Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Children Datteln, University of Witten/Herdecke, Datteln, Germany.
Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Children Datteln, University of Witten/Herdecke, Datteln, Germany,
Horm Res Paediatr. 2020;93(5):279-286. doi: 10.1159/000509786. Epub 2020 Oct 9.
A relation between thyroid-stimulating hormone (TSH), insulin resistance - both of which are related to obesity - and thyroid volume has been suggested. Therefore, we analyzed thyroid volume and structure in relation to thyroid function parameters, weight status, and insulin resistance.
This is a cross-sectional study in which weight status (BMI-SDS), thyroid function parameters (TSH, free tri-iodothyronine [fT3], and free thyroxine [fT4]), insulin resistance index (HOMA-IR), and thyroid volume (ultrasound) were determined in 617 overweight children (aged 10.4 ± 2.2 years, 50% male, BMI-SDS 2.5 ± 0.6) and in 27 normal-weight children of a similar age and gender. Furthermore, changes in thyroid volume and structure, and thyroid function parameters were analyzed in 83 obese children (51% male, mean age 10.3 ± 2.2) at baseline and at the end of a 1-year lifestyle intervention.
Overweight children had a significant greater thyroid volume (4.2 ± 1.8 vs. 4.1 ± 0.5 mL) and higher TSH (3.1 ± 1.5 vs. 2.4 ± 1.1 mU/L) and fT3 (4.4 ± 0.7 vs. 4.1 ± 0.5 pg/mL) concentrations compared to normal-weight children. In multiple linear regression analyses adjusted to multiple confounders, thyroid volume was significantly related to BMI-SDS (b coefficient 0.44 ± 0.10, r2 = 0.41) but not to any thyroid function parameter or HOMA-IR. Changes in BMI-SDS were significantly associated with changes in thyroid volume (r = 0.22). The changes in thyroid volume were not correlated to changes of any thyroid function parameter or HOMA-IR.
Thyroid volume is positively correlated to weight status in childhood obesity and the change is reversible after weight loss independently of thyroid function parameters and insulin resistance. Further studies are needed to understand why thyroid volume is increased reversibly in overweight children.
促甲状腺激素（TSH）、胰岛素抵抗与肥胖有关，而甲状腺体积与这两者之间存在关联。因此，我们分析了甲状腺体积与甲状腺功能参数、体重状况和胰岛素抵抗之间的关系。
这是一项横断面研究，其中体重状况（BMI-SDS）、甲状腺功能参数（TSH、游离三碘甲状腺原氨酸 [fT3] 和游离甲状腺素 [fT4]）、胰岛素抵抗指数（HOMA-IR）和甲状腺体积（超声）在 617 名超重儿童（年龄 10.4 ± 2.2 岁，50%为男性，BMI-SDS 为 2.5 ± 0.6）和 27 名年龄和性别相似的正常体重儿童中进行了测定。此外，还在 83 名肥胖儿童（51%为男性，平均年龄 10.3 ± 2.2 岁）中分析了基线和 1 年生活方式干预结束时甲状腺体积和结构以及甲状腺功能参数的变化。
与正常体重儿童相比，超重儿童的甲状腺体积（4.2 ± 1.8 比 4.1 ± 0.5 mL）和 TSH（3.1 ± 1.5 比 2.4 ± 1.1 mU/L）和 fT3（4.4 ± 0.7 比 4.1 ± 0.5 pg/mL）浓度显著更高。在调整了多种混杂因素的多元线性回归分析中，甲状腺体积与 BMI-SDS 显著相关（b 系数 0.44 ± 0.10，r2 = 0.41），但与任何甲状腺功能参数或 HOMA-IR 无关。BMI-SDS 的变化与甲状腺体积的变化显著相关（r = 0.22）。甲状腺体积的变化与任何甲状腺功能参数或 HOMA-IR 的变化均无相关性。
儿童肥胖症中甲状腺体积与体重状况呈正相关，减肥后这种变化是可逆的，与甲状腺功能参数和胰岛素抵抗无关。需要进一步的研究来了解为什么超重儿童的甲状腺体积是可逆性增加的。
