The prevalence of subclinical hypothyroidism in obese children and adolescents and its effects on metabolic parameters

Nurullah Çelik

doi:10.7197/cmj.vi.551051

EN

The prevalence of subclinical hypothyroidism in obese children and adolescents and its effects on metabolic parameters

Abstract

Objective: To compare cardiovascular risk factors in obese patients with or without Subclinical Hypothyroidism (SH), also to estimate the prevalence of SH in obese children and adolescents.

Method: A total of 226 obese children and adolescents aged 6-18 years were included in the study. Two groups were created as euthyroid group (n=195) and SH group (n=31). After an 8-12 hour overnight fasting, serum blood glucose, insulin, HDL, LDL, cholesterol, triglyceride TSH, free T4, ALT, AST levels were measured. HOMA-IR and atherogenic index (AI) were calculated.

Results: Prevalence of SH was estimated as 14.1 %. The values of fasting glucose, fasting insülin, ALT, AST, TSH, HOMA-IR levels were significantly higher ın SH group than euthyroid group. There was a positive correlation between TSH and fasting glucose, insülin, triglyceride, ALT, AST, HOMA-IR, AI. It was also demonstrated that the TSH level was significantly and independently related to HOMA-IR value ın multiple regression analysis (p=0.001).

Conclusions: Obese patients with SH may be more susceptible to metabolic complications than euthyroid subjects.

Keywords

Adolescent,obesity,Prevalence,subclinical hypothyroidism

References

1. Biondi B, Cooper DS: The clinical significance of subclinical thyroid dysfunction. Endocr.Rev. 2008; 29: 76-131
2. Salerno M, Capalbo D, Cerbone M, De LF: Subclinical hypothyroidism in childhood - current knowledge and open issues. Nat.Rev.Endocrinol. 2016; 12: 734-46
3. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC: Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann.Intern.Med. 2000; 132: 270-8
4. Diekman T, Lansberg PJ, Kastelein JJ, Wiersinga WM: Prevalence and correction of hypothyroidism in a large cohort of patients referred for dyslipidemia. Arch.Intern.Med. 1995; 155: 1490-5
5. Staub JJ, Althaus BU, Engler H, Ryff AS, Trabucco P, Marquardt K, Burckhardt D, Girard J, Weintraub BD: Spectrum of subclinical and overt hypothyroidism: effect on thyrotropin, prolactin, and thyroid reserve, and metabolic impact on peripheral target tissues. Am.J.Med. 1992; 92: 631-42
6. Jabbar A, Pingitore A, Pearce SH, Zaman A, Iervasi G, Razvi S: Thyroid hormones and cardiovascular disease. Nat.Rev.Cardiol. 2017; 14: 39-55
7. Bossowski A, Sawicka B, Szalecki M, Koput A, Wysocka J, Zelazowska-Rutkowska B: Analysis of serum adiponectin, resistin and leptin levels in children and adolescents with autoimmune thyroid disorders. J.Pediatr.Endocrinol.Metab 2010; 23: 369-77
8. Marwaha RK, Tandon N, Garg MK, Kanwar R, Sastry A, Narang A, Arora S, Bhadra K: Dyslipidemia in subclinical hypothyroidism in an Indian population. Clin.Biochem. 2011; 44: 1214-7

9. Reinehr T: Thyroid function in the nutritionally obese child and adolescent. Curr.Opin.Pediatr. 2011; 23: 415-20
10. Vigone MC, Capalbo D, Weber G, Salerno M: Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated? J.Endocr.Soc. 2018; 2: 1024-39
11. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O: Body mass index references for Turkish children. Acta Paediatr. 2006; 95: 194-8
12. Conwell LS, Trost SG, Brown WJ, Batch JA: Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. Diabetes Care 2004; 27: 314-9
13. Shen S, Lu Y, Qi H, Li F, Shen Z, Wu L, Yang C, Wang L, Shui K, Wang Y, Qiang D, Yun J, Weng X: Association between ideal cardiovascular health and the atherogenic index of plasma. Medicine (Baltimore) 2016; 95: e3866
14. Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuniga FA: Association between insulin resistance and the development of cardiovascular disease. Cardiovasc.Diabetol. 2018; 17: 122
15. Brenta G: Why can insulin resistance be a natural consequence of thyroid dysfunction? J.Thyroid Res. 2011; 2011: 152850
16. Souza LL, Guedes EP, Teixeira PF, Moreira RO, Godoy-Matos AF, Vaisman M: Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents. J.Pediatr.(Rio J.) 2016; 92: 532-8
17. Nader NS, Bahn RS, Johnson MD, Weaver AL, Singh R, Kumar S: Relationships between thyroid function and lipid status or insulin resistance in a pediatric population. Thyroid 2010; 20: 1333-9
18. Cerbone M, Capalbo D, Wasniewska M, Mattace RG, Alfano S, Meli R, De LF, Salerno M: Cardiovascular risk factors in children with long-standing untreated idiopathic subclinical hypothyroidism. J.Clin.Endocrinol.Metab 2014; 99: 2697-703
19. Kaltenbach TE, Graeter T, Oeztuerk S, Holzner D, Kratzer W, Wabitsch M, Denzer C: Thyroid dysfunction and hepatic steatosis in overweight children and adolescents. Pediatr.Obes. 2017; 12: 67-74
20. Pacifico L, Bonci E, Ferraro F, Andreoli G, Bascetta S, Chiesa C: Hepatic steatosis and thyroid function tests in overweight and obese children. Int.J.Endocrinol. 2013; 2013: 381014
21. Walsh JP: Setpoints and susceptibility: do small differences in thyroid function really matter? Clin.Endocrinol.(Oxf) 2011; 75: 158-9
22. Dahl M, Ohrt JD, Fonvig CE, Kloppenborg JT, Pedersen O, Hansen T, Holm JC: Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents. J.Clin.Res.Pediatr.Endocrinol. 2017; 9: 8-16
23. Zhang J, Jiang R, Li L, Li P, Li X, Wang Z, Li L, Teng W: Serum thyrotropin is positively correlated with the metabolic syndrome components of obesity and dyslipidemia in chinese adolescents. Int.J.Endocrinol. 2014; 2014: 289503
24. Neovius MG, Linne YM, Barkeling BS, Rossner SO: Sensitivity and specificity of classification systems for fatness in adolescents. Am.J Clin.Nutr. 2004; 80: 597-603
25. Han JC, Lawlor DA, Kimm SY: Childhood obesity. Lancet 2010; 375: 1737-48
26. Neovius M, Rossner SM, Vagstrand K, von Hausswolff-Juhlin YL, Hoffstedt J, Ekelund U: Adiposity measures as indicators of metabolic risk factors in adolescents. Obes.Facts. 2009; 2: 294-301
27. Reinehr T, Isa A, de SG, Dieffenbach R, Andler W: Thyroid hormones and their relation to weight status. Horm.Res. 2008; 70: 51-7
28. Wolters B, Lass N, Reinehr T: TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children. Eur.J.Endocrinol. 2013; 168: 323-9

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Nurullah Çelik ^*
0000-0003-1583-6807
Türkiye

Publication Date

December 31, 2019

Submission Date

April 8, 2019

Acceptance Date

December 31, 2019

Published in Issue

Year 1970 Volume: 41 Number: 4

DOI

https://doi.org/10.7197/cmj.vi.551051

IZ

https://izlik.org/JA88GP23RZ

Cite

RIS / Bibtex

AMA

1.Çelik N. The prevalence of subclinical hypothyroidism in obese children and adolescents and its effects on metabolic parameters. CMJ. 2019;41(4):691-697. doi:10.7197/cmj.vi.551051

Cited By

Predictive markers of metabolically healthy obesity in children and adolescents: can AST/ALT ratio serve as a simple and reliable diagnostic indicator?

European Journal of Pediatrics

https://doi.org/10.1007/s00431-023-05296-3

Öz

The prevalence of subclinical hypothyroidism in obese children and adolescents and its effects on metabolic parameters

Abstract

Keywords

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

DOI

IZ

Cite

Cited By

Predictive markers of metabolically healthy obesity in children and adolescents: can AST/ALT ratio serve as a simple and reliable diagnostic indicator?