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Thyroid function in obese children


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

Overview

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


Sources

1. Mantzoros CS, Ozata M, Negrao B, et al. Synchronicity of frequently sampled thyrotropin (TSH) and leptin concentrations in healthy adults and leptin-deficient subjects: evidence for possible partial TSH regulation by leptin in humans. J Clin Endocrinol Metab 2001; 86 (7): 3284–3291.

2. Santini F, Galli G, Maffei M, et al. Acute exogenous TSH administration stimulates leptin secretion in vivo. Eur J Endocrinol 2010; 163 (1): 63–67.

3. Moon MK, Kang GH, Kim HH, et al. Thyroid-stimulating hormone improves insulin sensitivity in skeletal muscle cells via cAMP/PKA/CREB pathway-dependent upregulation of insulin receptor substrate-1 expression. Mol Cell Endocrinol 2016; 436: 50–58.

4. Reinehr T. Thyroid function in the nutritionally obese child and adolescent. Curr Opin Pediatr 2011; 23 (4): 415–420.

5. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol 2010; 316 (2): 165–171.

6. Ševčíková Ľ, Nováková J, Hamade J, a kol. Percentilové grafy a antropometrické ukazovetele. Telesný vývoj detí a mládeže v SR: výsledky celoštátneho prieskumu v roku 2001. Bratislava: Úrad verejného zdravotníctva, 2004: 6–13.

7. Dekelbab BH, Abou Ouf HA, Jain I. Prevalence of elevated thyroid-stimulating hormone levels in obese children and adolescents. Endocr Pract 2010; 16 (2): 187–190.

8. Eliakim A, Barzilai M, Wolach B, Nemet D. Should we treat elevated thyroid stimulating hormone levels in obese children and adolescents? Int J Pediatr Obes 2006; 1 (4): 217–221.

9. Grandone A, Santoro N, Coppola F, et al. Thyroid function derangement and childhood obesity: an Italian experience. BMC Endocr Disord 2010, 10 (8).

10. Lobotková D, Staníková D, Staník J, et al. Lack of association between peripheral activity of thyroid hormones and elevated TSH levels in childhood obesity. J Clin Res Pediatr Endocrinol 2014; 6 (2): 100–104.

11. Shalitin S, Yackobovitch-Gavan M, Phillip M. Prevalence of thyroid dysfunction in obese children and adolescents before and after weight reduction and its relation to other metabolic parameters. Horm Res 2009; 71 (3): 155–161.

12. Stichel H, l’Allemand D, Grüters A. Thyroid function and obesity in children and adolescents. Horm Res 2000; 54 (1): 14–19.

13. Rumińska M, Witkowska-Sędek E, Majcher A, Pyrżak B. Thyroid function in obese children and adolescents and its association with anthropometric and metabolic parameters. Adv Exp Med Biol 2016; 912: 33–41.

14. Marras V, Casini MR, Pilia S, et al. Thyroid function in obese children and adolescents. Horm Res Pædiatr 2010; 73 (3): 193–197.

15. Reinehr T, Adelbert I, de Sousa G, et al. Thyroid hormones and their relation to weight status. Horm Res 2008; 70 (1): 51–57.

16. Lebl J, Šnajderová M, Koloušková S, Šumník Z. Poruchy funkce štítné žlázy. Čes-slov Pediat 2012; 67 (4): 282–287.

17. García-García E, Vázquez-López MÁ, García-Fuentes E, et al. Iodine intake and prevalence of thyroid autoimmunity and autoimmune thyroiditis in children and adolescents aged between 1 and 16 years. Eur J Endocrinol 2012; 167 (3): 387–392.

18. Kaloumenou I, Mastorakos G, Alevizaki M, et al. Thyroid autoimmunity in schoolchildren in an area with long-standing iodine sufficiency: correlation with gender, pubertal stage, and maternal thyroid autoimmunity. Thyroid 2008; 18 (7): 747–754.

19. Radetti G, Kleon W, Buzi F, et al. Thyroid function and structure are affected in childhood obesity. J Clin Endocrinol Metab 2008; 93 (12): 4749–4754.

20. Bhowmick SK, Dasari G, Levens KL, Rettig KR. The prevalence of elevated serum thyroid-stimulating hormone in childhood/adolescent obesity and of autoimmune thyroid diseases in a subgroup. J Natl Med Assoc 2007; 99 (7): 773–776.

21. García-García E, Vázquez-López MÁ, García-Fuentes E, et al. Thyroid function and thyroid autoimmunity in relation to weight status and cardiovascular risk factors in children and adolescents: A population-based study. J Clin Res Pediatr Endocrinol 2016; 8 (2): 157–162.

22. Pacifico L, Anania C, Ferraro F, et al. Thyroid function in childhood obesity and metabolic comorbidity. Clin Chim Acta 2012; 413 (3–4): 396–405.

23. Tajtáková M, Langer P, Fodor G, et al. Epidemiological profile of thyroid volume and disorders in Slovakia. Vnitr. Lék 2000; 46 (11): 756–763.

24. Podoba J, Rácová K, Urbánková H. Aktuálne problémy profylaxie ochorení z nedostatku jódu na Slovensku. Interná med 2016; 16 (2): 48–53.

25. Zamrazil V, Čerovská J. Jod a štítná žláza. Optimální přívod jodu a poruchy z jeho nedostatku. Praha: Mladá fronta, 2014: 1–49.

26. Krause AJ, Cines B, Pogrebniak E, et al. Associations between adiposity and indicators of thyroid status in children and adolescents Pediatr Obes 2016, Feb 22. doi: 10.1111/ijpo.12112. [Epub ahead of print].

27. Tichá Ľ, Kovács L, Tomečková E, et al. Leptín a endokrinné parametre u dievčat s menatálnou anorexiou. Čes-slov Pediat 2003; 58 (10): 621–627.

28. Ghamari-Langroudi M, Vella KR, Srisai D, et al. Regulation of thyrotropin-releasing hormone-expressing neurons in paraventricular nucleus of the hypothalamus by signals of adiposity. Mol Endocrinol 2010; 24 (12): 2366–2381.

29. Araujo RL, Andrade BM, da Silva ML, et al. Tissue-specific deiodinase regulation during food restriction and low replacement dose of leptin in rats. Am J Physiol Endocrinol Metab 2009; 296 (5): E1157–1163.

30. Araujo RL, Carvalho DP. Bioenergetic impact of tissue-specific regulation of iodothyronine deiodinases during nutritional imbalance. J Bioenerg Biomembr 2011; 43 (1): 59–65.

31. Lu S, Guan Q, Liu Y, et al. Role of extrathyroidal TSHR expression in adipocyte differentiation and its association with obesity. Lipids Health Dis 2012; 11: 17.

32. 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 (3): 323–329.

33. Wilms L, Larsen J, Pedersen PL, Kvetny J. Evidence of mitochondrial dysfunction in obese adolescents. Acta Paediatr 2010; 99 (6): 906–911.

34. D’Adamo E, De Leonibus C, Giannini C, et al. Thyroid dysfunction in obese pre-pubertal children: oxidative stress as a potential pathogenetic mechanism. Free Radic Res 2012; 46 (3): 303–309.

35. Araujo RL, Andrade BM, Padrón S, et al. High-fat diet increases thyrotropin and oxygen consumption without altering circulating 3,5,3’-triiodothyronine (T3) and thyroxine in rats: the role of iodothyronine deiodinases, reverse T3 production, and whole-body fat oxidation. Endocrinology 2010; 151 (7): 3460–3469.

36. Lazar L, Frumkin RBD, Battat E, et al. Natural history of thyroid function tests over 5 years in a large pediatric cohort. J Clin Endocrinol Metab 2009; 94 (5): 1678–1682.

37. Kaplowitz PB. Subclinical hypothyroidism in children: normal variation or sign of a failing thyroid gland? Int J Pediatr Endocrinol 2010; 2010: 281453.

38. Kaptein EM, Beale E, Chan LS. Thyroid hormone therapy for obesity and nonthyroidal illnesses: a systematic review. J Clin Endocrinol Metab 2009; 94 (10): 3663–3675.

39. Santini F, Marzullo P, Rotondi M, et al. Mechanisms in endocrinology: The crosstalk between thyroid gland and adipose tissue: signal integration in health and disease. Eur J Endocrinol 2014; 171 (4): R137–R152.

Labels
Neonatology Paediatrics General practitioner for children and adolescents
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