Prevalence of endocrine diseases in morbidly obese patients scheduled for bariatric surgery: beyond diabetes.
BACKGROUND
Bariatric surgery allows stable body weight reduction in morbidly obese patients. In presurgical evaluation, obesity-related co-morbidities must be considered, and a multidisciplinary approach is recommended. Precise guidelines concerning the endocrinological evaluation to be performed before surgery are not available. The aim of this study was to evaluate the prevalence of common endocrine diseases in a series of obese patients scheduled for bariatric surgery.


METHODS
We examined 783 consecutive obese subjects (174 males and 609 females) aged 18-65 years, who turned to the obesity centre of our department from January 2004 to December 2007 for evaluation before bariatric surgery. Thyroid, parathyroid, adrenal and pituitary function was evaluated by measurement of serum hormones. Specific imaging or supplementary diagnostic tests were performed when indicated.


RESULTS
The overall prevalence of endocrine diseases, not including type 2 diabetes mellitus, was 47.4%. The prevalence of primary hypothyroidism was 18.1%; pituitary disease was observed in 1.9%, Cushing syndrome in 0.8%, while other diseases were found in less than 1% of subjects. Remarkably, the prevalence of newly diagnosed endocrine disorders was 16.3%.


CONCLUSIONS
A careful endocrinological evaluation of obese subjects scheduled for bariatric surgery may reveal undiagnosed dysfunctions that require specific therapy and/or contraindicate the surgical treatment in a substantial proportion of patients. These results may help to define the extent of the endocrinological screening to be performed in obese patients undergoing bariatric surgery.
Department of Endocrinology and Kidney, University Hospital of Pisa, Via Paradisa 2, Pisa 56124, Italy. pfierab2001@yahoo.it
Paola
P
Fierabracci
Aldo
A
Pinchera
Silvia
S
Martinelli
Giovanna
G
Scartabelli
Guido
G
Salvetti
Monica
M
Giannetti
Andrea
A
Pucci
Giulia
G
Galli
Ilaria
I
Ricco
Giorgia
G
Querci
Teresa
T
Rago
Claudio
C
Di Salvo
Marco
M
Anselmino
Paolo
P
Vitti
Ferruccio
F
Santini
D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D015897:Comorbidity; D004700:Endocrine System Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D055815:Young Adult