Endocrine Abstracts

Objectives: Quality of life (QoL) is reduced in treated hyperthyroidism compared to age- and sex-matched controls. We previously reported excessive weight regain with the treatment of hyperthyroidism. Whether the treatment-related weight gain is affecting QoL of this patient group is unknown.

Methods: With a cross-sectional study design and data utilization from a prospectively completed database, we enrolled patients with treated hyperthyroidism. We included adult patients with overt hyperthyroidism six months to eight years’ post-diagnosis. We excluded patients with thyroiditis and any medications, major comorbidity or surgery, which could significantly affect the weight. The primary outcome was to examine whether percentage weight change (PWC=Weightlast–Weighto/Weighto×100%) after the treatment of hyperthyroidism was predictive of QoL. We utilized thyroid-specific (ThyPRO), generic and custom-made questionnaire tools and patient notes alongside self-completed questionnaires. We measured anthropometrics, body composition analysis and obtained a thyroid and cardiometabolic blood profile. QoL was pre-specified in three arms: ‘cosmetic complaints’ (M1) and a composite of ‘tiredness and overall QoL’ (M2) and ‘depressivity and anxiety’ (M3) domains (ThyPRO). We employed multiple linear regression for data analysis. We included age, sex, TSH categories (at assessment) and disease duration as covariates. We performed corrections for multiple testing (Banjamini-Hochberg method). Ethics approval was obtained.

Results: We included 108 patients; 68 (63%) females with mean (SD) age at 50 (14.5) yrs. Approximately, 80% had Graves’ disease and 74% were solely treated with anti-thyroid drugs. Weight gain of 7.2 (6.2) kg was observed over a disease duration of 41 (22.5) months. Analysis showed a good model fit for M1 (F(6,101)=8.50, P < 0.001, R²=33.6%) and M2 (F(6,101)=4.22, P = 0.001, R²=20%), but not for M3 (F(6,101)=1.8, P = 0.107, R²=9.7%). PWC had a predictive value on ‘cosmetic complaints’ (b=1.06, t=4.70, P < 0.001) but not on ‘tiredness and overall QoL’ (b=0.483, t=1.80, P = 0.075) domains. In secondary analysis, the PWC was not significant in predicting relevant domains of the SF-36 nor the EQ-5D surveys, likely indicating the reduced sensitivity of these tools in hyperthyroidism. When we asked patients to rate disease-related concerns, the three main perturbations included weight gain, fatigue and fear of recurrence (3/5, 2.7/5 and 2.7/5, respectively with 5/5 indicating severe concern/symptom). PWC was a significant predictor of self-reported weight gain (b=0.061, t=3.57, P < 0.001).

Conclusions: Weight gain has an adverse impact on some aspects of QoL, particularly cosmetic complaints, and is the most highly scored concern/symptom of patients with hyperthyroidism. This cumbersome aspect of treatment of hyperthyroidism needs more emphasis.