Aim: To investigate the relationship between metabolic parameters and thyroid hormone changes which occur in patients treated with thyroid replacement therapy following total thyroidectomy.
Material and Method: The study comprised 30 patients who underwent total thyroidectomy. Evaluations were made preoperatively and after 6 and 12 months postoperatively. Body mass index was calculated by recording height and weight of all patients, waist size was measured, arterial blood pressure was measured with a sphyngomanometer on the right arm after 10 mins of rest. Peripheral blood samples were taken after 12-hour fasting for the evaluation of low density lipoprotein, high density lipoprotein, total cholesterol, triglyceride, fasting glucose, fasting insulin, thyroid stimulating hormone, free T3, free T4, C-reactive protein, and haemoglobin A1c values.
Results: In the postoperative 1-year follow-up, a significant increase was determined in total cholesterol, low-density protein and triglyceride levels, which are related to cardiovascular risk, but no significant change was determined in high density protein levels. In addition, a significant increase was determined in the postoperative trend of both systolic and diastolic arterial blood pressures compared to the preoperative values.
Conclusion: Although euthyroid was achieved with follow-up of thyroid functions in the patients who underwent bilateral total thyroidectomy, it was found that there could be changes in metabolic parameters. Therefore, with close monitoring of the metabolic profile of these patients, it can be recommended that lifestyle changes are made when medical intervention is insufficient.
Agarwal G, Aggarwal V. Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? An evidence-based review. World J Surg. 2008;32:1313–1324. DOI: http://doi.org/10.1007/s00268-008-9579-8 [PMid: 18449595]
Rios A, Rodriguez JM, Galindo PJ, Montoya MJ, Canteras M, Parrilla P. Surgical treatment of multinodular goiter in young patients. Endocrine. 2005;27:245–252. DOI: http://doi.org/10.1385/ENDO:27:3:245
Delbridge L. Total thyroidectomy: the evolution of surgical technique. Aust N Z J Surg. 2003;73:761–768. DOI: http://doi.org/10.1046/j.1445-2197.2003.02756.x
Dillman WH. Biochemical basis of thyroid hormone action in the heart. Am J Med. 1990;88:626–630. DOI: http://doi.org/10.1016/0002-9343(90)90530-Q
Brent GA. The molecular basis of thyroid hormone action. N Engl J Med. 1994;1:847–853
Chidakel A, Mentuccia D, Celi FS. Peripheral metabolism of thyroid hormone and glucose homeostasis. Thyroid. 2005;5:899–903. DOI: http://doi.org/10.1089/thy.2005.15.899 [PMid: 16131332]
Knudsen N, Laurberg P, Rasmussen LB, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90:4019–4024. DOI: http://doi.org/10.1210/jc.2004-2225 [PMid: 15870128]
Isik A, Karavas E, Peker K, Soyturk M, Yilmaz I. Male Mondor's Disease is a Rare Entity. Breast J. 2016 Nov;22(6):700–701. DOI: http://doi.org/10.1111/tbj.12657 [PMid: 27550206]
Işık Arda, Fırat Deniz, Soyturk Mehmet, Demiryilmaz İsmail, Yilmaz İsmayil. İdiopatik Periportal Lenfadenopati. Gazi Medical Journal. 2016;27:51–52
IŞIK Arda, SAYAR İlyas, GÜLHAN Barış, FIRAT Deniz. Fascioliasis: A Rare Case Mimicking Cholelithiasis. J Kartal TR. 2016;27(2):145–146
Isik A, Eken H, Soyturk M, Firat D, Yilmaz I. A Rare Presentation of Accessory Breast in Axilla. Galician Medical Journal. 2016;23 (4):E201645 DOI: http://doi.org/10.21802/gmj.2016.4.5
Cooney MT, Dudina AL, Graham IM. Value and limitations of existing scores for the assessment of cardiovascular risk. A review for clinicians. J Am Coll Cardiol. 2009;54:1209–1227. DOI: http://doi.org/10.1016/j.jacc.2009.07.020 [PMid: 19778661]
Cooney MT, Dudina A, d'Agostino R, Graham IM. Cardiovascular risk estimation systems in primary prevention. Do they differ? Do they make a difference? Can we see the future? Circulation. 2010;122:300–310. DOI: http://doi.org/10.1161/CIRCULATIONAHA.109.852756 [PMid: 20644026]
Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: Fourth Joint Task Force of the European Society of Cardiology and other societies. Eur J Cardiovasc Prev Rehabil. 2007;Suppl 2:S1–113. DOI: http://doi.org/10.1097/01.hjr.0000277983.23934.c9 [PMid: 17726407]
İşgör A. Multinodüler guatr. In: İşgör A (Eds). Tiroid Hastalıkları ve Cerrahisi. İstanbul: Avrupa Tıp, 2000: 233-238.
Arslan M, Atmaca A, Ayvaz G, et al. Metabolik Sendrom kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği metabolik sendrom çalışma grubu 2009.
Reiner Z, Catapono AL, De Backer G, et al. ESC/EAS Kılavuzları: Dislipidemilerin tedavisi. Avrupa Kardiyoloji Cemiyeti (ESC) ve Avrupa Ateroskleroz Derneği (EAS) Dislipidemilerin Tedavisi Görev Grubu. Türk Kardiyol Dern Arş. 2011;Suppl 3:10–14
Kozakova M, Natali A, Dekker J, et al. Insulin sensitivity and carotid intima-media thickness: relationship between insulin sensitivity and cardiovascular risk study. Arterioscler Thromb Vasc Biol. 2013;33:1409–1417. DOI: http://doi.org/10.1161/ATVBAHA.112.300948 [PMid: 23599442]
De Pergola G, Ciccone M, Pannacciulli N, et al. Lower insulin sensitivity as an independent risk factor for carotid wall thickening in normotensive, non-diabetic, non-smoking normal weight and obese premenopausal women. Int J Obes Relat Metab Disord. 2000;24:825–829. DOI: http://doi.org/10.1038/sj.ijo.0801239 [PMid: 10918528]
Ozdemir S, Ozis E, Gulpinar K, Aydin TH, Suzen B, Korkmaz A. The effects of levothroxine substitution on body mass after total throidectomy for benign nodular goiter. Endocrine Regulations. 2010;44:147–153. DOI: http://doi.org/10.4149/endo_2010_04_147 [PMid: 21077724]
Erbil Y, Ozbey N, Giriş M, Salmaslioğlu A, Ozarmağan S, Tezelman S. Effects of thyroxine replacement on lipid profile and endothelial function after thyroidectomy. Br J Surg. 2007;94:1485–1490. DOI: http://doi.org/10.1002/bjs.5915 [PMid: 17703499]
Xiang GD, He YS, Zhao LS, Hou J, Yue L, Xiang HJ. Impairment of endothelium-dependent arterial dilation in Hashimoto's thyroiditis patients with euthyroidism. Clin Endocrinol. 2006;64:698–702. DOI: http://doi.org/10.1111/j.1365-2265.2006.02531.x [PMid: 16712674]
Monzani F, Caraccio N, Kozakowa M, et al. Effect of levothyroxine replacement on lipid profile and intima–media thickness in subclinical hypothyroidism: a double-blind placebo-controlled study. J Clin Endocrinol Metab. 2004;89:2099–2106. DOI: http://doi.org/10.1210/jc.2003-031669 [PMid: 15126526]
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.