Lomenick Jefferson P, El-Sayyid Maysa, Smith W Jackson
Division of Pediatric Endocrinology, University of Kentucky, Lexington, KY, USA.
J Pediatr. 2008 Jan;152(1):96-100. doi: 10.1016/j.jpeds.2007.06.006. Epub 2007 Oct 24.
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).
We retrospectively identified 68 subjects with acquired hypothyroidism who were seen at least once in our center in follow-up between 1995 and 2006.
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.
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.
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。
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。
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。
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。
