种荷尔蒙状况的积极影响.
科学领域:
- 内分泌学 在内分泌学.
- 代谢手术 代谢手术
- 激素乱 激素乱 激素乱 激素乱
背景情况:
- 低甲状腺症在沙特阿拉伯很普遍,不成比例地影响女性.
- 甲状腺功能低下症和肥胖之间存在着已知的双向关系.
- 减肥手术 (BS) 可能对肥胖个体的甲状腺功能产生积极影响.
研究的目的:
- 评估减肥手术对低甲状腺症患者甲状腺功能的影响.
- 为了评估对levothyroxine剂量要求的变化,在腹腔外科手术后.
主要方法:
- 在沙特阿拉伯塔伊夫的两个中心进行了观察性回顾性研究.
- 包括被诊断患有明显甲状腺功能低下症的致病性肥胖患者,他们接受了腹腔镜袖子胃切除术 (2016年1月 - 2021年12月).
- 在减肥手术前后分析了甲状腺特征 (TSH,FT4,FT3) 和勒沃西 (L-T4) 剂量的变化.
主要成果:
- 在1202名患者中,有70人符合纳入标准,主要是女性.
- 观察到TSH,FT4,FT3和levothyroxine (L-T4) 剂量的统计学上显著下降. 在腹腔外科手术后.
- 平均TSH从4.45±4.41下降到3.17±2.77mIU/L (p=0.009). 这也使得TSH的平均水平从4.45±4.41下降到3.17±2.77mIU/L (p=0.009). 平均FT4从13.17±2.73下降到11.63±5.88 pmol/L (p=0.046) 的时间. 平均FT3从2.75±1.96下降到1.94±2.12 pg/mL (p=0.009) 的时间. 平均L-T4剂量从98.68±56.18降至79.39±41.49微克 (p=0.046) 的水平.
结论:
- 腹部外科手术导致甲状腺功能低下症患者的甲状腺特征得到改善.
- 在减肥手术后,Levothyroxine的剂量要求显著降低.
- 减肥手术是一种有效的干预措施,可以改善肥胖患者的甲状腺功能低下症.
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