Sánchez B Trinidad, Godoy S Jaime, García B Hernán, Barja Y Salesa
Rev Chil Pediatr. 2014 Jun;85(3):288-97. doi: 10.4067/S0370-41062014000300004.
Study results regarding thyroid function in obese children are unknown. The objective of this study was to describe the levels of thyroid stimulating hormone (TSH), free plasma thyroxine (FT4), associated factors and frequency of hypothyroidism in these children.
A retrospective study of medical records of 260 obese children who consulted a physician for the first time between January 2007 and June 2012. Age, gender, puberty, weight, height and waist circumference (WC) were considered; body mass index (BMI z -score), weight/height (IPT) and height/age (NCHS 2000) were calculated, and TSH and FT4 were measured.
210 patients aged 2 to 18 years were included, 59% female, 51.4% prepubescent children, 23.9% were overweight and 76.1% obese. 70.8% of the children surveyed had central obesity. TSH and FT4 values were 2.31 μUI/mL (0.69 to 8.07) and 1.289 ± 0.17 ng/dL, respectively. Hypothyroidism was found in 21 patients (10%), 20 of these presented it as subclinical condition. An inverse correlation was present between age and log TSH and a direct correlation was described between log TSH and zBMI. Qnly zBMI was significant (p < 0.001, adjusted R2 8.2%, β 0.19) after using multiple regression. No differences in age, gender, nutritional status and puberty between euthyroid and hypothyroid patients were found.
9.5% of patients presented subclinical hypothyroidism, which supports TSH screening in obese children.
肥胖儿童甲状腺功能的研究结果尚不清楚。本研究的目的是描述这些儿童的促甲状腺激素（TSH）、游离血浆甲状腺素（FT4）水平、相关因素及甲状腺功能减退的发生率。
对2007年1月至2012年6月期间首次就诊的260例肥胖儿童的病历进行回顾性研究。记录年龄、性别、青春期、体重、身高和腰围（WC）；计算体重指数（BMI z评分）、体重/身高（IPT）和身高/年龄（2000年美国国家卫生统计中心标准），并检测TSH和FT4。
纳入210例年龄在2至18岁的患者，其中59%为女性，51.4%为青春期前儿童，23.9%为超重，76.1%为肥胖。70.8%的受调查儿童存在中心性肥胖。TSH和FT的值分别为2.31 μUI/mL（0.69至8.07）和1.289±0.17 ng/dL。21例患者（10%）存在甲状腺功能减退，其中20例为亚临床甲状腺功能减退。年龄与log TSH呈负相关，log TSH与zBMI呈正相关。多元回归分析后，只有zBMI具有统计学意义（p<0.001，调整后R²为8.2%，β为0.19）。甲状腺功能正常和甲状腺功能减退患者在年龄、性别、营养状况和青春期方面无差异。
9.5%的患者存在亚临床甲状腺功能减退，这支持对肥胖儿童进行TSH筛查。
