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Bariatric Surgery

Preoperative thyroid function and weight loss after bariatric surgery

Abstract

Thyroid function has an important role on body weight regulation. However, the impact of thyroid function on weight loss after bariatric surgery is still largely unknown. We evaluated the association between preoperative thyroid function and the excess weight loss 1 year after surgery, in 641 patients with morbid obesity who underwent bariatric surgery. Patients with a history of thyroid disease, treatment with thyroid hormone or antithyroid drugs and those with preoperative evaluation consistent with overt hypothyroidism or hyperthyroidism were excluded. The preoperative levels of TSH and FT4 were not associated with weight loss after bariatric surgery. The variation of FT3 within the reference range was also not associated with weight loss. In contrast, the subgroup with FT3 above the reference range (12.3% of patients) had a significantly higher excess weight loss than patients with normal FT3. This difference remained significant after adjustment for age, sex, BMI, type of surgery, TSH and FT4. In conclusion, we observed an association between high FT3 and a greater weight loss after bariatric surgery, highlighting a group of patients with an increased benefit from this intervention. Our results also suggest a novel hypothesis: the pharmacological modulation of thyroid function may be a potential therapeutic target in patients undergoing bariatric surgery.

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Acknowledgements

We would like to acknowledge all the endocrinologists, surgeons and nutritionists of the Multidisciplinary Group for Surgical Management of Obesity.

Funding

Ana Cristina Santos was funded by an FCT Investigator contract IF/01060/2015

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Correspondence to João Sérgio Neves.

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The authors declare that they have no conflict of interest.

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Neves, J.S., Souteiro, P., Oliveira, S.C. et al. Preoperative thyroid function and weight loss after bariatric surgery. Int J Obes 43, 432–436 (2019). https://doi.org/10.1038/s41366-018-0071-8

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