Turkiye Klinikleri Journal of Internal Medicine

.: ORIGINAL RESEARCH
Effects of Obesity on the Thyroid Hormone Levels: Retrospective Cross-Sectional Study
Obezitenin Tiroid Hormon Düzeyleri Üzerine Etkileri: Retrospektif Kesitsel Çalışma
Işılay KALAN SARIa, Şeyma YAVUZb, Serkan CEYLANc
aDivision of Endocrinology and Metabolic Disorders, University of Health Sciences Antalya Training and Research Hospital, Antalya, Türkiye
bClinic of Internal Medicine, Çanakkale Bayramiç State Hospital, Çanakkale, Türkiye
cDepartment of General Surgery, University of Health Sciences Antalya Training and Research Hospital, Antalya, Türkiye
Turkiye Klinikleri J Intern Med. 2023;8(1):1-7
doi: 10.5336/intermed.2021-87117
Article Language: EN
Full Text
ABSTRACT
 Objective: The incidence of obesity is increasing. Thyroid dysfunction has been extensively studied in obesity. The aim of this study is to determine thyroid hormone levels in patients with obesity (Class I and II obesity) and morbid obesity, and to determine the correlation between body mass index (BMI) and thyroid hormones. Material and Methods: Data from one hundred fifty-seven patients with obesity, including 71 patients with a BMI of 30-39.9 kg/m2 (Group 1) and 86 patients with morbid obesity with a BMI≥40 kg/m2 (Group 2), and 60 control subjects with a BMI of 18.5-24.9 kg/m2 were retrospectively reviewed. Thyroid hormone levels were compared. Consent was obtained from the patients and, if necessary, their legal representatives. The study was a retrospective cross-sectional study. Ethics committee approval was obtained for our study. Results: The mean age of obese and normal-weight individuals was similar (p=0.94). Thyroidstimulating hormone (TSH) levels were higher in patients than in controls (3.7±1.8 μIU/mL and 2.5±1.7, respectively; p=0.01). The prevalence of subclinical hypothyroidism (SCH) was higher in patients than in controls (p=0.003). There was a positive correlation between TSH and BMI (r=0.44, p=0.001). In subgroup analysis, TSH level was similar in Group 1 and Group 2 (p=0.07). TSH was higher in Group 1 (p=0.03) and Group 2 (p=0.01) than in the control group. The frequency of SCH was similar in Group 1 and Group 2 (p=0.06). The frequency of SCH was higher in Group 1 (p=0.006) and Group 2 (p=0.002) than in the control group. Conclusion: TSH level was higher in patients with obesity than in healthy controls. There was a positive correlation between BMI and TSH. Thyroid hormone levels were similar in patients with a BMI of 30-39.9 kg/m2 and morbid obesity. We recommend thyroid hormone screening in obesity.

Keywords: Obesity; thyroid hormones; thyroid-stimulating hormone
ÖZET
 Amaç: Obezite insidansı giderek artmaktadır. Obezitede tiroid disfonksiyonu kapsamlı bir şekilde çalışılmıştır. Bu çalışmanın amacı obez (Sınıf I ve II obezite) ve morbid obez hastalarda tiroid hormon düzeylerini belirlemek ve beden kitle indeksi (BKİ) ile tiroid hormonları arasındaki korelasyonu tanımlamaktır. Gereç ve Yöntemler: Obez 157 hastanın verisi, BKİ 30-39,9 kg/m2 olan 71 birey (Grup 1), BKİ≥40 kg/m2 olan 86 morbid obez birey (Grup 2) ve BKİ of 18,5-24,9 kg/m2 olan 60 kontrol birey retrospektif olarak tarandı. Tiroid hormon seviyeleri karşılaştırıldı. Hastalardan ve gereğinde yasal temsilcilerinden onam alındı. Çalışmamız retrospektif kesitsel çalışmadır. Çalışmamız için etik kurul onayı alınmıştır. Bulgular: Obez ve normal kilolu bireylerin yaş ortalamaları benzer bulundu (p=0,94). Obez hastalarda tiroid uyarıcı hormon (TSH) düzeyleri normal kilolu kontrol grubuna göre daha yüksekti (3,7±1,8 μIU/mL ve 2,5±1,7, sırasıyla; p=0,01). Obezite grubunda subklinik hipotiroidizm prevalansı normal kilolu kontrol grubuna göre daha yüksekti (p=0,003). Obez hastalarda TSH konsantrasyonları ve BKİ arasında pozitif korelasyon saptandı (r=0,44, p=0,001). Subgrup analizde Grup 1 ve Grup 2'nin TSH seviyesi benzerdi (p:0,07). TSH Grup 1 (p=0,03) ve Grup 2'de (p=0,01) kontrol grubuna göre daha yüksek saptandı. Subklinik hipotiroidi sıklığı Grup 1 ve Grup 2'de benzerdi (p=0,06). Subklinik hipotiroidi sıklığı Grup 1 (p=0,006) ve Grup 2'de (p=0,002) kontrol grubuna göre daha yüksekti. Sonuç: Obez hastalarda TSH düzeyi sağlıklı kontrol grubuna göre daha yüksek idi. BKİ ile TSH arasında pozitif bir korelasyon bulunmaktadır. BKİ 30-39,9 kg/m2 olan ve morbid obezitesi olan hastalarda tiroid hormon düzeyleri benzerdi. Biz obezitede TSH düzeylerinin taranmasını öneriyoruz.

Anahtar Kelimeler: Obezite; tiroid hormonları; tiroid uyarıcı hormon
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