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左甲状腺素治疗对获得性甲状腺功能减退症患儿体重及体重指数的影响。

Effect of levo-thyroxine treatment on weight and body mass index in children with acquired hypothyroidism.

作者信息

Lomenick Jefferson P, El-Sayyid Maysa, Smith W Jackson

机构信息

Division of Pediatric Endocrinology, University of Kentucky, Lexington, KY, USA.

出版信息

J Pediatr. 2008 Jan;152(1):96-100. doi: 10.1016/j.jpeds.2007.06.006. Epub 2007 Oct 24.

Abstract

OBJECTIVE

To determine whether normalization of thyroid-stimulating hormone (TSH) in children with acquired hypothyroidism is associated with a decrease in weight or body mass index (BMI).

STUDY DESIGN

We retrospectively identified 68 subjects with acquired hypothyroidism who were seen at least once in our center in follow-up between 1995 and 2006.

RESULTS

Treatment with levo-thyroxine decreased the mean TSH level from 147 microU/mL initially to 5.0 microU/mL at the second visit 4.4 months later. This was not associated with a significant change in weight or BMI. Of the 68 subjects, 31% lost weight by the second visit (mean 2.3 kg). The mean initial TSH level of this group was 349 microU/mL. Thirty of the 68 children had at least 2 years of follow-up, and 19/68 had at least 4 years of follow-up. Over those intervals, weight and BMI percentiles and z scores did not change significantly from baseline values.

CONCLUSIONS

Most children treated for acquired hypothyroidism exhibited little short-term or long-term change in weight or BMI despite near-normalization of TSH. Those children who lost weight tended to have severe hypothyroidism and to have only a small weight loss. Consequently, practitioners should not expect significant decreases in weight after treatment in most children with hypothyroidism.

摘要

目的

确定获得性甲状腺功能减退症患儿促甲状腺激素(TSH)水平正常化是否与体重或体重指数(BMI)下降有关。

研究设计

我们回顾性地确定了68例获得性甲状腺功能减退症患者,他们在1995年至2006年期间至少在我们中心接受过一次随访。

结果

左甲状腺素治疗使平均TSH水平从最初的147微单位/毫升降至4.4个月后第二次就诊时的5.0微单位/毫升。这与体重或BMI的显著变化无关。在68例患者中,31%在第二次就诊时体重减轻(平均2.3千克)。该组的平均初始TSH水平为349微单位/毫升。68名儿童中有30名至少随访了2年,19/68名至少随访了4年。在这些时间段内,体重和BMI百分位数及z评分与基线值相比没有显著变化。

结论

大多数接受获得性甲状腺功能减退症治疗的儿童,尽管TSH接近正常化,但体重或BMI在短期或长期内几乎没有变化。那些体重减轻的儿童往往患有严重的甲状腺功能减退症,且体重减轻幅度较小。因此,大多数甲状腺功能减退症患儿在治疗后,医生不应期望其体重会显著下降。

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