Several studies have reported a link between obesity and hyperuricaemia(1, 2). Hyperuricaemia is frequently observed in individuals with obesity and increases the risk of obesity. Meanwhile, obesity is a modifiable risk factor for hyperuricaemia.

Patients with obesity have mildly acquired resistance to thyroid hormones, similar to the insulin resistance phenomenon, which is characterised by high FT4 and TSH levels are stimultaneously presented(3). Recently, the thyroid feedback quantile index (TFQI) was proposed as a new approach to calculate the central sensitivity index to thyroid hormones, focusing on the deviation of the average pituitary response to thyroid hormones in the population and correlating this index with many metabolic disorders(3). Other indicators reflecting central sensitivity to thyroid hormones include the thyrotropin-thyroxine resistance index (TT4RI) and TSH index (TSHI)(4). However, the relationship between thyroid hormone sensitivity and uric acid (UA) levels in individuals with obesity remains unclear.

Laparoscopic sleeve gastrectomy (LSG)(5) has become a popular auxiliary weight-loss surgical method due to its minimal physiological damage, high safety, and significant therapeutic effects. The association between LSG and hyperuricaemia remission is well established by several randomised controlled trials (RCT) and observational studies(5, 6, 7). However, the consequences of bariatric surgery (BS) on changes in thyroid hormone levels after weight loss remains uncertain(8, 9, 10). TSH invariably decreases, FT3 often decreases, and variation of FT4 was insignificant(11, 12, 13). Furthermore, the effect of changes in UA levels on thyroid hormone sensitivity during LSG has not been previously examined. The present study aimed to investigate the relationship between thyroid hormone sensitivity and elevated UA levels in patients with obesity. Additionally, we evaluated the change and interrelationships between thyroid hormone sensitivity and UA levels after LSG.