Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Horm Res Paediatr. 2017;88(2):140-146. doi: 10.1159/000475993. Epub 2017 Jun 14.
BACKGROUND/AIMS: Thyroid-stimulating hormone (TSH) is affected in obesity and might influence metabolic risk. It is unclear what mechanisms cause elevated TSH in obesity. We aimed to investigate TSH status within the normal range and the association of TSH with degree of obesity and metabolic parameters in children with obesity.
A total of 3,459 children, aged 3.0-17.9 years, were identified in the Swedish Childhood Obesity Treatment Registry, BORIS. Age, gender, TSH, free triiodothyronine (fT3), free thyroxine (fT4), body mass index standard deviation scores (BMI SDS), as well as variables of lipid and glucose metabolism were examined.
Children with high-normal TSH (>3.0 mU/L) (28.8%) had higher BMI SDS compared to children with low-normal TSH (<3.0 mU/L) (p < 0.001). Multivariable regression analysis adjusted for age and gender showed that TSH levels were associated with BMI SDS (β: 0.21, 95% CI: 0.14-0.28, p < 0.001). Associations of thyroid hormones with markers of lipid and glucose metabolism were observed, where TSH was associated with fasting insulin, HOMA (homeostatic model assessment of insulin resistance), total cholesterol, and triglycerides.
A positive association between TSH levels and BMI SDS was seen in children with obesity. Associations of TSH and free thyroid hormones with glucose metabolism indicated that TSH might be one of several factors acting to determine body weight and obesity co-morbidities, although the underlying mechanism remains unclear.
背景/目的：促甲状腺激素（TSH）在肥胖中受到影响，可能会影响代谢风险。目前尚不清楚是什么机制导致肥胖患者 TSH 升高。我们旨在研究正常范围内 TSH 的状况，以及 TSH 与肥胖儿童肥胖程度和代谢参数的相关性。
共纳入 3459 名年龄为 3.0-17.9 岁的肥胖儿童，这些儿童均来自瑞典儿童肥胖治疗登记处 BORIS。检查了年龄、性别、TSH、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、体重指数标准差分数（BMI SDS）以及血脂和血糖代谢的变量。
高正常 TSH（>3.0 mU/L）（28.8%）儿童的 BMI SDS 高于低正常 TSH（<3.0 mU/L）儿童（p<0.001）。经年龄和性别调整的多变量回归分析显示，TSH 水平与 BMI SDS 相关（β：0.21，95%CI：0.14-0.28，p<0.001）。观察到甲状腺激素与血脂和血糖代谢标志物的相关性，其中 TSH 与空腹胰岛素、胰岛素抵抗的稳态模型评估（HOMA）、总胆固醇和甘油三酯相关。
肥胖儿童的 TSH 水平与 BMI SDS 呈正相关。TSH 和游离甲状腺激素与葡萄糖代谢的相关性表明，TSH 可能是决定体重和肥胖合并症的几个因素之一，尽管其潜在机制尚不清楚。
