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体重减轻对埃及肥胖青少年甲状腺功能和非酒精性脂肪肝的影响。

Impact of Weight Reduction on Thyroid Function and Nonalcoholic Fatty Liver among Egyptian Adolescents with Obesity.

作者信息

Amin Mona Karem, Ali Ahmed Ibrahim, Elsayed Hesham

机构信息

Pediatrics Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Pediatrics Department, Ministry of Health, Mansoura, Egypt.

出版信息

Int J Endocrinol. 2022 Mar 29;2022:7738328. doi: 10.1155/2022/7738328. eCollection 2022.

Abstract

BACKGROUND

The prevalence of childhood obesity has been increasing worldwide. This may explain the emergence of nonalcoholic fatty liver as the leading cause of liver disease. Several previous studies have addressed the association between thyroid function and nonalcoholic fatty liver disease.

OBJECTIVES

To study the impact of weight reduction through lifestyle modifications in adolescents with obesity.

METHODS

A prospective cohort study was done on 61 adolescents with obesity. Patients were evaluated at the first visit by the full history, clinical examination, and investigations (thyroid profile, lipid profile, liver function tests, HbA1c, and liver ultrasonography) as basal information. The intervention program included a dietary program, increasing physical activity, and decreasing sedentary activity. A postintervention evaluation was done at the end of six months which included anthropometric measures, laboratory results, and ultrasonographic estimation.

RESULTS

It was shown that the mean BMI of the participants had significantly decreased after lifestyle modification from (32.05 ± 3.36 kg/m2) to (28.1 ± 2.77 kg/m2) ( < 0.001). It also showed that the percentage of studied adolescents with elevated TSH decreased from 47.5% to 19.7% after the weight reduction program. Improvement was also achieved in the lipid profile and liver functions. The percentage of studied adolescents with ultrasound appearance of NAFLD decreased from 31.1% to 26.2% after weight reduction.

CONCLUSIONS

Lifestyle modification positively influences the metabolic derangement in obesity without medical treatment. ΔTSH is a significant predictor of the change in BMI z-score. It is also possible that hepatic steatosis affects thyroid function rather than the other way around.

摘要

背景

儿童肥胖症在全球范围内的患病率一直在上升。这可能解释了非酒精性脂肪性肝病成为肝病主要病因的出现。此前的几项研究探讨了甲状腺功能与非酒精性脂肪性肝病之间的关联。

目的

研究通过生活方式改变减轻肥胖青少年体重的影响。

方法

对61名肥胖青少年进行了一项前瞻性队列研究。在首次就诊时,通过完整病史、临床检查和检查(甲状腺功能指标、血脂指标、肝功能检查、糖化血红蛋白和肝脏超声检查)对患者进行评估,作为基础信息。干预方案包括饮食方案、增加体育活动和减少久坐行为。在六个月结束时进行干预后评估,包括人体测量指标、实验室检查结果和超声评估。

结果

结果显示,生活方式改变后,参与者的平均体重指数从(32.05±3.36kg/m²)显著降至(28.1±2.77kg/m²)(<0.001)<0.001)。还显示,在减重计划后,促甲状腺激素升高的研究青少年比例从47.5%降至19.7%。血脂和肝功能也有所改善。减重后,超声显示患有非酒精性脂肪性肝病的研究青少年比例从31.1%降至26.2%。

结论

生活方式改变对肥胖患者未经药物治疗的代谢紊乱有积极影响。促甲状腺激素变化是体重指数z评分变化的重要预测指标。肝脂肪变性也有可能影响甲状腺功能,而不是相反。

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