title: Influence of obesity and surgical weight loss on thyroid hormone levels.
abstract: BACKGROUND
  The pathophysiologic relationship between morbid obesity and thyroid hormones is not well understood. The goal of this study was to evaluate the influence of obesity and weight reduction after bariatric surgery on thyroid hormone levels.
  
  
  METHODS
  Patients who underwent gastric bypass or adjustable gastric banding at our institution, had no previous diagnosis of thyroid disorder, were not taking medication that could affect the thyroid function evaluation, and who were nonsmokers were included in this retrospective evaluation. The association between the thyroid-stimulating hormone (TSH) and free thyroxine (T(4)) levels and body mass index (BMI), and the influence of weight loss after bariatric surgery on these hormones were investigated at different points (preoperatively and 6 and 12 months after bariatric surgery).
  
  
  RESULTS
  A total of 86 patients met the study criteria. The TSH levels correlated positively with BMI (P <.001, r = .91) within the BMI range of 30-67 kg/m(2). The mean BMI change from 49 to 32 kg/m(2) after bariatric surgery was associated with a mean reduction in the TSH level from 4.5 to 1.9 microU/mL. Free T(4) showed no association with BMI and was not significantly influenced by weight loss. Before bariatric surgery, 10.5% of the subjects had laboratory values consistent with subclinical hypothyroidism. After bariatric surgery, 100% of these patients experienced significant weight reduction with simultaneous resolution of their subclinical hypothyroidism.
  
  
  CONCLUSIONS
  The results of our study have demonstrated a statistically significant positive association between serum TSH within the normal range and BMI. No association was found between BMI and free T(4) serum levels. The prevalence of subclinical hypothyroidism in study group was 10.5%. Weight loss after bariatric surgery improved or normalized thyroid hormone levels.
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Silas
authors.initials: S
authors.lastname: Chikunguwo
authors.forename: Stacy
authors.initials: S
authors.lastname: Brethauer
authors.forename: Vijaya
authors.initials: V
authors.lastname: Nirujogi
authors.forename: Tracy
authors.initials: T
authors.lastname: Pitt
authors.forename: Suthep
authors.initials: S
authors.lastname: Udomsawaengsup
authors.forename: Bipan
authors.initials: B
authors.lastname: Chand
authors.forename: Philip
authors.initials: P
authors.lastname: Schauer
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D015995:Prevalence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D015431:Weight Loss
chemical_list: D013972:Thyrotropin; D013974:Thyroxine