title: Weight homeostasis & its modulators in hyperthyroidism before & after treatment with carbimazole.
abstract: OBJECTIVE
  Hyperthyroidism is associated with increased food intake, energy expenditure and altered body composition. This study was aimed to evaluate the role of adipocytokines in weight homeostasis in patients with hyperthyroidism.
  
  
  METHODS
  Patients (n=27, 11men) with hyperthyroidism (20 Graves' disease, 7 toxic multinodular goiter) with mean age of 31.3±4.2 yr and 28 healthy age and body mass index (BMI) matched controls were studied. They underwent assessment of lean body mass (LBM) and total body fat (TBF) by dual energy X-ray absorptiometer (DXA) and blood sample was taken in the fasting state for measurement of leptin, adiponectin, ghrelin, insulin, glucose and lipids. Patients were re-evaluated after 3 months of treatment as by that time all of them achieved euthyroid state with carbimazole therapy.
  
  
  RESULTS
  The LBM was higher (P<0.001) in healthy controls as compared to hyperthyroid patients even after adjustment for body weight (BW), whereas total body fat was comparable between the two groups. Serum leptin levels were higher in patients with hyperthyroidism than controls (22.3±3.7 and 4.1±0.34 ng/ml, P<0.001), whereas adiponectin levels were comparable. Plasma acylated ghrelin was higher in patients than in controls (209.8±13.3 vs 106.2±8.2 pg/ml, P<0.05). Achievement of euthyroidism was associated with significant weight gain (P<0.001) and significant increase in lean body mass (P<0.001). The total body fat also increased but insignificantly from 18.4±1.8 to 19.9±1.8 kg. There was significant decrease (P<0.05) in serum leptin and acylated ghrelin but adiponectin levels remained unaltered after treatment. Serum leptin positively correlated with TBF and this correlation persisted even after adjustment for BW, BMI, gender and age (r=0.62, P=0.001). However, serum leptin and acylated ghrelin did not correlate with the presence or absence of hyperphagia.
  
  
  CONCLUSIONS
  Patients with hyperthyroidism predominantly had decreased lean body mass which increased after achievement of euthyroidism with carbimazole. The hyperphagia and the alterations in weight homeostasis associated with hyperthyroidism were independent of circulating leptin and ghrelin levels.
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Pinaki
authors.initials: P
authors.lastname: Dutta
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
authors.forename: Rama
authors.initials: R
authors.lastname: Walia
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
authors.forename: Sambit
authors.initials: S
authors.lastname: Das
authors.forename: Shariq Rashid
authors.initials: SR
authors.lastname: Masoodi
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects; D000328:Adult; D013956:Antithyroid Agents / Q000008:administration & dosage*; D001823:Body Composition / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects*; D002231:Carbimazole / Q000008:administration & dosage*; D004734:Energy Metabolism / Q000187:drug effects; D054439:Ghrelin / Q000097:blood; D006801:Humans; D006963:Hyperphagia / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D006980:Hyperthyroidism / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D020738:Leptin / Q000097:blood; D008297:Male; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D013956:Antithyroid Agents; D054439:Ghrelin; D020738:Leptin; D013963:Thyroid Hormones; D002231:Carbimazole