갑상선암 수술 후 치료 방법에 따른 체중, 체성분과 대사 지표의 변화

초록

Background and Objectives: Patients with thyroid cancer often have complained of weight gain and fatigue after thyroidectomy, even when they have achieved euthyroidism or mild thyroid stimulating hormone (TSH) suppression. The aim of this study was to identify the changes of weight, body composition and metabolic parameters after thyroidectomy in patients with thyroid cancer according to radioactive iodine (RAI) treatment. Materials and Methods: We prospectively recruited 40 women aged 40–60 years who were diagnosed differentiated thyroid cancer and scheduled for thyroidectomy in Seoul National University Hospital from June 2013 to April 2015. In the study group, 19 subjects had RAI treatment: 11 after thyroid hormone withdrawal and 8 after recombinant human TSH (rhTSH). Body composition using dual-energy X-ray absorptiometry (DXA) and metabolic parameters were measured at preoperative, postoperative 7 and 12 months. Results: There were no significant changes of weight at postoperative 7, 12 months. In subjects without RAI treatment, body fat (%) were significantly lower (37.4±5.5 vs. 34.6±5.5 vs. 35.0±5.4%, p＜0.001) and lean mass were higher (33.7±3.7 vs. 35.0±4.0 vs. 34.6±3.8 kg, p=0.002) at postoperative 7, 12 months compared to preoperative. However, there were no significant changes of body composition in subjects with RAI treatment. There were no significant differences between the changes in metabolic parameters including blood pressure, glucose and lipid profiles from preoperative to postoperative 12 months. Conclusion: Our study demonstrated that RAI treatment and thyroid function changes after thyroidectomy does not affect adversely on weight, body composition and metabolic parameter.

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