Souza Luciana Lopes de, Guedes Erika Paniago, Teixeira Patrícia Fátima Dos Santos, Moreira Rodrigo Oliveira, Godoy-Matos Amelio Fernando, Vaisman Mario
Instituto Estadual de Diabetes e Endocrinologia (IEDE), Divisão de Metabologia, Rio de Janeiro, RJ, Brazil.
Instituto Estadual de Diabetes e Endocrinologia (IEDE), Divisão de Metabologia, Rio de Janeiro, RJ, Brazil.
J Pediatr (Rio J). 2016 Sep-Oct;92(5):532-8. doi: 10.1016/j.jped.2016.01.011. Epub 2016 Jun 22.
To investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents.
A retrospective, longitudinal analysis of 199 overweight and obese pubescent adolescents was performed. The TSH and free T4 (fT4) levels, anthropometric measurements, and laboratory test results of these patients were analyzed.
27 individuals (13.56%) presented with TSH levels above the normal level (subclinical hypothyroidism [SCH]). Their waist circumference (WC) was significantly higher than those of euthyroid individuals. Serum TSH was positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Using TSH and BMI as independent variables, TSH levels were shown to be independently related to HOMA-IR (p=0.001) and TG (p=0.007). Among euthyroid subjects, individuals with TSH values <2.5mIU/mL exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values.
SCH in overweight and obese adolescents appears to be associated with excess weight, especially visceral weight. In euthyroid adolescents, there appears to be a direct relationship between TSH and some CRF. In conclusion, in the present sample of overweight and obese adolescents, TSH levels appear to be associated with IR and CRF.
在一组超重和肥胖的巴西青少年样本中，研究血清促甲状腺激素（TSH）、胰岛素抵抗（IR）与心血管危险因素（CRF）之间的关系。
对199名超重和肥胖的青春期青少年进行回顾性纵向分析。分析了这些患者的TSH和游离T4（fT4）水平、人体测量数据以及实验室检查结果。
27名个体（13.56%）的TSH水平高于正常水平（亚临床甲状腺功能减退症[SCH]）。他们的腰围（WC）显著高于甲状腺功能正常的个体。血清TSH与胰岛素抵抗稳态模型评估（HOMA-IR）指数、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）呈正相关。以TSH和BMI作为自变量，结果显示TSH水平与HOMA-IR（p=0.001）和TG（p=0.007）独立相关。在甲状腺功能正常的受试者中，TSH值<2.5mIU/mL的个体腰臀比、HDL-C水平和HOMA-IR评分在统计学上显著降低，且WC值有降低趋势。
超重和肥胖青少年中的SCH似乎与体重超标有关，尤其是内脏重量。在甲状腺功能正常的青少年中，TSH与某些CRF之间似乎存在直接关系。总之，在本超重和肥胖青少年样本中，TSH水平似乎与IR和CRF有关。
