甲状腺手术中的肥胖悖论:更高的BMI是否可以保护甲状腺功能低下症?
Tyler Fields1, Kimberly Ramonell2, Jessica Fazendin3
1Department of Surgery, Wellstar Atlanta Medical Center, Atlanta, GA, USA.
The American surgeon
|July 27, 2023
概括
较高的身体质量指数 (BMI) 和非白人种族与全甲状腺切除术后低副甲状腺症风险降低有关. 这些因素似乎对这种常见的术后并发症提供了保护,因此需要进一步调查.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 肥胖与副甲状腺激素 (PTH) 水平有关.
- 手术后的小甲状腺功能低下症是完全甲状腺切除术的已知并发症.
- 身体质量指数 (BMI) 和缺甲状腺症风险之间的关系需要进一步阐明.
研究的目的:
- 调查身体质量指数 (BMI) 与手术后偏偏甲状腺症的发生率之间的关联.
- 在全甲状腺切除术后,探索术后副甲状腺激素 (PTH) 水平的预测因素.
主要方法:
- 在2015年至2021年期间,对352名接受全甲状腺切除术的患者进行了回顾性审查.
- 对人口统计数据,BMI,手术指标以及手术前后PTH水平的分析.
- 多变量分析以确定术后PTH的独立预测因子.
主要成果:
- 患有病态肥胖症的患者 (BMI > 40) 与体重不足的患者 (BMI < 18.5) 相比,术后PTH水平显著更高.
- 患者的种族与手术前和手术后的PTH水平有显著的关联.
- 多变量分析证实了手术前的PTH,种族和BMI作为更高的术后PTH的独立预测因素.
结论:
- 升高的BMI与手术后偏偏甲状腺症的风险降低有关.
- 非白人种族也似乎在全甲状腺切除术后给予相对保护,防止甲状腺功能下降.
- 体重指数和种族是术后PTH水平的显著独立预测因素.
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