Krause A J, Cines B, Pogrebniak E, Sherafat-Kazemzadeh R, Demidowich A P, Galescu O A, Brady S M, Reynolds J C, Hubbard V S, Yanovski J A
Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
NIH Division of Nutrition Research Coordination, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, MD, USA.
Pediatr Obes. 2016 Dec;11(6):551-558. doi: 10.1111/ijpo.12112. Epub 2016 Feb 22.
In adults, obesity is associated with abnormalities of thyroid function; there are fewer studies in paediatric cohorts.
To examine associations of weight and adiposity with indices of thyroid function and thyroid-related metabolic factors in children.
DESIGN/METHODS: A sample of 1203 children without obesity (body mass index [BMI] < 95th percentile; N = 631) and with obesity (BMI ≥ 95th percentile; N = 572), age 5-18 years, had height and weight measured (to calculate BMI-Z score for age and sex) and had blood collected in the morning for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and leptin. A subset (N = 829) also underwent measurement of fat mass by dual-energy X-ray absorptiometry. Analyses examined associations of TSH and FT4 with adiposity and obesity-related conditions accounting for sociodemographic factors.
Thyroid-stimulating hormone was positively related to BMIz and fat mass (both p-values < 0.001). FT4 was negatively related to BMIz and fat mass (both p-values < 0.001). TSH was positively correlated to leptin (p = 0.001) even after accounting for fat mass.
Paediatric obesity is associated with higher TSH and lower FT4 concentrations and with a greater prevalence of abnormally high TSH. Leptin concentrations may in part explain obesity's effects on thyroid status, perhaps through leptin's effects on TSH secretion.
在成年人中，肥胖与甲状腺功能异常有关；而针对儿科队列的研究较少。
研究儿童体重和肥胖与甲状腺功能指标及甲状腺相关代谢因子之间的关联。
设计/方法：选取1203名5至18岁儿童作为样本，其中无肥胖者（体重指数[BMI]<第95百分位数；N = 631）和肥胖者（BMI≥第95百分位数；N = 572），测量身高和体重（以计算年龄和性别的BMI-Z评分），并于早晨采集血液检测促甲状腺激素（TSH）、游离甲状腺素（FT4）和瘦素。一个子集（N = 829）还通过双能X线吸收法测量了脂肪量。分析在考虑社会人口统计学因素的情况下，研究TSH和FT4与肥胖及肥胖相关状况之间的关联。
促甲状腺激素与BMIz和脂肪量呈正相关（p值均<0.001）。FT4与BMIz和脂肪量呈负相关（p值均<0.001）。即使在考虑脂肪量后，TSH仍与瘦素呈正相关（p = 0.001）。
儿童肥胖与较高的TSH浓度、较低的FT4浓度以及TSH异常升高的患病率较高有关。瘦素浓度可能部分解释了肥胖对甲状腺状态的影响，可能是通过瘦素对TSH分泌的影响。
