ABSTRACT

Obesity rates are increasing globally and it is becoming an epidemic. Considering the complications and diseases related to obesity, it is a cause of significant morbidity and mortality. Thyroid pathologies is a growing endocrine problem, too and especially in young women in our society its growing incidence is remarkable and it is usually accompanied by obesity and other endocrine problems. In this study, we aimed to evaluate the parameters of thyroid function in obese patients and establish the relationship.

The study included 180 patients who were admitted to the obesity outpatient clinic of Istanbul Education and Research Hospital between January 2012- and March 2013. The medical histories, age, sex, body mass index (BMI), free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (anti-TG) and anti-tiroid peroxidase antibody (anti-TPO) levels and thyroid ultrasonographies of the patients were all screened from patient files and were evaluated. SPSS for Windows statistical analysis method was used for evaluation.

It was established that 18.8% of the patients were hypothyroidic, 76.6% were euthyroidic, 2.77 % were subclinical hypothyroidic, 1.1% were subclinical hyperthyroidic and 0.5% were hyperthyroidic according to thyroid function tests. The mean BMI of hypothyroid group was 41.005 kg/m². Under medical therapy, thyroid function parameters of 88.3% of hypothyroidic patients were between normal range. The mean BMI of euthyroid group was 40.5 kg/m². Although they were euthyroidic, it was established as 11% of the patients had thyroiditis, 41.3% had thyroid nodules and 2.17 % of them had both thyroiditis and thyroid nodules according to ultrasonography results. Also 34% of this group had anti thyroid auto anti bodies. There was only 1 hyperthyroidic patient who had Graves disease and the patient’s BMI was 33.5 kg/m². The mean BMI of subclinical hypothyroidic group was BMI 40.863 kg/m²; also all of them had thyroid nodules.

Obesity is one of the diseases, which is common to be seen along with impaired thyroid functions. Especially hypothyroidism and Hashimoto thyroiditis are frequently seen in obese patients. In our study, the high incidence (21.57%) of hypothyroidism and subclinical hypothyroidism found in obese patients is supporting this relationship. Also the increased presence of thyroiditis and thyroid autoantibodies among euthyroidic patient is remarkable. The association of obesity with increased thyroid pathologies is highly noticeable especially among young women in our society. Insulin resistance, metabolic syndrome and obesity are common among those patients and they usually tend to be resistant to weight loss. And the decreased basic metabolism rate caused by impaired thyroid functions contribute to that situation. Thus; patients must be screened for both obesity and thyroid functions, and necessary treatment and follow-up should be initiated as soon as possible. (JAREM 2014; 2: 74-6)