Endocrine Abstracts

Obesity hypoventilation syndrome (OHS) is defined as the presence of awake alveolar hypoventilation characterized by daytime hypercapnia arterial PaCO₂ greater than 45 mm Hg that is a consequence of diminished ventilatory drive and capacity related to obesityin the absence of an alternate hypoventilation. Patients with advanced disease develop signsof right ventricular failure (cor pulmonale) and may have elevated jugular venous pressure with a prominent V wave, edema, hepatomegaly pulsatile liver develops if tricuspid regurgitation is severe ascites. The interplay between obesity and hypothyroidism exacerbates respiratory compromise leading to impaired gas exchange and respiratory mechanics. Our aim comparison of Obesity Related Hypoventilation Syndrome in Patients with and without Hypothyroidism.

Group 1 Without Hypothyroidism

Group 2 With Hypothyroidism

Compared two groups of patients with OHS 10 patients in each, with a BMI exceeding 60. Group 1 individuals without hypothyroidism, 2 men and 8 women. Group 2 consisted of 9 women and 1 man all diagnosed with hypothyroidism and receiving high doses of levothyroxine. We evaluated various clinical parameters between the two groups. Hypothyroidism can exacerbate respiratory compromise in obese individuals with obesity-related hypoventilation syndrome with decreased metabolic rate and reduced respiratory drive leading to hypoventilation and impaired gas exchange; cause obesity to worsen due to metabolic changes and fluid retention, further increasing the risk of respiratory compromise; contribute to upper airway obstruction and obstructive sleep apnea, which are common comorbidities in obese individuals with OHS.

Natrium Levels:Group 1 Normal.

Group 2 Natrium levels may be lower due to hypothyroidism-related fluid retention. Hyponatremia can play a significant role in OHS in patients with hypothyroidism by promoting water retention and diluting serum sodium levels. Arterial Blood Gas Analysis Group 1 Expected findings of hypercapnia and hypoxemia

Group 2 Similar hypercapnic and hypoxemic findings, possibly exacerbated by concurrent hypothyroidism. Oxygen Saturation:

Group 1 decreased oxygen saturation 70%

Group 2 Oxygen saturation may be further compromised due to hypothyroidism.

TSH Group 1 TSH normal range. Group 2 Elevated TSH

Levothyroxine Dose: Group 1 No levothyroxine treatment.

Group 2: Patients receiving high doses of levothyroxine Electrolytes: Group 1 Electrolyte levels normal. Group 2 Potential electrolyte imbalances, including hyponatremia, secondary to hypothyroidism. Treatment Differences: Group 1 Focus on OHS management, including weight loss interventions, positive airway pressure therapy, and respiratory support as needed. Group 2 In addition to OHS management, optimization of levothyroxine therapy to normalize thyroid function and address associated fluid retention and electrolyte imbalances. Conclusion underlying hypothyroidism presents a significant challenge in Patents with OHS.