Which endocrine tests are included in the bariatric preoperative endocrine evaluation?

Which endocrine tests are included in the bariatric preoperative endocrine evaluation?

• A. Thyroid function only
• B. A1c, TSH, androgens, Cushings
• C. A1c, TSH, androgens only
• D. A1c, TSH, Cushings only

Answer: (B)

Screening for metabolic and hormonal issues before bariatric surgery is essential because these factors influence perioperative risk, glucose control, and long-term outcomes. The preoperative endocrine evaluation should include A1c to detect diabetes or prediabetes, guiding anesthesia planning and postoperative management. Thyroid function testing with TSH identifies thyroid disorders that can affect metabolism, energy levels, weight, and healing after surgery. Assessing androgens helps detect hyperandrogenic states such as PCOS, which are common in obesity and impact fertility, menstrual function, and metabolic risk. Screening for Cushing's syndrome is included because endogenous cortisol excess can drive obesity and metabolic complications that require treatment beyond bariatric intervention. Together these tests cover major hormonal and metabolic contributors to obesity and surgical risk, making them the comprehensive set for preoperative evaluation. Omitting any of these would miss a potential factor that could alter management or outcomes.