Effects of Sleeve Gastrectomy on Thyrotropin Hormone (TSH) and Vitamin D Levels among Obese Patients in Nineveh Governorate


  • Samar Jassim Ibrahim Department of Chemistry, College of Education for Girls, University of Mosul, Mosul, Iraq.
  • Lelas Farhan Bdaiwi Department of Chemistry, College of Education for Girls, University of Mosul, Mosul, Iraq.
  • Muthanna Asaad Al Sherbit Al-Jamhory Teaching Hospital , Mosul health directorate, Ministry of Health, Mosul, Iraq.
  • Yasser Fawzi Zidan Al-Jamhory Teaching Hospital , Mosul health directorate, Ministry of Health, Mosul, Iraq.




Thyrotropin, Vitamin D, Calcium, Triglycerides, Lipoproteins, LDL, Lipoproteins, HDL


Objectives: This study aimed to assess the impact of bariatric surgery on thyrotropin (TSH), calcium, vitamin D, and lipid profile levels three months post-surgery among patients who underwent the procedure. We also investigated the prevalence of micronutrient deficiencies during the initial three months before and after surgery, along with monitoring the effects of gastric sleeve surgery on body mass index (BMI) reduction.

Methods: The study involved the analysis of data from a cohort comprising 30 patients of both genders who had undergone sleeve gastrectomy due to obesity, with a preoperative BMI of 40 kg/m² or higher. The research spanned from July 2022 to January 2023, with patients undergoing gastric sleeve surgery at Al-Zahrawi Hospital in Nineveh. These patients were subsequently followed up for a period of three months post-surgery.

Results: The study findings demonstrated a significant reduction in TSH, vitamin D, calcium, total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDLc), very low-density lipoproteins (VLDLc) cholesterol, and BMI in patients who underwent gastric sleeve surgery within the three-month follow-up period, in comparison to their pre-surgery levels. Additionally, there was a noteworthy increase in high-density lipoproteins of cholesterol (HDLc) in the serum of these patients post-operation. The results further indicated positive correlations between TSH, vitamin D, cholesterol, LDLc, and the Atherogenic Index. Likewise, positive correlations were observed between vitamin D, TSH, total cholesterol, triglycerides (TG), and LDLc.

Conclusion: Post-surgery deficiencies in vitamin D, calcium, and TSH levels are attributed to inadequate intake and absorption of micronutrients, highlighting the importance of nutritional supplementation. Sleeve gastrectomy offers a promising avenue for sustained BMI reduction in the long term.


H. Yu et al., “Decreased leptin is associated with alterations in thyroid-stimulating hormone levels after roux-en-y gastric bypass surgery in obese euthyroid patients with type 2 diabetes,” Obes. Facts, vol. 12, no. 3, pp. 272–280, 2019, doi: 10.1159/000499385.

M. A. Michalaki et al., “Thyroid function in humans with morbid obesity,” Thyroid, vol. 16, no. 1, pp. 73–78, 2006, doi: 10.1089/thy.2006.16.73.

M. M. G. Van Berckel, S. L. M. Van Loon, A. K. Boer, V. Scharnhorst, and S. W. Nienhuijs, “Visual Analysis of Biomarkers Reveals Differences in Lipid Profiles and Liver Enzymes before and after Gastric Sleeve and Bypass,” Obes. Facts, vol. 14, no. 1, pp. 21–31, 2021, doi: 10.1159/000510401.

N. Rezaieg, “Reward Systems and Ultra-processed Foods.,” Al- Anbar Med. J., vol. 18, no. 2, pp. 53–55, 2022, doi: 10.33091/amj.2022.176303.

K. A. Korzeniowska et al., “The association of thyroid-stimulating hormone (TSH) and free thyroxine (fT4) concentration levels with carbohydrate and lipid metabolism in obese and overweight teenagers,” Endokrynol. Pol., vol. 70, no. 2, pp. 172–178, 2019, doi: 10.5603/EP.a2018.0090.

E. Of and T. H. E. Test, “Liaison ® tsh ( [ref] 311211) 1.,” no. Vc, pp. 1–6, 2022.

M. R. Matrana and W. E. Davis, “Vitamin deficiency after gastric bypass surgery: A review,” South. Med. J., vol. 102, no. 10, pp. 1025–1031, 2009, doi: 10.1097/SMJ.0b013e3181b62614.

C. Liu, M. Shao, L. Lu, C. Zhao, L. Qiu, and Z. Liu, “Obesity, insulin resistance and their interaction on liver enzymes,” PLoS One, vol. 16, no. 4 April, pp. 1–9, 2021, doi: 10.1371/journal.pone.0249299.

S. Azulai et al., “Sleeve gastrectomy is associated with a greater reduction in plasma liver enzymes than bypass surgeries—a registry-based two-year follow-up analysis,” J. Clin. Med., vol. 10, no. 5, pp. 1–10, 2021, doi: 10.3390/jcm10051144.

B. Ma et al., “Hepatic Steatosis Is Associated with Elevated Serum Iron in Patients with Obesity and Improves after Laparoscopic Sleeve Gastrectomy,” Obes. Facts, vol. 14, no. 1, pp. 64–71, 2021, doi: 10.1159/000511736.

R. J. Singh, R. L. Taylor, G. S. Reddy, and S. K. G. Grebe, “C-3 epimers can account for a significant proportion of total circulating 25-hydroxyvitamin D in infants, complicating accurate measurement and interpretation of vitamin D status,” J. Clin. Endocrinol. Metab., vol. 91, no. 8, pp. 3055–3061, 2006, doi: 10.1210/jc.2006-0710.

M. Provided, M. Required, B. Not, Q. C. Materials, and T. Steps, “Flex ® reagent cartridge CRE2,” 2019.

H. U. Bergmeyer, P. Scheibe, and A. W. Wahlefeld, “Optimization of methods for aspartate aminotransferase and alanine aminotransferase,” Clin. Chem., vol. 24, no. 1, pp. 58–73, 1978, doi: 10.1093/clinchem/24.1.58.

G. N. Bowers and R. B. McComb, “A continuous spectrophotometric method for measuring the activity of serum alkaline phosphatase.,” Clin. Chem., vol. 12, no. 2, pp. 70–89, 1966, doi: 10.1093/clinchem/12.2.70.

S. El-Seadawy, H. E.-D. El-Attar, H. Elkhyat, and M. Helal, “(Clinical and biochemical investigations on bacterial diarrhea in Egyptian Buffalo Calves),” Benha Vet. Med. J., vol. 39, no. 2, pp. 90–94, 2020, doi: 10.21608/bvmj.2020.51991.1309.

P. Fossati and L. Prencipe, “Serum triglycerides determined colorimetrically with an enzyme that produces hydrogen peroxide,” Clin. Chem., vol. 28, no. 10, pp. 2077–2080, 1982, doi: 10.1093/clinchem/28.10.2077.

P. R. Hinton, “Statistics Explained: A Guide for Social Science Students,” 2nd ed. Routledge, 2004. doi: https://doi.org/10.4324/9780203496787.

M. Harris et al., “Transcriptional regulation of the thyrotropin-releasing hormone gene by leptin and melanocortin signaling,” J. Clin. Invest., vol. 107, no. 1, pp. 111–120, 2001, doi: 10.1172/JCI10741.

Y. Abu-Ghanem et al., “Effect of Sleeve Gastrectomy on Thyroid Hormone Levels,” Obes. Surg., vol. 25, no. 3, pp. 452–456, 2015, doi: 10.1007/s11695-014-1415-7.

A. Lautenbach et al., “Thyroid-stimulating hormone levels in euthyroid patients 8 years following bariatric surgery,” Int. J. Obes., vol. 46, no. 4, pp. 825–830, 2022, doi: 10.1038/s41366-021-01058-z.

K. Dogan, J. Homan, E. O. Aarts, H. de Boer, C. J. H. M. van Laarhoven, and F. J. Berends, “Long-term nutritional status in patients following Roux-en-Y gastric bypass surgery,” Clin. Nutr., vol. 37, no. 2, pp. 612–617, 2018, doi: 10.1016/j.clnu.2017.01.022.

S. A. Alsareii, A. M. Elbashir, and M. H. F. Shalayel, “Obesity and bariatric surgery: Ultimate need for Vitamin D supplementation,” Biomed. Pharmacol. J., vol. 10, no. 3, pp. 1187–1195, 2017, doi: 10.13005/bpj/1220.

A. A. ALhaboo & L. F. Bdaiwi, “Methods to assess Vitamin B12 bioavailability and technologies to enhance its absorption,” Egypt. J. Chem., vol. 64, no. 12, pp. 7283–7290, 2020, doi: 10.1093/nutrit/nuy026.

M. M. n, Eunsung Mouradian, “Fracture risk following bariatric surgery: a population-based study,” Bone, vol. 23, no. 1, pp. 1–7, 2008, doi: 10.1038/nature08365.Reconstructing.

G. Saleh and L. F. Bdaiwi, “Biochemical study of hepcidin and Interleukin_6 in the serum of patients with Down syndrome in Nineveh Governorate,” Egypt. J. Chem., vol. 66, no. 2, pp. 191–198, 2023, doi: 10.21608/ejchem.2022.134638.5922.

P. H. Smith, A. J. Bessette, A. H. Weinberger, C. E. Sheffer, and S. A. Mckee, “Nutrient Deficiency 10 Years Following Roux-en-Y Gastric Bypass: Who’s Responsible?,” Physiol. Behav., vol. 92, no. 3, pp. 135–140, 2016, doi: 10.1007/s11695-016-2364-0.Nutrient.

F. Carrasco et al., “Calcium absorption may be affected after either sleeve gastrectomy or Roux-en-Y gastric bypass in premenopausal women: A 2-y prospective study,” Am. J. Clin. Nutr., vol. 108, no. 1, pp. 24–32, 2018, doi: 10.1093/ajcn/nqy071.

J. N. S. Vitaminol, “Effects of Cabbage and Liver Leaf Lipid Protein Concentrate on the in Rats Serum Concentrations Kiharu IGARASHI ,* Akiko SATOH , Satoshi NUMAZAWA and Eiji TAKAHASHI Department of Bioproduction , Faculty of Agriculture , Yamagata University , Tsuruoka , Ya,” pp. 261–270, 1997.

R. S. Gill, S. Karmali, and A. M. Sharma, “Treating type 2 diabetes mellitus with sleeve gastrectomy in obese patients,” Obesity, vol. 19, no. 4, pp. 701–702, 2011, doi: 10.1038/oby.2010.261.

D. Abdoun, R. Al-Rawi, and B. Abulmajeed, “Prevalence of Dyslipidemia and Hypertension in Iraqi Adolescents with Type 1 Diabetes Mellitus,” Al- Anbar Med. J., vol. 18, no. 2, pp. 77–81, 2022, doi: 10.33091/amj.2022.176311.

A. Benetti et al., “Cholesterol metabolism after bariatric surgery in grade 3 obesity: Differences between malabsorptive and restrictive procedures,” Diabetes Care, vol. 36, no. 6, pp. 1443–1447, 2013, doi: 10.2337/dc12-1737.

V. Singla, S. Aggarwal, B. Singh, G. Tharun, V. Katiyar, and A. Bhambri, “Outcomes in Super Obese Patients Undergoing One Anastomosis Gastric Bypass or Laparoscopic Sleeve Gastrectomy,” Obes. Surg., vol. 29, no. 4, pp. 1242–1247, 2019, doi: 10.1007/s11695-018-03673-8.

E. Z. K. ; L. F. Bdaiw, “Biochemical study of Visfatin Hormone and Some Biochemical Parameters in The Serum of Obese Patients in Nineveh Governorate,” Egypt. J. Chem., 2022, doi: 10.1192/bjp.bp.114.145177.

M. W. Yeh, H. Zhou, E. J. Kuo, A. L. Adams, N. Li, and P. I. Haigh, “Biochemical dynamics of untreated primary hyperparathyroidism: An observational study,” Endocr. Pract., vol. 25, no. 5, pp. 470–476, 2019, doi: 10.4158/EP-2018-0489.

M. R. Aykota, M. Atabey, and M. R. Aykota, “Effect of sleeve gastrectomy on thyroid-stimulating hormone levels in morbidly obese patients with normal thyroid function,” Eur. Rev. Med. Pharmacol. Sci., vol. 25, no. 1, pp. 233–240, 2021, doi: 10.26355/eurrev_202101_24389.



How to Cite

Ibrahim, S. J. ., Bdaiwi, L. F. ., Al Sherbit, M. A. ., & Zidan, Y. F. . (2023). Effects of Sleeve Gastrectomy on Thyrotropin Hormone (TSH) and Vitamin D Levels among Obese Patients in Nineveh Governorate. Journal of Contemporary Medical Sciences, 9(4). https://doi.org/10.22317/jcms.v9i4.1408