Tiroid homeostazisi, insülin direnci ve kan parametrelerinin kilo verme üzerine olan etkileri

Year 2021, Volume: 46 Issue: 2, 548 - 554, 30.06.2021

Mehmet Eryılmaz , Duygu İlke Yıldırım

Abstract

Amaç: Birçok çalışma, obezitenin artmış serum tirotropin [TSH] ile ilişkili olduğunu göstermektedir, ancak obezite, serbest tiroid hormonları (serbest triiyodotironin [FT3] ve serbest tiroksin [FT4] dahil) arasındaki ilişki hala net değildir. Bu çalışmada bir obezite merkezinde tiroid homeostazisi, insülin direnci ve kan parametrelerinin kilo verme üzerine olan etkilerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Obezite merkezine 1 Kasım 2018 ile 13 Mart 2020 tarihleri arasında başvuran 3918 hastadan 417'si uygun bulunarak bu obezite önleme programı ve retrospektif, tanımlayıcı, kesitsel çalışmaya kabul edilmiştir.
Bulgular: Çalışmada 383’ü kadın hasta olmak üzere toplam 417 hasta ile görüşüldü. Hastaların ortalama yaşı 48.20 ± 11.03 yıldı. Kilo veren grupta; 6. ayda TSH, FT3, BMI, WC, HC, HbA1c ve HOMA-IR indeks değerleri anlamlı olarak daha düşüktü. Bu sonuçlara göre kilo veren hastaların kan parametreleri, TSH, FT3 ve insülin direnci azalmıştır. Kalça çevresi, BMI, BFP, FT3, HbA1c ve FBG, tek değişkenli analizlerimizde kilo kaybının önemli belirleyicileriydi. FT3 (olasılık oranı [OR]: 1. 854;% 95 CI: [1.223-2.811]; p = 0.004), BMI (OR: 0.948;% 95 CI: [0.914-0.984]; p = 0.005) ve FBG (OR: 0.984;% 95 CI: [0.973-0.996]; p = 0.007) kilo kaybını etkileyen çok değişkenli prediktörler olarak tanımlandı.
Sonuç: Bu çalışma, daha düşük BMI ve FBG seviyelerinin ve daha yüksek fT3 konsantrasyonlarının, obez hastalarda daha iyi bir kilo verme potansiyeli ile ilişkili olduğunu önermektedir.

Keywords

Obezite, insülin direnci, tiroid hormonları, kilo kaybı

Effects of thyroid homeostasis, insulin resistance and some parameters on weight loss

Abstract

Purpose: Many studies show that obesity is associated with increased serum thyrotropin [TSH] but the relationship between obesity, free thyroid hormones (including free triiodothyronine [FT3] and free thyroxin [FT4] is still unclear. The aim of this studywas to evaluate the effects of thyroid homeostasis, insulin resistance and blood parameters on weight loss in an obesity center.
Materials and Methods: Of 3918 patients applied to an obesity center between November 1st, 2018 and March 13th, 2020, 417 were found suitable and accepted in this obesity prevention program and retrospective, descriptive, cross-sectional study.
Results: A total of 417 patients were interviewed, 383 were female in this study. The mean age of participants was 48.20±11.03 years. In the group who lost weight; TSH, FT3, BMI, WC, HC, HbA1c and HOMA-IR index values were significantly lower in the sixth month. According to these results, the blood parameters, TSH, FT3 and insülin resistance of the patients are decreased who lose weight. Hip circumference, BMI, BFP, FT3, HbA1c and FBG were important determinants of weight loss in our univariate analyses. FT3 (odds ratio [OR]: 1.854; 95% CI: [1.223-2.811]; p=0.004), BMI (OR: 0.948; 95% CI: [0.914-0.984]; p=0.005) and FBG (OR: 0.984; 95% CI: [0.973-0.996]; p=0.007) were defined as multivariate predictors affecting weight loss.
Conclusion: This study advises that lower BMI and FBG levels, and higher fT3 concentrations are related with a better potential to lose weight in obese patients.

Keywords

Obesity, insulin resistance, thyroid hormones, weight loss

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