Levothyroxine Absorption in Morbidly Obese Patients Before and After Roux-En-Y Gastric Bypass (RYGB) Surgery

Imagem de Miniatura
Arquivos
art_GALRAO_Levothyroxine_Absorption_in_Morbidly_Obese_Patients_Before_and_2012.PDF (139.05 KB)
Citações na Scopus
45
Tipo de produção
article
Data de publicação
2012
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
RUBIO, Ileana Gabriela Sanchez
Citação
OBESITY SURGERY, v.22, n.2, p.253-258, 2012
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Roux-en-Y gastric bypass (RYGB) modifies the anatomical structure of the upper intestine tract, reduces gastric acid secretion, and may impair LT4 absorption. The aim of this study was to evaluate the LT4 absorption in morbidly obese patients before and after RYGB. Thirty morbidly obese patients were divided in two groups: The NS group included 15 patients before RYGB surgery (BMI = 43.1 +/- 4 kg/m(2)), and the S group included 15 patients after surgery (BMI = 37.3 +/- 4 kg/m(2)). Two baseline samples were collected, and 600 mu g of oral LT4 tablets were administered. Blood samples were collected at 30, 60, 120, 180, 240, 300, and 1440 min. Serum-free T4 (FT4), total T4 (TT4), and TSH were measured at each time point. The increase in TT4, FT4, and TSH (Delta TT4, Delta FT4, and Delta TSH) was calculated, subtracting from the baseline mean value. The pharmacokinetics parameters regarding LT4 absorption, maximum Delta TT4, and area under the curve(AUC) of both Delta TT4 and Delta FT4 were significantly higher in the S group compared with the NS group (p < 0.05). It was observed, however, that there was a significant delay in the absorption of LT4 in the S group. Basal serum TSH and leptin levels were higher in the NS group (p = 0.016 and 0.026, respectively), whereas basal serum TT4, FT4, Delta TSH, and the AUC of Delta TSH were similar between groups. In this study, we have demonstrated that Roux-en-Y bypass surgery does not diminish LT4 absorption. A small but significant delayed absorption of LT4, however, was observed in patients after surgery.
Palavras-chave
L-Thyroxine absorption, Bariatric surgery, Morbid obesity, Roux-en-Y bypass
URI
https://observatorio.fm.usp.br/handle/OPI/425
Referências
  1. Aoki Y, 2007, THYROID, V17, P1211, DOI 10.1089/thy.2006.0235
  2. AZIZI F, 1979, ANN INTERN MED, V90, P941
  3. BENVENGA S, 1995, THYROID, V5, P249, DOI 10.1089/thy.1995.5.249
  4. Benvenga S, 2008, THYROID, V18, P293, DOI 10.1089/thy.2007.0222
  5. BEVAN JS, 1986, INT J OBESITY, V10, P245
  6. Camargo RYA, 2008, EUR J ENDOCRINOL, V159, P293, DOI 10.1530/EJE-08-0192
  7. CAMPBELL NRC, 1992, ANN INTERN MED, V117, P1010
  8. Centanni M, 2006, NEW ENGL J MED, V354, P1787, DOI 10.1056/NEJMoa043903
  9. Checchi S, 2008, J CLIN ENDOCR METAB, V93, P465, DOI 10.1210/jc.2007-1544
  10. Chen AY, 2009, CANCER, V115, P3801, DOI 10.1002/cncr.24416
  11. Chiu AC, 1998, THYROID, V8, P667, DOI 10.1089/thy.1998.8.667
  12. Decker GA, 2007, AM J GASTROENTEROL, V102, P2571, DOI 10.1111/j.1572-0241.2007.01421.x
  13. Flier JS, 2000, J CLIN INVEST, V105, P859, DOI 10.1172/JCI9725
  14. Hays M T, 1991, Thyroid, V1, P241, DOI 10.1089/thy.1991.1.241
  15. HAYS MT, 1994, THYROID, V4, P55, DOI 10.1089/thy.1994.4.55
  16. Hennemann G, 2001, ENDOCR REV, V22, P451, DOI 10.1210/er.22.4.451
  17. Hollenberg AN, 2008, THYROID, V18, P131, DOI 10.1089/thy.2007.0251
  18. Kok P, 2005, J CLIN ENDOCR METAB, V90, P4659, DOI 10.1210/jc.2005-0920
  19. LIEL Y, 1994, AM J MED, V97, P363, DOI 10.1016/0002-9343(94)90303-4
  20. Marzullo P, 2010, J CLIN ENDOCR METAB, V95, P3965, DOI 10.1210/jc.2009-2798
  21. MCLEAN M, 1993, LANCET, V341, P1286, DOI 10.1016/0140-6736(93)91195-R
  22. Mistry D, 2011, CLIN ENDOCRINOL, V74, P384, DOI 10.1111/j.1365-2265.2010.03940.x
  23. NORTHCUT.RC, 1969, J AMER MED ASSOC, V208, P1857, DOI 10.1001/jama.208.10.1857
  24. PAPAVRAMIDIS ST, 1995, OBES SURG, V5, P298, DOI 10.1381/096089295765557674
  25. Santini F, 2005, J CLIN ENDOCR METAB, V90, P124, DOI 10.1210/jc.2004-1306
  26. Sherman SI, 1995, AM J THER, V2, P814, DOI 10.1097/00045391-199510000-00014
  27. SHERMAN SI, 1994, AM J MED, V96, P531, DOI 10.1016/0002-9343(94)90093-0
  28. Singh N, 2001, THYROID, V11, P967, DOI 10.1089/105072501753211046
  29. WENZEL KW, 1977, METABOLISM, V26, P1, DOI 10.1016/0026-0495(77)90121-4
  30. Zaninotto P, 2009, J EPIDEMIOL COMMUN H, V63, P140, DOI 10.1136/jech.2008.077305

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/25