1Endocrinology and Metabolism Unit, Department of Pediatrics, University of Patras Medical School, Patras, Greece.
2First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Childrens' Hospital, Athens, Greece.
Child Obes. 2019 Sep;15(6):411-415. doi: 10.1089/chi.2019.0025. Epub 2019 Jun 6.
In the context of a worldwide increase in childhood obesity, euthyroid hyperthyrotropinemia has been consistently reported and raises questions about its etiology, its potential metabolic complications, and its management. In this study we analyze the thyroid function with respect to BMI, pubertal status, and sex in children with obesity and discuss our results on an integrative context with the existent data from the literature. In this case-control study, we compared 389 children and adolescents with obesity to 158 controls. Age, sex, thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), BMI standard deviation score, and pubertal status were recorded. One factor-analysis of variance (ANOVA) was used with < 0.05. Mean serum TSH of children with obesity was higher (2.95 ± 1.2 mU/L) compared to normal weight group (2.42 ± 1.43 mU/L) ( < 0.0001). Only in females of both groups, serum TSH, T4, and T3 concentrations were all lower during puberty compared to prepuberty. In prepubertal girls and boys with obesity, a statistically significant correlation between TSH and BMI was found ( = 0.32, = 0.012 and = 0.47, < 0.001, respectively), which is not sustained during puberty. Our results confirm the TSH elevation in children with obesity and indicates that puberty and adiposity have a differential sex-dependent impact on thyroid axis function.
在全球儿童肥胖率上升的背景下，持续报道了甲状腺功能正常的高促甲状腺素血症，并对其病因、潜在代谢并发症及其管理提出了疑问。在这项研究中，我们分析了肥胖儿童的甲状腺功能与 BMI、青春期状态和性别之间的关系，并在综合现有文献数据的基础上讨论了我们的研究结果。在这项病例对照研究中，我们比较了 389 名肥胖儿童和青少年与 158 名对照者。记录了年龄、性别、促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、BMI 标准差评分和青春期状态。采用单因素方差分析（ANOVA）， < 0.05。肥胖儿童的平均血清 TSH 较高（2.95±1.2 mU/L），与正常体重组（2.42±1.43 mU/L）相比（ < 0.0001）。只有在两组的女性中，青春期时血清 TSH、T4 和 T3 浓度均低于青春期前。在肥胖的青春期前女孩和男孩中，TSH 与 BMI 之间存在统计学显著相关性（ = 0.32， = 0.012 和 = 0.47， < 0.001，分别），而在青春期期间这种相关性不持续。我们的研究结果证实了肥胖儿童 TSH 升高，并表明青春期和肥胖对甲状腺轴功能具有性别依赖性的差异影响。
