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Tang Y, Liu W, Wang W, Zhao H, Lu Z, Li Q, Yan Z, He H, Zhao Z, Ke Z, Li F, Tong W, Sun F, Zhu Z. Changes in thyroid hormones predict weight regain in patients with obesity who undergo metabolic surgery. Diabetes Obes Metab 2024; 26:3842-3848. [PMID: 38924605 DOI: 10.1111/dom.15731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
AIM To investigate the relationship between thyroid function and weight regain in patients with obesity after metabolic surgery. METHODS This retrospective study enrolled 162 patients who underwent metabolic surgery. Correlations between decreases in thyroid hormone levels and changes in weight, waist circumference (WC) and the Chinese visceral adiposity index (CVAI) were assessed. Binary logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and clinically useful cut-off values, respectively. RESULTS The levels of thyroid-stimulating hormone (TSH) and free triiodothyronine (FT3) decreased markedly at 1 year after surgery, as did weight, body mass index (BMI), triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, WC and CVAI. Decreases in TSH and FT3 after metabolic surgery were associated with changes in weight, BMI and CVAI. Binary logistic regression and ROC curve analyses confirmed that decreases in TSH can predict good weight loss after metabolic surgery to some extent. Finally, binary logistic regression and ROC curve analyses confirmed that changes in TSH can predict weight regain after metabolic surgery. CONCLUSIONS Changes in TSH and FT3 after metabolic surgery were correlated with changes in weight and CVAI. Changes in thyroid hormones can predict weight regain in patients with obesity who underwent metabolic surgery.
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Affiliation(s)
- Yi Tang
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Wei Liu
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Wuhao Wang
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Huandong Zhao
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Zongshi Lu
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Qiang Li
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Zhencheng Yan
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Hongbo He
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Zhigang Zhao
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Zhigang Ke
- Department of General Surgery, Daping Hospital, Army Medical University of PLA, Chongqing, China
| | - Fan Li
- Department of General Surgery, Daping Hospital, Army Medical University of PLA, Chongqing, China
| | - Weidong Tong
- Department of General Surgery, Daping Hospital, Army Medical University of PLA, Chongqing, China
| | - Fang Sun
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
| | - Zhiming Zhu
- Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University of PLA, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing, China
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Ke Z, Zhou X, Sun F, Li F, Tong W, Zhu Z. Effect of bariatric surgery versus medical therapy on long-term cardiovascular risk in low BMI Chinese patients with type 2 diabetes: a propensity score-matched analysis. Surg Obes Relat Dis 2021; 18:475-483. [PMID: 34969592 DOI: 10.1016/j.soard.2021.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/07/2021] [Accepted: 11/14/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Reducing the risk of death due to cardiovascular disease (CVD) is an important direction for diabetes prevention and treatment. The Chinese population with type 2 diabetes (T2D) has a high risk of developing CVD at relatively low body mass index (BMI) levels. Currently, no studies have evaluated the effect of bariatric surgery versus medical therapy on long-term CVD risk in patients with T2D and low BMI. OBJECTIVES To compare bariatric surgery versus medical therapy for long-term CVD risk in Chinese patients with T2D and low BMI by using the China Prediction for ASCVD Risk equations and the United Kingdom Prospective Diabetes Study risk engine. SETTING University hospital, China. METHODS Medical records of patients with T2D with a BMI <35 kg/m2 undergoing bariatric surgery or medical therapy from May 2010 to December 2018 were reviewed. A 1:1 propensity score matching was performed by using 7 preoperative characteristics. Variables for calculating CVD risk scores over the 5-year follow-up were assessed. RESULTS A total of 684 patients with T2D underwent bariatric surgery (n = 75) or medical therapy (n = 609), and 52 pairs of matched subjects were selected from both groups after propensity score matching. The 10-year and lifetime atherosclerotic CVD risk by using the China Prediction for ASCVD Risk equation at 5 years follow-up period in the bariatric surgery group improved significantly compared with the medical therapy group. In the fifth year of follow-up, the 10-year risk of coronary heart disease, fatal coronary heart disease, stroke, and fatal stroke by using the United Kingdom Prospective Diabetes Study risk engine were much lower in the bariatric surgery group than in the medical therapy group (10.37 ± 5.64% versus 27.25 ± 7.28%, P = .004; 6.3 ± 4.5% versus 22.3 ± 7.35%, P = .002; 4.97 ± 3.73% versus 15.05 ± 3.63%, P = .001; .59 ± .45% versus 1.52 ± .14%, P < .001. respectively). The use of glucose-lowering medications, including insulin, was reduced from baseline in both groups, and patients in the bariatric surgery group required significantly fewer of these medications than those in the medical therapy group. CONCLUSION Bariatric surgery in patients with T2D and low BMI conferred a lower calculated risk of CVD compared with medical therapy over 5 years of follow-up.
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Affiliation(s)
- Zhigang Ke
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Xunmei Zhou
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension Chongqing, China
| | - Fang Sun
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension Chongqing, China
| | - Fan Li
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Weidong Tong
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, China.
| | - Zhiming Zhu
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension Chongqing, China.
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