Sawicka Beata, Bossowski Artur
Pediatr Endocrinol Diabetes Metab. 2013;19(1):5-10.
Overweight and diseases connected with it are an increasing problem in children and adolescents. Thyroid disease leads to a change of weight - in hyperthyroidism body mass is reduced whereas in hypothyroidism it is increased. It is emphasized that changes in hormones such as peptide levels are in close relationship with the regulation of body mass. Nesfatin-1 is a recently described anorexigenic peptide produced by the brain. Nesfatin-1 also reduces body weight gain, suggesting a role as a new modulator of energy balance. Excess nesfatin in the brain leads to a loss of appetite, less frequent hunger, a sense of fullness´, and a drop in body fat and weight. A lack of nesfatin-1 in the brain leads to an increase of appetite, more frequent episodes of hunger, an increase of body fat and weight, and the inability to feel full´. Aim of the study was to evaluate nesfatin-1 levels in young patients with untreated Graves´ disease, subclinical Hashimoto´ thyroiditis, and in healthy children.
The study group formed 78 patients of the Outpatient Endocrinology Clinic of Pediatrics, Endocrinology, Diabetology with Cardiology Division. In all the patients, nesfatin level was analyzed by the ELISA´s method.
In the group with hyperthyroidism in Graves´ disease lower levels of nesfatin-1 were found compared to the group of healthy children (19.37 vs 32.96 ng/ml; p<0.02); after appropriate treatment in that group the levels of nesfatin-1 were higher compared to the group with hyperthyroidism, but lower compared to the group of healthy children (20.35 vs 32.96 ng/ml; NS). On the other hand, nesfatin-1 levels were lower in children with untreated subclinical hypothyroidism in Hashimoto´s thyroiditis compared to the group of healthy children (17.2 vs32.96 ng/ml; p<0.002). After treatment of L-thyroxine lower levels of nesfatin-1 were found compared to the control group (14.5 vs 32.96 ng/ml; NS). No relationship between nesfatin-1 and thyroid hormones was observed.
It might be that disturbances in thyroid hormones in thyroid diseases do not have an essential effect on changes of nesfatin-1 - an appetite-controlling hormone/peptide. Secondly, nesfatin-1 levels were lower in children with untreated autoimmune thyroid diseases, however, the mechanism is also unknown.
超重及其相关疾病在儿童和青少年中是一个日益严重的问题。甲状腺疾病会导致体重变化——甲状腺功能亢进时体重减轻，而甲状腺功能减退时体重增加。需要强调的是，诸如肽水平等激素变化与体重调节密切相关。Nesfatin-1是一种最近被描述为由大脑产生的厌食肽。Nesfatin-1还能减少体重增加，表明其作为能量平衡新调节剂的作用。大脑中Nesfatin-1过量会导致食欲不振、饥饿频率降低、“饱腹感”以及体脂和体重下降。大脑中缺乏Nesfatin-1会导致食欲增加、饥饿发作更频繁、体脂和体重增加以及无法“感到饱腹”。本研究的目的是评估未经治疗的格雷夫斯病、亚临床桥本甲状腺炎的年轻患者以及健康儿童的Nesfatin-1水平。
研究组由儿科内分泌门诊、内分泌与糖尿病及心脏病科的78名患者组成。对所有患者采用酶联免疫吸附测定（ELISA）法分析Nesfatin水平。
与健康儿童组相比，格雷夫斯病甲状腺功能亢进组的Nesfatin-1水平较低（19.37对32.96 ng/ml；p<0.02）；该组经过适当治疗后，Nesfatin-1水平高于甲状腺功能亢进组，但低于健康儿童组（20.35对32.96 ng/ml；无统计学意义）。另一方面，与健康儿童组相比，桥本甲状腺炎未经治疗的亚临床甲状腺功能减退儿童的Nesfatin-1水平较低（17.2对32.96 ng/ml；p<0.002）。左甲状腺素治疗后，与对照组相比，Nesfatin-1水平较低（14.5对32.96 ng/ml；无统计学意义）。未观察到Nesfatin-1与甲状腺激素之间的关系。
甲状腺疾病中甲状腺激素紊乱可能对食欲控制激素/肽Nesfatin-1的变化没有重要影响。其次，未经治疗的自身免疫性甲状腺疾病儿童的Nesfatin-1水平较低，但其机制也尚不清楚。
