Does the treatment-related weight change predict quality of life in patients with hyperthyroidism?

Abstract

Quality of life (QoL) is reduced and weight is increased in treated hyperthyroidism. Whether the treatment-related weight gain is affecting QoL of this patient group is unknown. With a cross-sectional study design and data utilization from a prospectively completed database, I enrolled patients with treated hyperthyroidism, six months to eight years’ post-diagnosis. The primary outcome was to examine whether percentage weight change (PWC) after treatment of hyperthyroidism was predictive of QoL. The secondary outcome was whether PWC had any impact on cardiometabolic markers. I pre-specified three dependent variables: ‘cosmetic complaints’, a composite of ‘tiredness and overall QoL’ and ‘depressivity and anxiety’ domains (ThyPRO). I included age, sex, TSH categories and disease duration as covariates. I utilized a generalized linear model and the Spearman’s rho test for the primary and secondary outcome, respectively, and the Benjamini-Hochberg method for corrections. I included 108 patients; 68 (63%) females with mean (SD) age at 50 (14.5) yrs. Weight gain of 7.2 (6.2) kg was observed over a disease duration of 41 (22.5) months. Weight gain was the most highly cited concern of our patients as evidenced by data triangulation. PWC had a predictive value on ‘cosmetic complaints’ (b=0.47, P=0.022) and on ‘tiredness and overall QoL’ (b=0.62, P=0.011) domains. PWC correlated with lipoprotein(a) (r=0.284, p=0·007), sex hormone-binding globulin (r=-0.349, p=0.001), final body mass index (r=0.275, p=0.004), systolic blood pressure (r=0.222, p=0.026), waist circumference (r=0.234, p=0.042) and visceral adipose tissue (r=0.233, p=0.043). In conclusion, weight gain does have an adverse impact on aspects of QoL and cardiometabolic profile. More focus should be placed on tackling this hurdle in clinical practice and international guidelines.