Kara Ozlem
Department of Pediatric Endocrinology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
Clin Exp Pediatr. 2020 Mar;63(3):110-114. doi: 10.3345/cep.2019.01536. Epub 2020 Mar 6.
Subclinical hypothyroidism (SH) is a common condition in obese children. However, its effect on glucose and lipid metabolism in obese children remains controversial.
The present study aimed to investigate the association between SH and metabolic parameters.
A total of 215 obese children and adolescents aged 6-18 years were included in this retrospective cross-sectional study. The patients' anthropometric measurements such as thyrotropin (TSH), free thyroxine (fT4), fasting plasma glucose, and insulin levels, as well as homeostasis model assessment for insulin resistance (HOMA-IR) index, and lipid profiles were evaluated. The patients were allocated to the SH group (fT4 normal, TSH 5-10 mIU/L) (n=77) or the control group (fT4 normal, TSH<5 mIU/L) (n=138). The glucose and lipid metabolisms of the 2 groups were compared.
SH was identified in 77 of 215 patients (36%). Mean body mass index was similar in both groups. The mean serum insulin, HOMA-IR, and triglyceride (TG) levels were higher and the mean high-density lipoprotein cholesterol level was lower in the SH group than in the control group (P=0.007, P=0.004, P=0.01, and P=0.02, respectively). A positive correlation was observed between TSH level and insulin level, HOMA-IR, and TG level.
SH was identified in some of the obese children and adolescents. A clear association was observed between SH, insulin resistance, and dyslipidemia in obese children.
亚临床甲状腺功能减退（SH）在肥胖儿童中是一种常见病症。然而，其对肥胖儿童糖脂代谢的影响仍存在争议。
本研究旨在探讨SH与代谢参数之间的关联。
本回顾性横断面研究纳入了215名6至18岁的肥胖儿童和青少年。评估了患者的人体测量指标，如促甲状腺激素（TSH）、游离甲状腺素（fT4）、空腹血糖和胰岛素水平，以及胰岛素抵抗稳态模型评估（HOMA-IR）指数和血脂谱。将患者分为SH组（fT4正常，TSH 5 - 10 mIU/L）（n = 77）或对照组（fT4正常，TSH < 5 mIU/L）（n = 138）。比较两组的糖脂代谢情况。
215名患者中有77名（36%）被诊断为SH。两组的平均体重指数相似。SH组的平均血清胰岛素、HOMA-IR和甘油三酯（TG）水平高于对照组，而平均高密度脂蛋白胆固醇水平低于对照组（分别为P = 0.007、P = 0.004、P = 0.01和P = 0.02）。观察到TSH水平与胰岛素水平、HOMA-IR和TG水平之间呈正相关。
在部分肥胖儿童和青少年中发现了SH。在肥胖儿童中，SH、胰岛素抵抗和血脂异常之间存在明显关联。
