Clinics of Pediatric Endocrinology, Dr. Sami Ulus Women Health, Children's Education and Research Hospital, Ankara, Turkey,
Eat Weight Disord. 2013 Mar;18(1):87-90. doi: 10.1007/s40519-013-0008-0. Epub 2013 Apr 3.
Obesity is a worldwide epidemic. In recent years, increasing attention has been focused on thyroid function in obesity.
To establish the prevalence of elevated thyroid-stimulating hormone (TSH) levels in obese children and adolescents, and identify the relationship between TSH levels and other metabolic and hormonal variables before and after weight reduction.
We evaluated 150 obese subjects (aged 3-17 years) for anthropometric, biochemical, metabolic and hormonal variables. Measurements were taken at baseline and, in a subgroup of children with hyperthyrotropinemia, after a 6-month intervention program based on exercise, behavior therapy, and nutrition education.
At baseline, 23 participants (15.3 %) had hyperthyrotropinemia, and 21 of these patients completed the weight reduction intervention. Among these 21 patients, 14 had substantial weight loss and a significant decrease in TSH and free T3 levels.
We conclude that TSH and T3 levels are significantly increased in childhood obesity; in most cases, however, these increases cannot be elucidated by thyroid autoimmunity or iodine deficiency. If thyroid disorders are excluded beforehand, an elevated TSH with normal thyroid hormone levels in obese children seems rather a consequence than a cause of obesity since weight loss leads to a normalization of elevated TSH levels. In this context, thyroid hormone alterations in obesity suggest an adaptation process.
肥胖是一种全球性的流行疾病。近年来，人们越来越关注肥胖与甲状腺功能之间的关系。
确定肥胖儿童和青少年促甲状腺激素（TSH）水平升高的患病率，并确定 TSH 水平与减重前后其他代谢和激素变量之间的关系。
我们评估了 150 名肥胖受试者（年龄 3-17 岁）的人体测量学、生化、代谢和激素变量。在基线时进行测量，并在伴有高促甲状腺素血症的儿童亚组中，在基于运动、行为疗法和营养教育的 6 个月干预计划后进行测量。
基线时有 23 名参与者（15.3%）存在高促甲状腺素血症，其中 21 名患者完成了减重干预。在这 21 名患者中，有 14 名患者体重明显减轻，TSH 和游离 T3 水平显著降低。
我们得出结论，儿童肥胖症患者的 TSH 和 T3 水平显著升高；然而，在大多数情况下，这些增加不能用甲状腺自身免疫或碘缺乏来解释。如果事先排除甲状腺疾病，肥胖儿童中 TSH 升高而甲状腺激素水平正常，似乎是肥胖的结果而不是原因，因为体重减轻会导致 TSH 水平升高正常化。在这种情况下，肥胖症中甲状腺激素的改变表明存在适应过程。
