Helena Julià1,2, David Benaiges3,4,5, Paula Mollà2, Juan Pedro-Botet1,2,6, Montserrat Villatoro1, Laia Fontané1, Jose M Ramon6,7, Elisenda Climent1,2, Juana A Flores Le Roux1,2,6, Alberto Goday1,2,6,8. 1. Department of Endocrinology and Nutrition, Hospital del Mar, Paseo Marítimo, 25-29, E-08003, Barcelona, Spain. 2. Department of Medicine, Universitat Autònoma de Barcelona, Campus Universitari Mar. Dr. Aiguader, 80, E-08003, Barcelona, Spain. 3. Department of Endocrinology and Nutrition, Hospital del Mar, Paseo Marítimo, 25-29, E-08003, Barcelona, Spain. 96002@parcdesalutmar.cat. 4. Department of Medicine, Universitat Autònoma de Barcelona, Campus Universitari Mar. Dr. Aiguader, 80, E-08003, Barcelona, Spain. 96002@parcdesalutmar.cat. 5. Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr Aiguader, 80, E-08003, Barcelona, Spain. 96002@parcdesalutmar.cat. 6. Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr Aiguader, 80, E-08003, Barcelona, Spain. 7. Unit of Gastrointestinal Surgery, Hospital del Mar, Institut de Recerca IMIM-Hospital del Mar, Barcelona, Spain. 8. CiberOBN, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0, E-28029, Madrid, Spain.
Abstract
INTRODUCTION: Levothyroxine (LT4) requirements can presumably be modified differently after laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). The present study compared changes in LT4 dose in hypothyroid subjects undergoing LRYGB or LSG 2 years after the procedure. MATERIAL AND METHODS: A 2-year follow-up observational study was conducted in a prospective cohort of obese patients who had undergone bariatric surgery and were receiving LT4. Indication for the type of surgical procedure was based on clinical criteria. Repeated measures ANOVA models were used to examine differences within and between groups. RESULTS: Thirty-five consecutive patients were included for analysis: 22 LRYGB and 13 LSG. Total daily LT4 dosage decreased in the LSG group (133.7 ± 50.3 mcg/day at baseline to 104.3 ± 43.3 mcg/day at 2 years; p = 0.047) whereas it remained stable in the LRYGB group (129.5 ± 46.1 mcg/day at baseline to 125.2 ± 55.7 mcg/day at 2 years; p = 1.000). Differences between groups became significant at 24 months. Daily weight-based LT4 dose increased in the LRYGB group (1.11 ± 0.38 mcg/kg day at baseline to 1.57 ± 0.74 mcg/kg day at 2 years; p = 0.005) with no significant changes in the LSG group (1.15 ± 0.35 mcg/kg day at baseline vs 1.11 ± 0.49 mcg/kg day at 2 years; p = 1.000). CONCLUSION: LRYGB and LSG showed different changes in LT4 requirements 2 years after surgery. There was an early decrease in daily total LT4 dose requirements after LSG, which suggests an early preventive reduction to be validated in future studies.
INTRODUCTION:Levothyroxine (LT4) requirements can presumably be modified differently after laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). The present study compared changes in LT4 dose in hypothyroid subjects undergoing LRYGB or LSG 2 years after the procedure. MATERIAL AND METHODS: A 2-year follow-up observational study was conducted in a prospective cohort of obesepatients who had undergone bariatric surgery and were receiving LT4. Indication for the type of surgical procedure was based on clinical criteria. Repeated measures ANOVA models were used to examine differences within and between groups. RESULTS: Thirty-five consecutive patients were included for analysis: 22 LRYGB and 13 LSG. Total daily LT4 dosage decreased in the LSG group (133.7 ± 50.3 mcg/day at baseline to 104.3 ± 43.3 mcg/day at 2 years; p = 0.047) whereas it remained stable in the LRYGB group (129.5 ± 46.1 mcg/day at baseline to 125.2 ± 55.7 mcg/day at 2 years; p = 1.000). Differences between groups became significant at 24 months. Daily weight-based LT4 dose increased in the LRYGB group (1.11 ± 0.38 mcg/kg day at baseline to 1.57 ± 0.74 mcg/kg day at 2 years; p = 0.005) with no significant changes in the LSG group (1.15 ± 0.35 mcg/kg day at baseline vs 1.11 ± 0.49 mcg/kg day at 2 years; p = 1.000). CONCLUSION: LRYGB and LSG showed different changes in LT4 requirements 2 years after surgery. There was an early decrease in daily total LT4 dose requirements after LSG, which suggests an early preventive reduction to be validated in future studies.
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