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Relationship Between Hormonal Mechanisms of Diabetes Mellitus and Hypothyroidism Post-Bariatric Surgery.
糖尿病的激素机制与减肥手术后甲状腺功能减退的关系。
- 影响因子:2.09
- DOI:10.2174/1573399815666190417145440
- 作者列表:"Goes LG","da Luz Eltchechem C","Wouk J","Malfatti CRM","da Silva LA
- 发表时间:2020-01-01
Abstract
BACKGROUND:Obesity, diabetes mellitus may be related to the health, the relationship and the physiological capacity of the production of thyroid hormones (TH), triiodothyronine (T3) and thyroxine (T4). OBJECTIVES:The main aims of this review are to describe the relationship between obesity, appetite, weight management, hormonal mechanisms of diabetes mellitus and hypothyroidism post-bariatric surgery. METHODOLOGY:An in-depth literature search was conducted to identify scientific studies, which analyzed the correlation between diabetes mellitus and hypothyroidism post-bariatric surgery. RESULTS:Bariatric surgery decreases hypothyroidism, reduces the need for pharmacological action (such as levothyroxine), controls the weight and body fat and increases the sensitivity to leptin and insulin. CONCLUSION:The reduction of the stomach and intestine by bariatric surgery is an evolutionary and beneficial action, because it may lead to a drastic decrease on numbers of conditions such as diabetes, obesity, hypothyroidism, and others. Thus, new studies should also focus on patients' post-operatory conditions, such as lifetime, regulation and functioning of organs after reduced nutrition, and consumption and delivery of nutrients to health maintenance.
摘要
背景: 肥胖、糖尿病可能与甲状腺激素 (TH) 、三碘甲状腺原氨酸 (T3) 和甲状腺素 (T4) 的产生、关系及生理能力有关。 目的: 本综述的主要目的是描述肥胖、食欲、体重管理、糖尿病和减肥手术后甲状腺功能减退的激素机制之间的关系。 方法: 进行了深入的文献检索,以确定科学研究,分析了糖尿病和减肥手术后甲状腺功能减退之间的相关性。 结果: 减肥手术减少甲状腺功能减退,减少对药理作用 (如左旋甲状腺素) 的需要,控制体重和体脂,增加对瘦素和胰岛素的敏感性。 结论: 减肥手术减少胃和肠是一种进化和有益的作用,因为它可能导致诸如糖尿病、肥胖、甲状腺功能减退、和其他人。因此,新的研究还应关注患者的术后状况,如生命、营养减少后器官的调节和功能,以及营养物质的消耗和输送以维持健康。
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METHODS::Ancillary molecular testing has emerged as a promising way to refine the preoperative risk stratification of thyroid nodules with indeterminate fine needle aspiration (FNA) biopsy results. Commercially available molecular tests for thyroid FNAs include those that analyze samples for mutations and gene fusions, gene expression alterations, microRNA expression alterations, chromosomal copy number alterations, or a combination thereof. This review summarizes the performance characteristics of the most current iterations of three tests currently marketed for cytologically indeterminate thyroid nodules: ThyroSeq v3, ThyGeNEXT/ThyraMIR, and Afirma Gene Sequencing Classifier.
METHODS:OBJECTIVES/HYPOTHESIS:The definition of large-volume pathologic N1 metastases has been changed in the 2017 version 2 of the National Comprehensive Cancer Network guidelines, leading to a controversy over the optimal surgical approach selection for patients with biopsy-proven papillary thyroid carcinoma (PTC). The aim of this study was to investigate the therapeutic efficacy of total thyroidectomy (TT) and thyroid lobectomy (TL) for these patients. STUDY DESIGN:Retrospective population-based database analysis. METHODS:A total of 906 consecutive PTC patients with pathologic N1 metastases (>5 involved nodes with metastases ≤5 mm in the largest dimension) were retrieved from the Surveillance, Epidemiology, and End Results database, and divided into two groups (≤2 mm, >2-5 mm) based on the size of the extent of disease. Overall survival (OS) was then compared between patients treated with TT and TL, followed by Cox proportional hazards regression analysis to explore multiple prognostic factors. RESULTS:OS favored TT compared with TL in patients with more than five involved nodes and metastases >2 to 5 mm in the largest dimension (P < .05). Cox analysis showed that the TL was not an independent factor associated with poorer OS than TT in these patients (P > .05). CONCLUSIONS:TT showed better survival than TL for patients with more than five involved nodes and metastases >2 to 5 mm in the largest dimension. For patients with more than five involved nodes and metastases ≤2 mm in the largest dimension, either TT or TL can be recommended because there was no difference in survival. LEVEL OF EVIDENCE:NA Laryngoscope, 130:269-273, 2020.
METHODS:BACKGROUND:Obesity, diabetes mellitus may be related to the health, the relationship and the physiological capacity of the production of thyroid hormones (TH), triiodothyronine (T3) and thyroxine (T4). OBJECTIVES:The main aims of this review are to describe the relationship between obesity, appetite, weight management, hormonal mechanisms of diabetes mellitus and hypothyroidism post-bariatric surgery. METHODOLOGY:An in-depth literature search was conducted to identify scientific studies, which analyzed the correlation between diabetes mellitus and hypothyroidism post-bariatric surgery. RESULTS:Bariatric surgery decreases hypothyroidism, reduces the need for pharmacological action (such as levothyroxine), controls the weight and body fat and increases the sensitivity to leptin and insulin. CONCLUSION:The reduction of the stomach and intestine by bariatric surgery is an evolutionary and beneficial action, because it may lead to a drastic decrease on numbers of conditions such as diabetes, obesity, hypothyroidism, and others. Thus, new studies should also focus on patients' post-operatory conditions, such as lifetime, regulation and functioning of organs after reduced nutrition, and consumption and delivery of nutrients to health maintenance.
主要分为内科治疗的甲状腺疾病和外科治疗的甲状腺疾病两大类。内科治疗的甲状腺疾病主要包括甲状腺功能亢进症和甲状腺炎症。外科治疗的甲状腺疾病包括甲状腺肿和甲状腺肿瘤。