Adverse Outcomes in Patients With Hypothyroidism Undergoing Bariatric Surgery: A Retrospective Study Using TriNetX
Authors' conclusion
Preexisting hypothyroidism in bariatric patients increases the risks of adverse outcomes. However, the risk of obesity-related outcomes is decreased in this population when compared to nonsurgical care.
Study context
- Population
- Patients with obesity who underwent bariatric surgery (BS) or not, with and without hypothyroidism; mean age 46.7 ± 12 years, 88% female5,700 per cohort
- Participants
- 5,700 vs 5,700
- Exposure
- Hypothyroidism vs no hypothyroidism in patients with obesity undergoing bariatric surgery; BS vs nonsurgical care
- Hypothyroidismn = 5,700
- No hypothyroidismn = 5,700reference
- Outcome
- Short-term outcomes
- Follow-up
- Short term
Methodological detailspropensity score-matched, TriNetX Global Collaborative Network database
- Propensity score-matched
- TriNetX Global Collaborative Network database
Main finding
As reported in the abstract
Each group vs no hypothyroidismEstimate (CI)
Hypothyroidism
RR, readmission 1.25(1.14–1.36)
Hypothyroidism
RR, incisional hernia 1.56(1.12–2.18)
Hypothyroidism
RR, biliary diseases 1.39(1.05–1.86)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Long-term incident cerebrovascular events, diabetes and dyslipidemia after BSHypothyroidismvs No hypothyroidismCerebrovascular events · propensity score-matched | 1.25 (1.00–1.55) | |
| Long-term incident cerebrovascular events, diabetes and dyslipidemia after BSHypothyroidismvs No hypothyroidismDiabetes · propensity score-matched | 1.39 (1.12–1.74) | |
| Long-term incident cerebrovascular events, diabetes and dyslipidemia after BSHypothyroidismvs No hypothyroidismDyslipidemia · propensity score-matched | 1.20 (1.02–1.42) | |
| 0.512Hazard ratio (log scale) |
Other long-term outcomes after BS
- Higher risk of fall, HR
- 1.20 (1.02-1.40) (CI)
- Higher risk of osteoporosis, HR
- 1.30 (1.07-1.58) (CI)
- Higher risk of polyneuropathy, HR
- 1.34 (1.08-1.66) (CI)
- Higher risk of hypoglycemia, HR
- 1.51 (1.23-1.87) (CI)
- Higher risk of iron deficiency, HR
- 1.17 (1.04-1.31) (CI)
- Higher risk of vitamin B deficiency, HR
- 1.34 (1.20-1.49) (CI)
Subgroup: gastric bypass
- Hypothyroidism-associated risks of poor outcomes were higher in patients who underwent gastric bypass
Hypothyroidism: BS vs nonsurgical care
- With BS, lower risk of obesity-related outcomes but higher risk of iron and vitamin B deficiencies, osteoporosis and hypoglycemia vs nonsurgical care
Original publication
Adverse Outcomes in Patients With Hypothyroidism Undergoing Bariatric Surgery: A Retrospective Study Using TriNetX. J Clin Endocrinol Metab. Published 16 September 2025. doi:10.
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