title: Evolution of subclinical hypothyroidism and its relation with glucose and triglycerides levels in morbidly obese patients after undergoing sleeve gastrectomy as bariatric procedure.
abstract: BACKGROUND
  There is an increased prevalence of subclinical hypothyroidism (SCH) in patients with obesity. It is unclear if this biochemical abnormality may be a secondary phenomenon of obesity or a real hypothyroid state.
  
  
  METHODS
  A retrospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and November 2012 was performed. Weight loss, body mass index (BMI) and excess weight loss, baseline glucose, lipid profiles, and TSH levels were obtained before operation and postoperative determinations at 3, 6, and 12 months after surgery.
  
  
  RESULTS
  Sixty patients were included. Prevalence of subclinical hypothyroidism was 16.7% preoperatively, 10% at 3 months, 3.3% at 6 months, and 1.7% at 12 months. A significant correlation could be established between TSH decrease and weight loss at 12 months (Pearson 0.603; p = 0.007). TSH decrease showed a significant correlation with glucose and glycated hemoglobin decrease from 6th month onwards. Referring to lipid profile, an association of TSH decrease with total cholesterol, LDL cholesterol, or HDL cholesterol could not be determined. A significant association between TSH decrease and triglycerides and cardiovascular risk index triglycerides/HDL cholesterol reductions could also be established 12 months after surgery.
  
  
  CONCLUSIONS
  SCH is usually corrected after bariatric surgery, while there are no significant changes in total or LDL cholesterol. This suggests that, in morbidly obese subjects, SCH is, in most patients, just a consequence of the abnormal fat accumulation and not a real hypothyroid state.
authors.affiliation: Bariatric Surgery Unit, Department of Surgery, General University Hospital Elche, Elche, Alicante, Spain, jruiztovar@gmail.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.forename: Evangelina
authors.initials: E
authors.lastname: Boix
authors.forename: Isabel
authors.initials: I
authors.lastname: Galindo
authors.forename: Lorea
authors.initials: L
authors.lastname: Zubiaga
authors.forename: María
authors.initials: M
authors.lastname: Diez
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007037:Hypothyroidism / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human