Eliakim Alon, Barzilai Marina, Wolach Baruch, Nemet Dan
Child Health & Sports Center, Meir General Hospital, Kfar-Saba, Sackler School of Medicine, Tel-Aviv University, Israel.
Int J Pediatr Obes. 2006;1(4):217-21. doi: 10.1080/17477160600805006.
To examine the prevalence of abnormal thyroid function tests among obese children and adolescents, and to study the effect of thyroid hormone supplementation on body weight, linear growth and lipid profiles in these children.
Thyroid function tests and lipid profiles were measured in 196 obese children and adolescents. Thyroid auto-antibodies were measured in children with hyperthyrotropinemia (elevated thyroid stimulating hormone (TSH) and normal free thyroxine-FT4). All children with hyperthyrotropinemia participated in a combined dietary-behavioral-physical activity weight management intervention. Fifteen of the obese children with hyperthyrotropinemia were also treated with thyroid hormone substitution for 6 months and were compared to non-treated subjects (n = 26).
Forty-one obese children had hyperthyrotropinemia (20.9%). Positive thyroid auto-antibodies were only found in 19.5% of these children. Treatment had no significant effect on body weight, linear growth and lipid profile, except for causing a greater decrease in triglyceride levels. TSH levels returned to normal ranges in the majority of children with hyperthyrotropinemia who participated in the combined intervention, irrespective of thyroxine treatment.
Hyperthyrotropinemia is relatively common in obese children, but autoimmune thyroid disease accounts for a minority of the cases. TSH levels returned to normal in the majority of patients even without thyroid hormone administration. No beneficial effects on body weight, body mass index, linear growth and body lipids were found in treated subjects, suggesting that thyroid substitution is not necessary in most cases.
研究肥胖儿童及青少年甲状腺功能检查异常的患病率，并探讨补充甲状腺激素对这些儿童体重、线性生长及血脂谱的影响。
对196名肥胖儿童及青少年进行甲状腺功能检查和血脂谱检测。对促甲状腺激素血症（促甲状腺激素（TSH）升高而游离甲状腺素-FT4正常）患儿检测甲状腺自身抗体。所有促甲状腺激素血症患儿均参与饮食-行为-体育活动相结合的体重管理干预。15名促甲状腺激素血症肥胖儿童还接受了6个月的甲状腺激素替代治疗，并与未治疗的受试者（n = 26）进行比较。
41名肥胖儿童患有促甲状腺激素血症（20.9%）。这些儿童中仅19.5%检测到甲状腺自身抗体阳性。治疗对体重、线性生长和血脂谱无显著影响，仅甘油三酯水平下降幅度更大。参与联合干预的大多数促甲状腺激素血症患儿，无论是否接受甲状腺素治疗，TSH水平均恢复至正常范围。
促甲状腺激素血症在肥胖儿童中相对常见，但自身免疫性甲状腺疾病仅占少数病例。即使不给予甲状腺激素，大多数患者的TSH水平也会恢复正常。接受治疗的受试者在体重、体重指数、线性生长和身体脂质方面未发现有益影响，提示大多数情况下无需进行甲状腺替代治疗。
