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This version published online on May 24, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0920
A more recent version of this article appeared on August 1, 2005
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Submitted on April 27, 2005
Accepted on May 12, 2005

HIGH CIRCULATING TSH LEVELS IN OBESE WOMEN ARE REDUCED AFTER BODY WEIGHT LOSS INDUCED BY CALORIC RESTRICTION

Petra Kok, Ferdinand Roelfsema, Janneke G Langendonk, Marijke Frölich, Jacobus Burggraaf, A. Edo Meinders, and Hanno Pijl*

Dept. of General Internal Medicine, Leiden University Medical Center, The Netherlands; Dept. of Endocrinology and Metabolic diseases, Leiden University Medical Center, The Netherlands; Dept. of Clinical Chemistry, Leiden University Medical Center, The Netherlands; Centre for Human Drug Research, Leiden University Medical Center, The Netherlands

* To whom correspondence should be addressed. E-mail: h.pijl{at}lumc.nl.

1. Context. Previous clinical studies concerning the impact of body weight loss on single plasma TSH concentration measurements or the TSH response to TRH in obese humans have shown variable results.

2. Objective. To investigate the effect of weight loss induced by caloric restriction on diurnal TSH concentrations and secretion in obese humans.

3. Design. Clinical, prospective, cross over study (2004)

4. Setting. Clinical Research Center in the LUMC

5. Participants. Eleven obese premenopausal women (BMI 33.3 ± 0.7 kg/m2).

6. Intervention. Weight loss (50% reduction overweight by caloric restriction).

7. Main Outcome Measure(s). 24 h plasma TSH concentrations (10 min intervals) and the 24 h TSH secretion rate, calculated by a waveform-independent deconvolution technique (Pulse).

8. Results. 24 h TSH secretion rate was significantly higher in obese women than in normal weight controls and weight loss was accompanied by diminished TSH release (before 43.4 ± 6.4 vs. after weight loss 34.4 ± 5.9 mU/L \x 24 h, P = 0.02). Circulating free triiodothyronine levels dropped after weight loss from 4.3 ± 0.19 to 3.8 ± 0.14 pmol/L (P = 0.04). Differences in 24 h TSH release correlated positively with the decline of circulating leptin (R2 = 0.62, P < 0.01).

9. Conclusions. Elevated TSH secretion in obese women is significantly reduced by the diet induced loss of overweight. Among various physiological cues, leptin may be involved in this phenomenon. The decrease of TSH and free triiodothyronine may blunt energy expenditure in response to long term calorie restriction, thereby frustrating weight loss attempts of obese individuals.
Key words: Leptin • Anterior Pituitary • Caloric restriction • Thyrotropin • Obesity




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