Thyroid function in obese children

Česká verzia

Authors: D. Lobotková; Ľ. Tichá; D. Staníková; J. Staník; Ľ. Podracká
Authors place of work: Bratislava ; Detská klinika Lekárskej fakulty Univerzity Komenského a Detskej fakultnej nemocnice s poliklinikou
Published in the journal: Čes-slov Pediat 2017; 72 (1): 33-38.
Category: Original Papers

Summary

Introduction:
Increasing prevalence of obesity and new data in the field of neuroendocrinne regulation of metabolism has recently led to the growing interest in thyroid function in obese patients.

Objectives:
To evaluate thyroid function in a cohort of obese children and adolescents compared to healthy lean controls and to study changes in thyroid hormones in relation to weight reduction in the obese children.

Methods:
Serum thyroid-stimulating hormone (TSH), free thyroxin (fT4) and free triiodothyronin (fT3) were measured in 150 obese children (mean age 12.0±3.1 years) and 50 lean controls (mean age 12.2±3.3 years). Moreover serum reverse triiodothyronine (rT3) levels were also measured in a subgroup of 51 obese children and 15 controls. In 80 obese patients thyroid function was re-evaluated after 1 year follow-up.

Results:
An elevated serum TSH level (≥4 mIU/L) was found more frequently in the obese children compared to the normal-weight children (19.3% vs. 6.0%, p<0.05). Serum TSH levels were significantly higher in the obese children compared to the controls (2.67 vs. 1.99 mIU/L, p<0.0001), while no difference was observed in the peripheral thyroid hormones (fT4, fT3 and rT3). Obese children with elevated TSH levels (≥4 mIU/L) had significantly higher fT3 levels than obese children with normal TSH levels (8.4 vs. 7.8 pmol/l; p=0.028). Significant positive correlation has been found between BMI-SDS and TSH (r=0.306, p<0.00001), but not between BMI and peripheral thyroid hormones. After 1 year follow-up of obese children the changes in BMI SDS correlated positively with the changes in serum TSH levels (r=0.376; p<0.001).

Conclusion:
An isolated moderate elevation of serum TSH levels without presence of autoimmune disease is a frequent finding in obese children and is likely to normalize spontaneously after weight reduction.

Key words:
thyroid gland, thyroid-stimulating hormone, thyroid hormones, obesity

Zdroje

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