减重手术对肥胖合并亚临床甲状腺功能减退症影响的Meta分析

Influence of bariatric surgery on subclinical hypothyroidism in obese patients: a Meta-analysis

目的系统评价减重手术对肥胖相关的亚临床甲状腺功能减退症(SH)的影响。方法检索PubMed、Embase、Cochrane Library、万方、中国知网等数据库关于减重手术对肥胖合并SH影响的相关研究,检索起止时间均从建库至2019年4月。采用MINORS (methodological index for nonrandomized studies)条目进行纳入文献质量评价,使用RevMan 5.3软件进行Meta分析。结果共纳入5项队列研究。Meta分析结果示:减重手术可促使合并SH的肥胖患者血清TSH下降(SMD=1.94,95%CI:1.59~2.30,P<0.00001),而对FT4无影响(SMD=0.15,95%CI:-0.77~1.08,P=0.74)。减重手术可改善肥胖合并SH(OR=49.75, 95%CI:15.08~164.15, P<0.00001)。结论减重手术可以明显改善肥胖合并SH。

Objective To conduct a meta-analysis regarding the impact of bariatric surgery on obesity-related subclinical hypothyroidism(SH).Methods A literature search was conducted on the databases which included the PubMed,Embase,Cochrane library,Wanfang and CNKI about the effect of bariatric surgery on obesity with SH.The retrieval time was from inception to April 2019.The quality of the included trials was assessed by methodological index for non-randomized studies(MINORS).Meta analysis was performed using RevMan 5.3.Results Five articles were included into meta-analysis,which indicated that bariatric surgery was associated with a reduction in TSH(SMD=1.94,95%CI:1.59~2.30,P<0.00001),but no change in FT4(SMD=0.15,95%CI:-0.77~1.08,P=0.74).In addition,bariatric surgery was expected to benefit obese patients with SH(OR=49.75,95%CI:15.08~164.15,P<0.00001).Conclusions The significant improvement of SH in obese patients can be an additional benefit of bariatric surgery.