Changes in Plasma Levels of N-Arachidonoyl Ethanolamine and N-Palmitoylethanolamine following Bariatric Surgery in Morbidly Obese Females with Impaired Glucose Homeostasis

Aim. We examined endocannabinoids (ECs) in relation to bariatric surgery and the association between plasma ECs and markers of insulin resistance.Methods. A study of 20 participants undergoing bariatric surgery. Fasting and 2-hour plasma glucose, lipids, insulin, and C-peptide were recorded preoperatively and 6 months postoperatively with plasma ECs (AEA, 2-AG) and endocannabinoid-related lipids (PEA, OEA).Results. Gender-specific analysis showed differences in AEA, OEA, and PEA preoperatively with reductions in AEA and PEA in females postoperatively. Preoperatively, AEA was correlated with 2-hour glucose (r=0.55,P=0.01), HOMA-IR (r=0.61,P=0.009), and HOMA %S (r=-0.71,P=0.002). OEA was correlated with weight (r=0.49,P=0.03), waist circumference (r=0.52,P=0.02), fasting insulin (r=0.49,P=0.04), and HOMA-IR (r=0.48,P=0.05). PEA was correlated with fasting insulin (r=0.49,P=0.04). 2-AG had a negative correlation with fasting glucose (r=-0.59,P=0.04).Conclusion. Gender differences exist in circulating ECs in obese subjects. Females show changes in AEA and PEA after bariatric surgery. Specific correlations exist between different ECs and markers of obesity and insulin and glucose homeostasis.

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The effect of combination therapy of insulin glargine, metformin, and sitagliptin on insulin secretion, insulin resistance, and metabolic parameters in obese subjects with type 2 diabetes

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1610497z ◽

2016 ◽

Vol 144 (9-10) ◽

pp. 497-502

Author(s):

Teodora Beljic-Zivkovic ◽

Milica Marjanovic-Petkovic ◽

Miljanka Vuksanovic ◽

Ivan Soldatovic ◽

Dobrila Kanlic ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Body Mass Index ◽

Waist Circumference ◽

Insulin Glargine ◽

Body Mass ◽

Fasting Glucose ◽

C Peptide ◽

Obese Subjects

Introduction. A combination of drugs is required for treatment of obese subjects with diabetes, due to multiple pathogenic mechanisms implicated in the development of both diabetes and obesity. Objective. Assessment of the effect of sitagliptin added to insulin glargine and metformin, in obese subjects with type 2 diabetes. Methods. A total of 23 obese subjects on metformin and insulin glargine participated in the study. Titration of insulin glargine during a one-month period preceded the addition of 100 mg of sitagliptin daily. Body mass index, waist circumference, fasting, and prandial glucose were measured monthly, lipids and hemoglobin A1c (HbA1c) every three months, insulin, c-peptide and glucagon at the start and after six months of treatment. Homeostatic models for insulin secretion (HOMA B) and insulin resistance (HOMA IR) were calculated. Results. Participants were 58.65 ?} 7.62 years of age with a body mass index of 35.06 ?} 5.15 kg/m2, waist circumference of 115.04 ?} 15.5 cm, and the duration of diabetes of 4.11 ?} 2.57 years. With the titration of insulin glargine, target fasting glucose levels were not achieved. Waist circumference and body mass index decreased during three months of sitagliptin treatment, thereafter remaining stable. HbA1c decreased significantly after three and six months of therapy. C-peptide increased significantly, while glucagon level fell. HOMA indexes were unchanged. Conclusion. Sitagliptin can improve diabetes control and induce modest weight loss in obese subjects poorly controlled on insulin glargine and metformin. Titration of insulin glargine to optimal fasting glucose values is a prerequisite of success of this combination therapy.

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Comparison of Glucose and Lipid Metabolism Abnormality during Nilotinib, Imatinib and Dasatinib Therapy – Results of Enigma 2 Study

Blood ◽

10.1182/blood.v124.21.1813.1813 ◽

2014 ◽

Vol 124 (21) ◽

pp. 1813-1813 ◽

Cited By ~ 2

Author(s):

Racil Zdenek ◽

Petra Belohlavkova ◽

Petr Cetkovsky ◽

Edgar Faber ◽

Hana Klamova ◽

...

Keyword(s):

Insulin Resistance ◽

Total Cholesterol ◽

Board Of Directors ◽

Ldl Cholesterol ◽

Fasting Glucose ◽

Fasting Insulin ◽

Advisory Committees ◽

C Peptide ◽

Peripheral Insulin Resistance ◽

Fast Development

Abstract Background: Recently we have published results of pilot study on CML patients demonstrating fast development of hyperinsulinaemia, peripheral insulin resistance, hypoadiponectinaemia and hypercholesterolemia during nilotinib therapy. Aims: To analyze results from follow up multicenter study “ENIGMA 2” with the aim to confirm or to exclude results from the pilot study, as well as to analyze whether these abnormalities are detected in control groups of patients treated with other TKIs - imatinib and dasatinib. Methods: Patients received intensive laboratory workup before the start of TKI and after 3 month of therapy. This included fasting insulin, glucose, adiponectin and lipid serum concentration, HbA1c and oral glucose tolerance test. Patients with TKI treatment interruption for >2 weeks and/or dose reduction for > 25% were excluded. Results: Between 2/2011-6/2014 in 5 centers 37 CML patients initiated therapy with nilotinib, 18 with imatinib and 8 with dasatinib. After 3 months patients treated with nilotinib developed significant hypersinulinaemia and hyperglycaemia as result of fast development of peripheral insulin resistance. This was proved by significant increase in HOMA-2 index during 3 months of nilotinib therapy (mean – 1.4 vs. 1.8; p = 0.0023). Moreover, we have proved significant decrease of adiponectin (major insulin sensitizer) concentration as well as significant increase in total and LDL cholesterol concentration after 3 month of nilotinib treatment. Details are presented in Table. Contrary – none of these abnormalities were detected in the control group of patients treated with imatinib and dasatinib, including any change in insulin resistance measured by HOMA-2 index (means – 0.9 vs. 1.3; p = 0.1046 and 1.1 vs. 1.1; p = 0.9255). Moreover, administration of imatinib (and probably also dasatinib, however only limited data are available at this moment) leads to increase of adiponectin concentration, which serves as major insulin sensitizer in peripheral tissues. Conclusions: Our study proved fast development of peripheral insulin resistance already during the first 3 months of nilotinib therapy as underlying cause of glucose and secondary also lipid metabolism impairment during this treatment. Moreover, this was not proved for patients treated with imatinib and dasatinb and significant increase in adiponectin concentration during imatinib (and probably dasatinib) therapy could at least partly explain observed amelioration of diabetes 2 during its administration described in some studies Supported by the CELL – the Czech Leukemia Study Group – for life Table. NILOTINIB THERAPY (n=37) Start Month 3 p mean (range) mean (range) Fasting glucose [mmol/l] 5.3 (4.5-6.7) 5.7 (4.6-8.2) <0.0001 Fasting insulin [mU/l] 11.2 (2.4-28.3) 14,1 (2.5-32.7) 0.0037 Fasting C-peptide [pmol/ml] 0.73 (0.53-1.78) 0.76 (0.76-3.31) 0.4953 Fasting HbA1c [mmol/mol] 38.9 (24.0-55.0) 38.2 (25.0-57.0) 0.3900 Fasting adiponectin [mg/l] 16.6 (2.1-45.1) 8.6 (2.6-22.4) 0.0019* Total cholesterol [mmol/l] 4.8 (2.5-6.7) 5.9 (4.4-7.9) <0.0001 LDL cholesterol [mmol/l] 2.8 (1.1-4.9) 3.6 (2.1-5.7) <0.0001 IMATINIB THERAPY (n=18) Start Month 3 p mean (range) mean (range) Fasting glucose [mmol/l] 5.5 (4.4-7.7) 5.6 (4.2-6.4) 0.7567 Fasting insulin [mU/l] 6.7 (2.0-19.0) 9.8 (2.0-37.80) 0.1369 Fasting C-peptide [pmol/ml] 0.77 (0.25-1.55) 0.72 (0.27-1.78) 0.4569 Fasting HbA1c [mmol/mol] 44.8 (33.0-59.0) 41.1 (30.0-55.0) 0.005 Fasting adiponectin [mg/l] 10.8 (2.1-25.7) 26.1 (6.0-45.2) <0.0001** Total cholesterol [mmol/l] 5.1 (3.3-7.1) 4,7 (2.6-7.1) 0.1123 LDL cholesterol [mmol/l] 3.1 (1.7-4.7) 2.7 (1.2-4.7) 0.064 DASATINIB THERAPY (n=8) Start Month 3 p mean (range) mean (range) Fasting glucose [mmol/l] 5.8 (4.6-6.8) 5.3 (3.3-6.7) 0.1764 Fasting insulin [mU/l] 8.1 (2.5-19.3) 8.4 (2.6-17.9) 0.8815 Fasting C-peptide [pmol/ml] 0.63 (0.16-1.11) 0.60 (0.24-1.03) 0.8223 Fasting HbA1c [mmol/mol] 38.8 (31.0-51.0) 37.8 (30.0-56.0) 0.684 Fasting adiponectin [mg/l] 17.3 (9.2-26.7) 12.9 (5.5-21.4) 0.0106*** Total cholesterol [mmol/l] 4.0 (3.0-5.0) 4.5 (3.6-5.8) 0.0831 LDL cholesterol [mmol/l] 2.2 (1.6-3.0) 2.5 (1.9-3.3) 0.1140 *number of paired measurements = 24 **number of paired measurements = 12 ***number of paired measurements = 3 Disclosures Zdenek: Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Klamova:Novartis and Bristol Myers-Squibb: Consultancy, Honoraria. Mayer:Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau.

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Jejunal Insulin Signalling Is Increased in Morbidly Obese Subjects with High Insulin Resistance and Is Regulated by Insulin and Leptin

Journal of Clinical Medicine ◽

10.3390/jcm9010196 ◽

2020 ◽

Vol 9 (1) ◽

pp. 196 ◽

Cited By ~ 1

Author(s):

Carolina Gutierrez-Repiso ◽

Ailec Ho-Plagaro ◽

Concepción Santiago-Fernandez ◽

Sara Garcia-Serrano ◽

Francisca Rodríguez-Pacheco ◽

...

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Epithelial Cells ◽

Intestinal Epithelial Cells ◽

Insulin Signalling ◽

Morbidly Obese ◽

Model Assessment ◽

Intestinal Epithelial ◽

High Insulin ◽

Obese Subjects

Little is known about the jejunal insulin signalling pathways in insulin resistance/diabetes states and their possible regulation by insulin/leptin. We study in jejunum the relation between insulin signalling and insulin resistance in morbidly obese subjects with low (MO-low-IR) or with high insulin resistance (MO-high-IR), and with type 2 diabetes treated with metformin (MO-metf-T2DM), and the effect of insulin/leptin on intestinal epithelial cells (IEC). Insulin receptor substrate-1 (IRS1) and the catalytic p110β subunit (p110β) of phosphatidylinositol 3-kinase (PI3K) were higher in MO-high-IR than in MO-low-IR. The regulatory p85α subunit of PI3K (p85α)/p110β ratio was lower in MO-high-IR and MO-metf-T2DM than in MO-low-IR. Akt-phosphorylation in Ser473 was reduced in MO-high-IR compared with MO-low-IR. IRS1 and p110-β were associated with insulin and leptin levels. The improvement of body mass index (BMI) and HOMA-IR (homeostasis model assessment of insulin resistance index) after bariatric surgery was associated with a higher IRS1 and a lower p85α/p110β ratio. IEC (intestinal epithelial cells) incubation with a high glucose + insulin dose produced an increase of p85α and p110β. High dose of leptin produced an increase of IRS1, p85α and p110β. In conclusion, despite the existence of insulin resistance, the jejunal expression of genes involved in insulin signalling was increased in MO-high-IR. Their expressions were regulated mainly by leptin. IRS1 and p85α/p110β ratio was associated with the evolution of insulin resistance after bariatric surgery.

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Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0261 ◽

2018 ◽

Vol 0 (0) ◽

Author(s):

Vivian L. Chin ◽

Kristen M. Willliams ◽

Tegan Donnelley ◽

Marisa Censani ◽

Rushika Conroy ◽

...

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Total Testosterone ◽

Morbidly Obese ◽

Fasting Insulin ◽

Adolescent Boys ◽

Obese Adolescent ◽

Gonadal Dysfunction ◽

T1 And T2

Abstract Background Elevated body mass index (BMI) is associated with hypogonadism in men but this is not well described in adolescents. The aim is to evaluate gonadal dysfunction and the effects of weight loss after gastric banding in obese adolescent boys. Methods Thirty-seven of 54 boys (age 16.2±1.2 years, mean BMI 48.2 kg/m2) enrolled at the Center for Adolescent Bariatric Surgery at Columbia University Medical Center had low total testosterone for Tanner 5 <350 ng/dL. Sixteen had long-term hormonal data for analysis at baseline (T0), 1 year (T1) and 2 years (T2) post-surgery. T-tests, chi-squared (χ2) tests, correlation and linear mixed models were performed. Results At T0, the hypogonadal group had higher systolic blood pressure (SBP) (75th vs. 57th percentile, p=0.02), fasting insulin (19 vs. 9 μIU/mL, p=0.0008) and homeostatic index of insulin resistance (HOMA-IR) (4.2 vs. 1.9, p=0.009) compared to control group. Total testosterone was negatively correlated with fasting insulin and HOMA-IR. In the long-term analysis, BMI, weight, waist circumference (WC), and % excess weight decreased at T1 and T2 compared to T0. Mean total testosterone at T0, T1 and T2 were 268, 304 and 368 ng/dL, respectively (p=0.07). There was a statistically significant negative correlation between BMI and testosterone after 2 years (r=−0.81, p=0.003). Conclusions Low testosterone levels but unaltered gonadotropins are common in this group and associated with insulin resistance. While a significant increase in testosterone was not found over time, the negative relationship between BMI and testosterone persisted, suggesting there may be an optimal threshold for testosterone production with respect to BMI. Long-term studies are needed.

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The relationship between serum FGF-23 concentration and insulin resistance, prediabetes and dyslipidemia in obese children and adolescents

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0507 ◽

2019 ◽

Vol 32 (7) ◽

pp. 707-714 ◽

Cited By ~ 3

Author(s):

Yesim Kutluturk ◽

Aysehan Akinci ◽

Ibrahim Halil Ozerol ◽

Saim Yologlu

Keyword(s):

Insulin Resistance ◽

Glucose Tolerance ◽

Children And Adolescents ◽

Bone Mineralization ◽

Significant Negative Correlation ◽

Fasting Insulin ◽

Obese Children ◽

C Peptide ◽

Obese Subjects ◽

Fgf 23

Abstract Background Obesity is known to cause metabolic disturbances including insulin resistance, dyslipidemia and alters bone mineralization. The effects of obesity on fibroblast growth factor 23 (FGF-23), which is important in bone mineralization, have not yet been clarified. Our aim was to investigate the association between FGF-23 concentration and obesity-associated dysmetabolism. Methods Subjects comprised 46 obese children and adolescents. The same number of age-matched, healthy controls were recruited. Markers of bone mineralization and glucose metabolism were measured. Thyroid function and insulin resistance were investigated in both groups. In obese subjects; an oral glucose tolerance test (OGTT) was performed and hemoglobin A1c and lipid fractions were measured. Bone mineral density and hepatic steatosis were investigated. Results Serum FGF-23, α-klotho and 1,25(OH)2D3 concentrations were significantly lower while fasting insulin, fasting glucose, C-peptide and alkaline phosphatase (ALP) concentrations and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the obese group compared to controls. A significant negative correlation was observed between free tri-iodothyronine (fT3) and both FGF-23 and α-klotho in the obese group. Significant negative correlation was found between FGF-23 and C-peptide and a positive correlation was found between FGF-23 and high density lipoprotein-cholesterol (HDL-c) in the obese subjects with impaired glucose tolerance (IGT). Significant negative correlations were found between FGF-23 and both fasting insulin levels and C-peptide levels in the obese subjects with hepatic steatosis. Conclusions In our study, insulin resistance-associated hyperinsulinism and/or lower 1,25(OH)2D3 levels, both present in obese children and adolescents, may lead to decreased serum FGF-23 concentrations in obese subjects.

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GLP-1 and peptide YY secretory response after fat load is impaired by insulin resistance, impaired fasting glucose and type 2 diabetes in morbidly obese subjects

Clinical Endocrinology ◽

10.1111/cen.12221 ◽

2013 ◽

Vol 80 (5) ◽

pp. 671-676 ◽

Cited By ~ 19

Author(s):

José C. Fernández-García ◽

Mora Murri ◽

Leticia Coin-Aragüez ◽

Juan Alcaide ◽

Rajaa El Bekay ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Impaired Fasting Glucose ◽

Peptide Yy ◽

Fasting Glucose ◽

Secretory Response ◽

Morbidly Obese ◽

Obese Subjects

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Changes in the Composition and Function of Lipoproteins after Bariatric Surgery in Patients with Severe Obesity

Journal of Clinical Medicine ◽

10.3390/jcm10081716 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1716

Author(s):

Idoia Genua ◽

Núria Puig ◽

Inka Miñambres ◽

Sonia Benítez ◽

Pedro Gil ◽

...

Keyword(s):

Bariatric Surgery ◽

Lipid Profile ◽

Healthy Subjects ◽

Control Group ◽

Morbidly Obese ◽

Qualitative Properties ◽

Ldl Particles ◽

Obese Subjects ◽

Lipoprotein Composition ◽

Qualitative Characteristics

The effect of bariatric surgery on lipid profile and the qualitative characteristics of lipoproteins was analyzed in morbidly obese subjects. Thirteen obese patients underwent bariatric surgery. Plasma samples were obtained before surgery and at 6 and 12 months after the intervention. Thirteen healthy subjects comprised the control group. Lipid profile, hsCRP, and the composition and functional characteristics of VLDL, LDL, and HDL were assessed. At baseline, plasma from subjects with obesity had more triglycerides, VLDLc, and hsCRP, and less HDLc than the control group. These levels progressively normalized after surgery, although triglyceride and hsCRP levels remained higher than those in the controls. The main differences in lipoprotein composition between the obese subjects and the controls were increased apoE in VLDL, and decreased cholesterol and apoJ and increased apoC-III content in HDL. The pro-/anti-atherogenic properties of LDL and HDL were altered in the subjects with obesity at baseline compared with the controls, presenting smaller LDL particles that are more susceptible to modification and smaller HDL particles with decreased antioxidant capacity. Bariatric surgery normalized the composition of lipoproteins and improved the qualitative characteristics of LDL and HDL. In summary, patients with obesity present multiple alterations in the qualitative properties of lipoproteins compared with healthy subjects. Bariatric surgery reverted most of these alterations.

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Plasma resistin, adiponectin and leptin levels in lean and obese subjects: correlations with insulin resistance

Acta Endocrinologica ◽

10.1530/eje.0.1490331 ◽

2003 ◽

Vol 149 (4) ◽

pp. 331-335 ◽

Cited By ~ 350

Author(s):

JV Silha ◽

M Krsek ◽

JV Skrha ◽

P Sucharda ◽

BL Nyomba ◽

...

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Adipose Tissue ◽

Statistical Significance ◽

Model Assessment ◽

Fasting Insulin ◽

Homeostasis Model Assessment ◽

Glucose Levels ◽

Obese Subjects ◽

The Relationship

OBJECTIVE: Adipose tIssue regulates insulin sensitivity via the circulating adipocytokines, leptin, resistin and adiponectin. The objective of this study was to compare the levels of resistin, adiponectin and leptin in lean and obese subjects and determine the relationship between circulating adipocytokines and insulin resistance. METHODS: We examined plasma levels of resistin, adiponectin and leptin in 17 lean subjects with a mean body mass index (BMI) of approximately 23 and 34 non-diabetic obese individuals with a mean BMI approximately 33. Insulin resistance was assessed using the homeostasis model assessment ratio (HOMA-R) formula derived from fasting insulin and glucose levels. RESULTS: Resistin levels were not significantly different between the two groups but were significantly higher in women compared with men, 35.4+/-6.5 (s.e.) vs 15.4+/-2.9 microg/L, P<0.01. Resistin did not correlate with BMI but did significantly correlate with HOMA-R, P<0.01, and this correlation remained significant after adjustment for gender and BMI. Adiponectin levels were significantly lower in obese compared with lean subjects, P<0.005, and higher in women, P<0.001, but showed no significant correlation with HOMA-R. Leptin levels were significantly higher in obese subjects and women and correlated with HOMA-R and resistin. DISCUSSION: In this small group of patients we demonstrated that insulin resistance correlated most strongly with leptin levels. A significant correlation between resistin levels and insulin resistance was also observed. Although a similar trend was apparent for adiponectin, the correlation with insulin resistance did not achieve statistical significance.

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Kefir reduces insulin resistance and inflammatory cytokine expression in an animal model of metabolic syndrome

Food & Function ◽

10.1039/c6fo00339g ◽

2016 ◽

Vol 7 (8) ◽

pp. 3390-3401 ◽

Cited By ~ 13

Author(s):

Damiana D. Rosa ◽

Łukasz M. Grześkowiak ◽

Célia L. L. F. Ferreira ◽

Ana Carolina M. Fonseca ◽

Sandra A. Reis ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Animal Model ◽

Inflammatory Cytokine ◽

Fasting Glucose ◽

Cytokine Expression ◽

Fasting Insulin ◽

Insulin Levels ◽

Reduce Insulin Resistance

Kefir supplementation in rats with induced metabolic syndrome was able to lower fasting glucose, fasting insulin levels, and reduce insulin resistance.

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Obese patients with higher TSH levels had an obvious metabolic improvement after bariatric surgery

Endocrine Connections ◽

10.1530/ec-21-0360 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1326-1336

Author(s):

Nannan Bian ◽

Xiaomeng Sun ◽

Biao Zhou ◽

Lin Zhang ◽

Qiu Wang ◽

...

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Thyroid Function ◽

Fasting Blood Glucose ◽

Thyroid Stimulating Hormone ◽

Morbidly Obese ◽

Obese Patients ◽

Free Triiodothyronine ◽

The Relationship ◽

Tsh Levels

Objective Bariatric surgery has become the most effective treatment for morbid obesity. Increasing evidence showed that bariatric surgery can alleviate insulin resistance and influence thyroid function. This study aimed to investigate the relationship between changes in thyroid function and adipose tissue insulin resistance (adipo-IR) after bariatric surgery. Methods A total of 287 non-diabetic participants with regular thyroid function were recruited and divided into the lean, overweight and obese groups. Among them, 50 morbidly obese patients submitted to bariatric surgery. Results The obese group had a higher level of adipo-IR, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), FT3/free thyroxine (FT4) and metabolism disorders than the lean and overweight groups. BMI was correlated with TSH, FT3, FT3/FT4 and adipo-IR (r = 0.309, 0.315, 0.322 and 0.651, respectively, all P < 0.001). Adipo-IR was significantly correlated with TSH (r = 0.402, P < 0.001), FT3 (r = 0.309, P < 0.001), and FT3/FT4 (r = 0.228, P < 0.05). Bariatric surgery resulted in a sharp decline in BMI, adipo-IR, TSH, FT3 and FT3/FT4 levels, meanwhile, metabolic disorders improved. The decrease in BMI after bariatric surgery was significantly correlated with reductions in adipo-IR (r = 0.577, P < 0.001) and TSH (r = 0.401, P = 0.005). Interestingly, the fasting blood glucose, fasting insulin, adipo-IR and TSH in the higher TSH group decreased more remarkably than in the lower TSH group. Conclusion Obese individuals with higher TSH levels had an obvious metabolic improvement after bariatric surgery.

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