Low Preoperative Free Triiodothyronine, Particularly in Females, Is Associated With Reduced Weight Loss and Diabetes Remission After Bariatric Surgery in Euthyroid Adults.

Li S, Tu Y, Zhang H, +5 more, Liu F.

research-articleOpen access

AI summary — for doctors, generated from the abstract only

In a cohort of over 1,500 euthyroid patients with obesity, lower baseline free triiodothyronine (FT3), especially in women, was associated with reduced weight loss and diabetes remission after bariatric surgery.

What was studied

A cross-sectional cohort of 1,567 euthyroid patients with overweight/obesity (1,034 with complete 1-year postoperative data) examined relationships between baseline thyroid hormones (notably FT3) and body composition, and whether baseline FT3 predicted successful weight loss (total WL ≥25%) and diabetes remission after bariatric surgery; the exact glucose-based definition of diabetes remission was not reported in the available abstract text.

Key findings

FT3 plateaued beyond an age threshold and correlated linearly with fat-free mass index.
Higher baseline FT3 tertiles were significantly associated with greater likelihood of successful weight loss and diabetes remission at 1 year, with stronger associations in females.
Identified FT3 thresholds: 4.75 (women) and 5.05 (men) for weight loss; 4.57 (women) and 5.00 (men) for diabetes remission.
Preoperative FT3 levels below these thresholds were significantly associated with reduced weight loss and diabetes remission over 3 years.

Clinical relevance

The findings suggest preoperative FT3 level, with sex-specific thresholds, may help identify patients at risk of a suboptimal bariatric surgery response, which could be relevant to preoperative risk stratification, though specific effect sizes (e.g., odds ratios) were not given in the abstract.

Who should care

Endocrinology

Limitations

Cross-sectional design for the thyroid-hormone/obesity relationships limits causal inference; exact statistical effect sizes for the FT3-outcome associations and the precise diabetes remission definition were not reported in the available abstract text.

Lower pre-surgery FT3, particularly in women, predicted worse weight loss and diabetes remission after bariatric surgery in this large cohort.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Aims

With the rising prominence of GLP-1 receptor agonists, identifying predictors of optimal bariatric surgery candidates has become increasingly important. We investigated cross-sectional relationships between thyroid hormones and obesity-related parameters, and evaluated the predictive value of baseline thyroid hormones for weight loss (WL) and diabetes remission (DR) after bariatric surgery.

Methods

This study included a cross-sectional cohort of 1567 euthyroid patients with overweight or obesity, of whom 1034 with complete 1 year postoperative data were included in the longitudinal analysis. Body composition was assessed using validated predictive equations and abdominal MRI. The primary outcomes were successful WL (total WL ≥ 25%) and DR (fasting glucose < 5.6 mmol/L and HbA1c < 6.0% without antidiabetic medications) during the 3 year follow-up.

Results

Breakpoint analysis indicated that free triiodothyronine (FT3) plateaued beyond an age threshold while showing a linear correlation with fat-free mass index. Higher baseline FT3 tertiles were significantly linked to increased likelihood of achieving successful WL and DR at 1 year follow-up, with stronger associations in females. Optimal FT3 thresholds were identified as 4.75 (females) and 5.05 (males) for WL, and 4.57 (females) and 5.00 (males) for DR. Preoperative FT3 levels below these thresholds were significantly associated with reduced WL and DR over 3 years.

Conclusions

Serum FT3 exhibits an age-related breakpoint effect, and low preoperative FT3, particularly in females, is a critical predictor of suboptimal short- and long-term WL and DR success post-bariatric surgery. Sex-specific FT3 thresholds may aid in preoperative risk stratification and inform personalised treatment decisions in the era of expanding obesity therapeutics.

DOI

10.1002/dmrr.70228

PMID

42733963

PMCID

PMC13572958

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

Want more like this?

Browse more from the feed. A free account unlocks the full feed, saving and communities.

Back to the research feed

Create a free account · Sign in