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患有病态肥胖症的胃绕道手术:对甲状腺功能测试和胰岛素抵抗状态的影响
Parvin Layegh1, Razieh Ayati2, Ali Jangjoo3
1Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Caspian journal of internal medicine
|May 29, 2024
概括
胃绕道手术显著改善了致病性肥胖患者的胰岛素耐药性和T3总水平. 然而,TSH和自由T4甲状腺激素的变化可能需要更长的随访期.
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:
- 致病性肥胖与甲状腺功能的改变和胰岛素抵抗有关.
- 关于胃绕道手术对甲状腺功能测试 (TFT) 影响的先前研究已经产生了不一致的结果.
- 在手术前致病性肥胖个体的甲状腺状况对于准确的评估至关重要.
研究的目的:
- 评估胃绕道手术 (GBS) 对TFT和胰岛素耐药性的影响.
- 为了比较病态肥胖患者的手术前和手术后3个月的测量.
- 调查减肥和荷尔蒙变化之间的潜在相关性.
主要方法:
- 一项前后研究设计,涉及29名患有病态肥胖的受试者 (BMI≥40).
- 排除标准包括先前存在的甲状腺疾病,甲状腺剥离疗法或影响甲状腺功能的药物.
- 测量包括体质指数 (BMI),甲状腺刺激激素 (TSH),自由T4,总T3,禁食血糖和胰岛素 (HOMA-IR) 在GBS之前和3个月后.
主要成果:
- 手术后观察到BMI,HOMA-IR和总T3的显著降低 (p<0.001).
- 在TSH (p=0.203) 或自由T4 (p=0.33) 中没有发现显著变化.
- 在HOMA-IR和自由T4 (p=0.038) 的变化之间发现了负相关性.
结论:
- 胃绕道手术可以在三个月内显著改善BMI,胰岛素敏感性和T3总量.
- 在短期内,TSH和自由T4的变化可能不会明显,可能需要更长的随访期.
- 需要进一步的研究来了解减肥手术对甲状腺功能的长期影响.
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