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Peter Laurberg Department of Endocrinology, Aalborg Hospital, Aalborg

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Nils Knudsen Medical Clinic I, Bispebjerg Hospital, Copenhagen, Denmark

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Stig Andersen Department of Endocrinology, Aalborg Hospital, Aalborg

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Allan Carlé Department of Endocrinology, Aalborg Hospital, Aalborg

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Inge Bülow Pedersen Department of Endocrinology, Aalborg Hospital, Aalborg

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Jesper Karmisholt Department of Endocrinology, Aalborg Hospital, Aalborg

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, but considerably different in some details. Obesity and Pituitary-Thyroid Activation Thyroid function tests in people who are morbidly obese may differ from those in a comparable group of lean people, with a serum TSH that is higher in the

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Pedro Weslley Souza Rosario Santa Casa de Belo Horizonte, Belo Horizonte, Brazil

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Gabriela Franco Mourão Santa Casa de Belo Horizonte, Belo Horizonte, Brazil

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Maria Regina Calsolari Santa Casa de Belo Horizonte, Belo Horizonte, Brazil

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disease). Additionally, when the normal range obtained for adults is used, a discrete elevation of TSH can be seen in older adults (>70 years) [ 2 , 5 ]. Morbidly obese individuals may also exhibit discretely elevated TSH [ 2 , 6 ]. Elevated TSH can also

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Tilman Witte The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, N.H., USA
Institute for Community Medicine, Greifswald, Germany

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Henry Völzke Institute for Community Medicine, Greifswald, Germany

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Markus M. Lerch Departments of Medicine A, Greifswald, Germany

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Katrin Hegenscheid Departments of Diagnostic Radiology, Greifswald, Germany

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Nele Friedrich Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald School of Medicine, Greifswald, Germany

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Till Ittermann Institute for Community Medicine, Greifswald, Germany

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John A. Batsis The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, N.H., USA
Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, N.H., USA

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G, Ferrannini E: Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: Effects of weight loss. Int J Obes (Lond) 2009;33:1001-1006; erratum Int J Obes (Lond) 2010

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Laura P.B. Elbers Department of Internal Medicine, Medical Center Slotervaart, University of Amsterdam, Amsterdam
Departments of Vascular Medicine, University of Amsterdam, Amsterdam

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Hjalmar A. Boon Department of Internal Medicine, Medical Center Slotervaart, University of Amsterdam, Amsterdam

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Maaike I. Moes Department of Internal Medicine, Medical Center Slotervaart, University of Amsterdam, Amsterdam

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Bregje van Zaane Department of Internal Medicine, Medical Center Slotervaart, University of Amsterdam, Amsterdam
Departments of Vascular Medicine, University of Amsterdam, Amsterdam

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Dees P.M. Brandjes Department of Internal Medicine, Medical Center Slotervaart, University of Amsterdam, Amsterdam
Departments of Vascular Medicine, University of Amsterdam, Amsterdam

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Eric Fliers Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam

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Harry R. Büller Departments of Vascular Medicine, University of Amsterdam, Amsterdam

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Suzanne Cannegieter Department of Clinical Epidemiology, Leiden University Medical Center
Einthoven Laboratory for Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Victor E.A. Gerdes Department of Internal Medicine, Medical Center Slotervaart, University of Amsterdam, Amsterdam
Departments of Vascular Medicine, University of Amsterdam, Amsterdam

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. [ 8 ] was 17.7 pmol/l, and in the MEGA Study [ 1 ], which was a large case-control study investigating risk factors for VTE, the median FT 4 level was 16.6 pmol/l in the controls. The literature about the association between (morbid) obesity and

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Muhammed Erkam Sencar Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Davut Sakiz Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Murat Calapkulu Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Sema Hepsen Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Muhammed Kizilgul Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Ilknur Unsal Ozturk Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Bekir Ucan Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Murat Bayram Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Busra Betul Cagir Department of Internal Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Safak Akin Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Mustafa Ozbek Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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Erman Cakal Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey

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. Neuroendocrinology . 1995 Aug ; 62 ( 2 ): 130 – 4 . 10.1159/000126997 8584112 0028-3835 23 MacCuish A , Razvi S , Syed AA . Effect of weight loss after gastric bypass surgery on thyroid function in euthyroid people with morbid obesity . Clin

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Laura Croce Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Fausta Beneventi Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Federica Ripepi Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy

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Irene De Maggio Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Alberto Malovini Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Informatics and Systems Engineering for Clinical Research, Pavia (PV), Italy

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Camilla Bellingeri Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Francesca Coperchini Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy

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Marsida Teliti Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Mario Rotondi Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Arsenio Spinillo Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Flavia Magri Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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iodine deficiency ( 13 ). Moreover, patients living with morbid obesity frequently experience a raised serum TSH, in the absence of positivity for thyroid autoantibodies and/or abnormal findings at thyroid ultrasound ( 14 ). The physiopathology and

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Eyun Song Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Jonghwa Ahn Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Hye-Seon Oh Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Min Ji Jeon Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Gu Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Bae Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Young Kee Shong Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Tae Yong Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism? Eur J Endocrinol . 2009 Mar ; 160 ( 3 ): 403 – 8 . 10.1530/EJE-08-0734 19073832 0804-4643 17 Haas V , Onur S , Paul T , Nutzinger

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María de los Ángeles Garayalde Gamboa Service of Endocrinology, Metabolism, Nutrition, and Diabetes, Buenos Aires British Hospital, Buenos Aires, Argentina

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Melina Saban Service of Endocrinology, Metabolism, Nutrition, and Diabetes, Buenos Aires British Hospital, Buenos Aires, Argentina

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Marina Ines Curriá Service of Endocrinology, Metabolism, Nutrition, and Diabetes, Buenos Aires British Hospital, Buenos Aires, Argentina

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, Magalhães D , et al. The Effect of the Bariatric Surgery Type on the Levothyroxine Dose of Morbidly Obese Hypothyroid Patients . Obes Surg . 2018 Nov ; 28 ( 11 ): 3538 – 43 . 10.1007/s11695-018-3388-4 30008061 0960-8923 16 Azran C

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Alison-Michelle Naujack Institute for Human Genetics, Department of Epigenetics & Metabolism, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany

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Christin Krause Institute for Human Genetics, Department of Epigenetics & Metabolism, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany

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Jan H Britsemmer Institute for Human Genetics, Department of Epigenetics & Metabolism, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany

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Natalie Taege Institute for Human Genetics, Department of Epigenetics & Metabolism, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany

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Jens Mittag Institute for Experimental Endocrinology, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany

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Henriette Kirchner Institute for Human Genetics, Department of Epigenetics & Metabolism, Center of Brain Behavior & Metabolism, University of Lübeck, Lübeck, Germany

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liver biopsies as used for the miRNA 4.0 array, and additional patients with morbid obesity (BMI ≥ 35, total n  = 68) were classified according to their MAS into non-MASH (≤3 MAS, n  = 37) and MASH (≥4 MAS, n  = 29) ( Table 1 ). miR-34a-5p was

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Flora Veltri Department of Endocrinology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Kris Poppe Department of Endocrinology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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deiodinase activity has been described, which leads to a higher conversion of T4 to T3 [ 35 ]. Finally, obesity has been associated with a higher prevalence of TPO-Abs [ 36 ]. The guidelines of the ATA recommend TSH screening in morbidly obese pregnant women

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