Биология ва тиббиёт муаммолари 2025, №2.1 (160)

Subject of the article

БАРИАТРИК ЖАРРОҲЛИКДАН СЎНГ ГИПОТИРОИД БЕМОРЛАРДА ЛЕВОТИРОКСИНГА БЎЛГАН КУНЛИК ЭҲТИЁЖДАГИ ЎЗГАРИШЛАР (38-41)

Authors

Алимов Анвар Валиевич, Муратова Шахло Тахиржановна, Махмудова Сахобат Мухсимовна

Institution

Академик Ё.Х.Турақулов номидаги Республика ихтисослаштирилган эндокринология илмий-амалий тиббиёт маркази, Ўзбекистон Республикаси, Тошкент ш.

Abstract

Бариатрик жарроҳлик аралашуви қалқонсимон без гормонлари ажралишини тартибга солишга, қалқонсимон без дориларига эҳтиёжни камайтиришга ва умумий қалқонсимон без функциясини яхшилашга ёрдам бериши мумкин. Ушбу тадқиқот бариатрик жарроҳлик ўтказган гипотироид беморларнинг тиреоид статуси ва левотироксинга бўлган эҳтиёжидаги ўзгаришларни баҳолашга қаратилган. 2023-йил феврал-март ойларида Тошкент шаҳридаги хусуий клиникада бариатрик жарроҳлик ўтказган 95 бемордан 16 нафари (16,8%) гипотиреоз ташхиси билан ажратилиб, амалиётдан 6 ой ўтиб тиреоид статуси ва левотироксинга эҳтиёжи баҳоланди. Натижаларга кўра беморларнинг ўртача ТВИ 7,5 кг/м² га, ТТГ 6,57±1,74 дан 4,2±1,6 ммол/л гача пасайди. Эркин Т4 0,72±0,2 дан 1,0±0,27 нг/дл гача ошди. ЛТ4 кунлик доза эҳтиёжи 12,5 мкг/гунга камайди.

Key words

Бариатрик жарроҳлик, гипотиреоз, левотироксин, тиреоид статус.

Literature

1. Adamska, A., Raczkowski, A., Stachurska, Z., Kondraciuk, M., Krętowski, A. J., Adamski, M., Kowalska, I., & Kamiński, K. A. (2022). Body Composition and Se-rum Concentration of Thyroid Hormones in Euthyroid Men and Women from General Population. Journal of clinical medicine, 11(8), 2118. https://doi.org/10.3390/jcm11082118 2. Aderinto, N., Olatunji, G., Kokori, E., Olaniyi, P., Isarinade, T., & Yusuf, I. A. (2023). Recent advances in bariatric surgery: a narrative review of weight loss proce-dures. Annals of medicine and surgery (2012), 85(12), 6091–6104. https://doi.org/10.1097/MS9.0000000000001472 3. Chen, F., Chen, R., Zhou, J., Xu, W., Zhou, J., Chen, X., Gong, X., & Chen, Z. (2024). Impaired Sensitivity to Thyroid Hormones is Associated with Central Obesity in Euthyroid Type 2 Diabetes Mellitus Patients with Over-weight and Obesity. Diabetes, metabolic syndrome and obesity : targets and therapy, 17, 3379–3396. https://doi.org/10.2147/DMSO.S472550 4. Chiung-Hui Peng, C., Han, C., Waisayanand, N., De Leo, S., Srimatkandada, P., Kommareddy, S., Pearce, E. N., He, X., & Lee, S. Y. (2023). Changes in Urinary Iodine Levels Following Bariatric Surgery. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 29(9), 710–715. https://doi.org/10.1016/j.eprac.2023.06.008 5. Fallahi, S.M. Ferrari, S. Camastra et al. TTG normaliza-tion in bariatric surgery patients after the switch from L-thyroxine in tablet to an oral liquid formulation. Obes. Surg. 27(1), 78–82 (2017). https://doi.org/10.1007/s11695-016-2247-4 6. Gadiraju, Silpa; Lee, Clare J.; Cooper, David S. . (2016). Levothyroxine Dosing Following Bariatric Sur-gery. Obesity Surgery, 26(10), 2538–2542. doi:10.1007/s11695-016-2314-x 7. Gruneisen, E., Yang, J. W., & Pasqua, M. (2025). Levo-thyroxine malabsorption following sleeve gastrectomy. Endocrinology, Diabetes & Metabolism Case Reports, 2025(1), e240115. Retrieved Feb 18, 2025, from https://doi.org/10.1530/EDM-24-0115 8. Guan, B., Chen, Y., Yang, J., Yang, W., & Wang, C. (2017). Effect of Bariatric Surgery on Thyroid Function in Obese Patients: a Systematic Review and Meta-Analysis. Obesity surgery, 27(12), 3292–3305. https://doi.org/10.1007/s11695-017-2965-2 9. Heshka, S., Ruggiero, A., Bray, G. et al. Altered body composition in type 2 diabetes mellitus. Int J Obes 32, 780–787 (2008). https://doi.org/10.1038/sj.ijo.0803802 10. I. Pirola, A.M. Formenti, E. Gandossi et al. Oral liquid L-thyroxine (L-t4) may be better absorbed compared to L-T4 tablets following bariatric surgery. Obes. Surg. 23(9), 1493–1496 (2013). https://doi.org/10.1007/s11695-013-1015-y 11. Ismailov S.I., Rashitov M.M. Progress in the field of iodine deficiency disorders prevention in Republic of Uz-bekistan (1998–2016). Clinical and experimental thyroidology. 2016;12(3):20-24. (In Russ.) https://doi.org/10.14341/ket2016320-24 12. Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., Sawka, A. M., & American Thyroid Association Task Force on Thyroid Hormone Replacement (2014). Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid: official journal of the American Thyroid Association, 24(12), 1670–1751. https://doi.org/10.1089/thy.2014.0028 13. Neves, J. S., Castro Oliveira, S., Souteiro, P., Pedro, J., Magalhães, D., Guerreiro, V., Bettencourt-Silva, R., Costa, M. M., Cristina Santos, A., Queirós, J., Varela, A., Freitas, P., Carvalho, D., & AMTCO Group (2018). Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Patients with Morbid Obe-sity and Normal Thyroid Function. Obesity surgery, 28(1), 97–103. https://doi.org/10.1007/s11695-017-2792-5 14. Ren, R., Jiang, X., Lu, L., Li, X., Luo, Y., & Shi, Y. (2014). Association between thyroid hormones and body fat in euthyroid subjects. Clinical Endocrinology, 80(4), 585–590. https://doi.org/10.1111/cen.12311 15. Solanki, Jayesh D.; Makwana, Amit H.; Mehta, Hemant B.; Gokhale, Pradnya A.; Shah, Chinmay J..Body Composition in Type 2 Diabetes: Change in Quality and not Just Quantity that Matters. International Journal of Preventive Medicine 6(1): p 122, | DOI: 10.4103/2008-7802.172376 16. Teshaev, O. R., Ruziev, U. S., Tavasharov, B. N., & Zhumaev, N. A. (2020). EFFECTIVENESS OF BARIATRIC AND METABOLIC SURGERY IN THE TREATMENT OF OBESITY. Medical news, (6 (309)), 64-66. 17. Turcan L., Gerasimov G.A., Parvanta I., Timmer A. Progress in Iodine Deficiency Disorders (IDD) Control and Elimination in Europe and Central Asia Region (ECAR) in 2010–2020. Clinical and experimental thyroidology. 2021;17(4):4-16. https://doi.org/10.14341/ket12713 18. Virili, C., Antonelli, A., Santaguida, M. G., Benvenga, S., & Centanni, M. (2019). Gastrointestinal Malabsorption of Thyroxine. Endocrine reviews, 40(1), 118–136. https://doi.org/10.1210/er.2018-00168