Visceral and subcutaneous adipose tissue, which one induced thyroid dysfunction in patients with morbid obesity

XuYang Jia; Lei Du; HuiHui Ma; DongLei Zhou; Shen Qu; LiJun Zheng

doi:10.1016/j.soard.2021.02.012

Visceral and subcutaneous adipose tissue, which one induced thyroid dysfunction in patients with morbid obesity

Surg Obes Relat Dis. 2021 Jun;17(6):1175-1181. doi: 10.1016/j.soard.2021.02.012. Epub 2021 Feb 17.

Authors

XuYang Jia¹, Lei Du², HuiHui Ma², DongLei Zhou³, Shen Qu², LiJun Zheng⁴

Affiliations

¹ Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China; Department of Metabolic Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China.
² Department of Metabolic Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China; National Metabolic Management Center, Shanghai, P.R. China.
³ Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China; Department of Metabolic Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China. Electronic address: m18637480762@126.com.
⁴ Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital affiliated to Tongji University, Tongji Medical School, Shanghai, P.R. China.

PMID: 33757703
DOI: 10.1016/j.soard.2021.02.012

Abstract

Background: Thyroid dysfunction in patients with morbid obesity usually resolves after bariatric surgery. However, the role of diverse types of adipose tissue in the process remains unknown.

Objectives: We aim to investigate the effects of visceral and subcutaneous fat on thyroid function in a Chinese population with morbid obesity who underwent sleeve gastrectomy (SG).

Setting: University hospital, Shanghai, China METHODS: Repeated measurement data of thyroid hormone and body fat were collected at 0, 3, 6, 12, 24, and 36 months after sleeve gastrectomy. Dual-energy X-ray absorptiometer and quantitative computerized tomography (CT) were used to compute visceral fat and subcutaneous fat. Repeated measures correlation (rmmcorr) package was employed for correlation analysis with generalized additive mixed model (GAMM) determining the independent factors.

Results: Thyroid stimulating-hormone (TSH) showed notable decrease at 36 months after surgery, coupled with reduction of BMI (38.08 kg/cm² versus 24.28 kg/cm²), C-reactive protein (CRP), visceral adipose tissue (786.74 cm² versus 367.44 cm²), body fat rate, and waistline (118.13 cm versus 100.87 cm). Only visceral fat, diabetes, and CRP proved to be independent variables for TSH decline, without correlation with subcutaneous fat.

Conclusion: The present study is first to report the effects of different types of body fat on thyroid function in a Chinese population with morbid obesity, revealing that loss of visceral fat is the key to improving endocrine and metabolic activity after bariatric surgery.

Keywords: Morbid obesity; Sleeve gastrectomy; Thyroid hormone resistance; Thyroid-stimulating hormones; Visceral adipose tissue.

MeSH terms

Adipose Tissue
Bariatric Surgery* / adverse effects
China
Gastrectomy / adverse effects
Humans
Intra-Abdominal Fat / diagnostic imaging
Obesity, Morbid* / surgery
Subcutaneous Fat / diagnostic imaging
Thyroid Gland