Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Parameters Analyzed
2.3. Analytical Procedures
2.4. Calculations
2.5. Statistical Analysis
3. Results
3.1. Preoperative Characteristics
3.2. Evolution over Time of the Clinical and Analytical Parameters
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Median | 25th Percentile | 75th Percentile | |
---|---|---|---|
BMI (kg/m2) t0 | 47.1 | 42.5 | 49.4 |
Body Fat (%) t0 | 51.2 | 49.1 | 53.3 |
Lean Body Weight (kg) t0 | 57.4 | 53.5 | 62.4 |
Body Surface Area (m2) t0 | 2.3 | 2.2 | 2.4 |
Fasting Glucose (mg/dL) t0 | 92.0 | 78.0 | 115.0 |
Fasting Insulin (µIU/mL) t0 | 6.4 | 3.6 | 11.5 |
Free T4 (ng/dL) t0 | 1.6 | 1.4 | 1.7 |
TSH (µU/mL) t0 | 2.6 | 1.2 | 6.9 |
3 Months after Surgery | 6 Months after Surgery | 12 Month safter Surgery | |||||||
---|---|---|---|---|---|---|---|---|---|
Median | P25 | P75 | Median | P25 | P75 | Median | P25 | P75 | |
BMI | 38.0 | 33.6 | 40.2 | 32.8 | 29.6 | 36.5 | 31.6 | 29.1 | 34.0 |
EWL (%) | 43.3 | 34.7 | 47.4 | 58.1 | 49.8 | 63.6 | 65.6 | 60.1 | 75.2 |
EBMIL (%) | 48.2 | 37.0 | 52.8 | 64.8 | 53.4 | 76.2 | 71.5 | 65.6 | 80.1 |
Body Fat (%) | 43.4 | 38.2 | 48.9 | 36.8 | 35.2 | 41.0 | 36.7 | 30.3 | 41.2 |
Body Surface Area (m2) | 2.0 | 1.9 | 2.1 | 1.9 | 1.8 | 2.0 | 1.8 | 1.8 | 1.9 |
Fasting Glucose (mg/dL) | 84.0 | 78.0 | 89.0 | 81.0 | 74.0 | 88.0 | 82.0 | 78.0 | 88.0 |
Fasting Insulin (µIU/mL) | 5.7 | 3.6 | 6.0 | 5.2 | 3.4 | 9.2 | 7.8 | 3.1 | 10.0 |
Free T4 (ng/dL) | 1.2 | 1.1 | 1.5 | 1.1 | 1.0 | 1.2 | 1.1 | 1.0 | 1.2 |
TSH (µU/mL) | 2.1 | 1.1 | 3.2 | 3.1 | 2.0 | 3.7 | 3.3 | 1.7 | 5.0 |
Before Surgery | 3 Months after Surgery | 6 Months after Surgery | 12 Months after Surgery | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Median | P25 | P75 | Median | P25 | P75 | Median | P25 | P75 | Median | P25 | P75 | p * | |
LT4 dose | 100.0 | 75.0 | 112.0 | 100.0 | 75.0 | 122.0 | 88.0 | 75.0 | 114.0 | 100.0 | 75.0 | 119.5 | 0.058 |
LT4 dose/BSA (m2) | 41.7 | 30.6 | 49.5 | 48.2 | 35.8 | 59.0 | 46.3 | 37.0 | 57.5 | 53.8 | 39.2 | 63.8 | <0.001 |
LT4 dose/kg actual weight | 0.8 | 0.6 | 0.9 | 1.1 | 0.8 | 1.3 | 1.1 | 0.8 | 1.3 | 1.3 | 0.9 | 1.6 | <0.001 |
LT4 dose/kg ideal body weight | 1.72 | 1.24 | 1.94 | 1.81 | 1.13 | 2.16 | 1.65 | 1.13 | 2.10 | 1.82 | 1.33 | 2.15 | 0.058 |
LT4 dose/kg adjusted body weight | 1.2 | 0.8 | 1.4 | 1.4 | 1.0 | 1.7 | 1.4 | 1.0 | 1.7 | 1.6 | 1.1 | 1.9 | <0.001 |
LT4 dose/kg body fat | 1.5 | 1.3 | 1.9 | 2.8 | 1.7 | 3.3 | 2.5 | 1.8 | 4.8 | 3.6 | 2.4 | 5.4 | <0.001 |
LT4 dose/kg lean body weight | 1.7 | 1.0 | 1.9 | 2.0 | 1.1 | 2.2 | 1.6 | 1.2 | 2.4 | 2.0 | 1.5 | 2.3 | <0.001 |
Absolute Change at 12 Months | Relative Change at 12 Months (%) | ||||||
---|---|---|---|---|---|---|---|
Median | P25 | P75 | Median | P25 | P75 | p * | |
LT4 dose | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.083 |
LT4 dose/BSA (m2) | 12.05 | 6.61 | 14.85 | 25.94 | 20.23 | 30.32 | <0.001 |
LT4 dose/kg actual weight | 0.53 | 0.29 | 0.63 | 58.62 | 44.56 | 69.84 | <0.001 |
LT4 dose/kg ideal body weight | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.109 |
LT4 dose/kg adjusted body weight | 0.33 | 0.22 | 0.51 | 26.35 | 21.43 | 33.38 | <0.001 |
LT4 dose/kg body fat | 2.02 | 1.59 | 3.23 | 134.86 | 113.13 | 178.67 | 0.001 |
LT4 dose/kg lean body weight | 0.22 | 0.16 | 0.38 | 17.35 | 11.83 | 18.91 | 0.001 |
LT4 Dose | LT4 Dose/BSA (m2) | |||||
---|---|---|---|---|---|---|
B | SE | p | B | SE | p | |
Intercept | 100.16 | 9.06 | <0.001 | 45.41 | 4.17 | <0.001 |
Linear time (months after surgery) | 0.65 | 0.20 | 0.142 | 0.88 | 5.13 | <0.001 |
BS type (SG vs. RYGB) | −17.74 | 12.09 | 0.142 | −9.07 | 5.74 | 0.110 |
LT4 dose/kg Ideal Body Weight | LT4 dose/kg Actual Weight | |||||
B | SE | p | B | SE | p | |
Intercept | 1.82 | 0.15 | <0.001 | 0.90 | 0.09 | <0.001 |
Linear time (months after surgery) | 0.01 | 0.004 | 0.095 | 0.03 | 0.01 | <0.001 |
BS type (SG vs. RYGB) | −0.40 | 0.20 | 0.051 | −0.18 | 0.13 | 0.160 |
LT4 dose/kg Adjusted Body Weight | LT4 dose/kg Body Fat | |||||
Intercept | 1.29 | 0.12 | <0.001 | 1.87 | 0.24 | <0.001 |
Linear time (months after surgery) | 0.03 | 0.004 | <0.001 | 0.18 | 0.04 | <0.001 |
BS type (SG vs. RYGB) | −0.27 | 0.16 | 0.092 | 0.03 | 0.58 | 0.950 |
LT4 dose/kg Lean Body Weight | ||||||
Intercept | 1.82 | 0.17 | <0.001 | |||
Linear time (months after surgery) | 0.02 | 0.004 | <0.001 | |||
BS type (SG vs. RYGB) | −0.47 | 0.23 | 0.041 |
BMI | Body Fat (%) | Lean Body Weight (kg) | EWL (%) | EBMIL (%) | |
---|---|---|---|---|---|
LT4 dose | −0.309 (−0.537; −0.040) * | −0.189 (−0.470; 0.125) | −0.232 (−0.500; 0.077) | −0.068 (−0.412; 0.294) | −0.087 (−0.428; 0.276) |
LT4 dose/BSA (m2) | −0.855 (−0.915; −0.759) * | −0.817 (−0.899; −0.680) * | −0.784 (−0.879; −0.630) * | 0.631 (0.356; 0.805) * | 0.615 (0.333; 0.796) * |
LT4 dose/kg actual Weight | −0.904 (−0.944; −0.838) * | −0.895 (−0.943; −0.811) * | −0.839 (−0.910; −0.718) * | 0.851 (0.712; 0.926) * | 0.841 (0.693; 0.921) * |
LT4 dose/kg ideal body weight | −0.310 (−0.537; −0.040) * | −0.187 (−0.468; 0.128) | −0.226 (−0.496; 0.084) | −0.045 (−0.393; 0.314) | −0.062 (−0.408; 0.299) |
LT4 dose/kg adjusted body weight | −0.863 (−0.920; −0.770) * | −0.814 (−0.897; −0.675) * | −0.783 (−0.878; −0.628) * | 0.605 (0.313; 0.792) * | 0.588 (0.289; 0.783) * |
LT4 dose/kg body fat | −0.673 (−0.812; −0.461) * | −0.700 (−0.829; −0.500) * | −0.667 (−0.808; −0.452) * | 0.496 (0.106; 0.754) * | 0.495 (0.104; 0.753) * |
LT4 dose/kg lean body weight | −0.730 (−0.849; −0.542) * | −0.590 (−0.762; −0.342) * | −0.647 (−0.798; −0.420) * | 0.240 (−0.191; 0.594) | 0.231 (−0.200; 0.588) |
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Juiz-Valiña, P.; Cordido, M.; Outeiriño-Blanco, E.; Pértega, S.; Urones, P.; García-Brao, M.J.; Mena, E.; Pena-Bello, L.; Sangiao-Alvarellos, S.; Cordido, F. Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss. J. Clin. Med. 2021, 10, 3685. https://doi.org/10.3390/jcm10163685
Juiz-Valiña P, Cordido M, Outeiriño-Blanco E, Pértega S, Urones P, García-Brao MJ, Mena E, Pena-Bello L, Sangiao-Alvarellos S, Cordido F. Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss. Journal of Clinical Medicine. 2021; 10(16):3685. https://doi.org/10.3390/jcm10163685
Chicago/Turabian StyleJuiz-Valiña, Paula, María Cordido, Elena Outeiriño-Blanco, Sonia Pértega, Paula Urones, María Jesús García-Brao, Enrique Mena, Lara Pena-Bello, Susana Sangiao-Alvarellos, and Fernando Cordido. 2021. "Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss" Journal of Clinical Medicine 10, no. 16: 3685. https://doi.org/10.3390/jcm10163685
APA StyleJuiz-Valiña, P., Cordido, M., Outeiriño-Blanco, E., Pértega, S., Urones, P., García-Brao, M. J., Mena, E., Pena-Bello, L., Sangiao-Alvarellos, S., & Cordido, F. (2021). Evaluation of Thyroid Hormone Replacement Dosing in Morbidly Obese Hypothyroid Patients after Bariatric Surgery-Induced Weight Loss. Journal of Clinical Medicine, 10(16), 3685. https://doi.org/10.3390/jcm10163685