Rijks Jesse M, Plat Jogchum, Dorenbos Elke, Penders Bas, Gerver Willem-Jan M, Vreugdenhil Anita C E
Centre for Overweight Adolescent and Children's Healthcare, Department of Pediatrics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.
School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HR Maastricht, The Netherlands.
J Clin Endocrinol Metab. 2017 Jun 1;102(6):2051-2058. doi: 10.1210/jc.2016-3057.
Overweight and obese children have an increased risk to develop cardiovascular diseases (CVDs) in which thyroid-stimulating hormone (TSH) has been suggested as an intermediary factor. However, results of cross-sectional studies are inconclusive, and intervention studies investigating changes in TSH concentrations in association with changes in cardiovascular risk parameters in overweight and obese children are scarce.
To gain insight in associations of circulating TSH concentrations and cardiovascular risk parameters in overweight and obese children.
Nonrandomized lifestyle intervention.
Centre for Overweight Adolescent and Children's Healthcare.
Three hundred thirty euthyroid overweight and obese children.
Long-term lifestyle intervention.
TSH concentrations, pituitary TSH release in response to thyrotropin-releasing hormone (TRH), and cardiovascular risk parameters.
At baseline, serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TAG), and monocyte chemotactic protein 1 concentrations were significantly associated with serum TSH concentrations. TSH release by the pituitary in response to exogenous TRH was not associated with cardiovascular risk parameters. During lifestyle intervention, several cardiovascular risk parameters significantly improved. In children whose body mass index z score improved, changes in TSH concentrations were significantly associated with changes in TC, LDL-C, and TAG concentrations.
In euthyroid overweight and obese children, circulating TSH concentrations are positively associated with markers representing increased CVD risk. Changes in TSH concentrations are also associated with changes in lipid concentrations in children with successful weight loss, which is consistent with TSH being an intermediary factor in modulating lipid and lipoprotein metabolism.
超重和肥胖儿童患心血管疾病（CVD）的风险增加，其中促甲状腺激素（TSH）被认为是一个中介因素。然而，横断面研究的结果尚无定论，且针对超重和肥胖儿童TSH浓度变化与心血管风险参数变化之间关系的干预研究较少。
了解超重和肥胖儿童循环TSH浓度与心血管风险参数之间的关系。
非随机生活方式干预。
超重青少年和儿童医疗保健中心。
330例甲状腺功能正常的超重和肥胖儿童。
长期生活方式干预。
TSH浓度、垂体对促甲状腺激素释放激素（TRH）的反应性TSH释放以及心血管风险参数。
在基线时，血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TAG）和单核细胞趋化蛋白1浓度与血清TSH浓度显著相关。垂体对外源性TRH的反应性TSH释放与心血管风险参数无关。在生活方式干预期间，多个心血管风险参数显著改善。在体重指数z评分改善的儿童中，TSH浓度变化与TC、LDL-C和TAG浓度变化显著相关。
在甲状腺功能正常的超重和肥胖儿童中，循环TSH浓度与代表CVD风险增加的标志物呈正相关。TSH浓度变化也与体重减轻成功的儿童的血脂浓度变化相关，这与TSH作为调节脂质和脂蛋白代谢的中介因素一致。
