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总体体重减轻诱导在减肥手术后甲状腺功能的改变
Ziru Tian1,2, Yuntao Nie1, Zhengqi Li1
1Department of General Surgery & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China.
Frontiers in endocrinology
|February 14, 2024
概括
腹部外科手术显著降低甲状腺刺激激素 (TSH) 和甲状腺激素在手术后一年. 更大的术后体重减轻独立与TSH水平的更明显下降相关.
科学领域:
- 内分泌学 在内分泌学.
- 腹部外科 腹部外科
- 代谢健康 代谢健康
背景情况:
- 减肥手术是显著减肥的公认方法.
- 它对甲状腺功能的影响,特别是甲状腺刺激激素 (TSH) 和甲状腺激素,仍然是正在进行的研究和辩论的主题.
- 体重减轻程度与手术后甲状腺参数变化之间的准确关系需要进一步阐明.
研究的目的:
- 为了研究在减肥手术后甲状腺激素和TSH的变化.
- 确定手术后一年的总体重减轻率 (%TWL) 与TSH (ΔTSH) 的变化之间的相关性.
- 评估术后体重减轻是否是 ΔTSH 的独立预测因子.
主要方法:
- 对肥胖,经过袖子胃切除术或Roux-en-Y胃绕道 (2017-2022) 的甲状腺患者的回顾性分析.
- 在手术后一年测量TSH,自由甲状腺素 (FT4),自由三甲状腺素 (FT3),总甲状腺素 (TT4) 和总三甲状腺素 (TT3) 水平.
- 应用皮尔森相关性和多变量线性回归来分析%TWL和ΔTSH之间的关系.
主要成果:
- 总共分析了256名患者,一年后平均TWL%达到28.29%.
- 在腹腔外科手术后一年,TSH,FT3,FT4,TT3和TT4水平显著下降 (所有患者P<0.001).
- 皮尔森相关性显示了%TWL和ΔTSH (r=0.184,P=0.003) 之间的显著正相关性. 多变量回归证实了%TWL作为 ΔTSH 的独立预测因子 (β=0.180,P=0.008).
结论:
- 腹部外科手术导致TSH和甲状腺激素水平在手术后一年显著降低.
- 手术后的体重减轻是影响TSH下降的独立因素.
- 体重减轻的增加与TSH水平的更大降低有关.
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