瘦素和脂联素在肥胖的正常甲状腺功能和甲状腺功能减退儿童和青少年中的胰岛素抵抗。
Insulin resistance, leptin and adiponectin in lean and hypothyroid children and adolescents with obesity.
机构信息
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
出版信息
BMC Pediatr. 2022 May 2;22(1):245. doi: 10.1186/s12887-022-03318-x.
BACKGROUND
Obesity usually complicates hypothyroidism. Adipokines like leptin and adiponectin secreted by adipose tissue modulate insulin resistance (IR), appetite, and obesity. The association between adipokines, IR, and thyroid hormone has not been sufficiently studied in children. We investigated leptin and adiponectin as well as IR and their association with thyroid hormone in both lean and hypothyroid children and adolescents with obesity.
METHODS
The study included 30 lean hypothyroid, 30 hypothyroid children and adolescents with obesity, and 30 healthy lean children as the control group. Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), fasting blood glucose, fasting insulin, homeostatic model assessment method of insulin resistance (HOMA-IR), leptin, and adiponectin levels were estimated in all participants.
RESULTS
Fasting insulin, HOMA-IR, and leptin levels were significantly elevated in hypothyroid children compared to the control group; more in hypothyroid children with obesity. In contrast, adiponectin levels were significantly lower in the hypothyroid children with obesity compared to the lean hypothyroid children and controls. HOMA-IR was positively correlated to TSH and BMI but inversely correlated with fT3 and fT4 in hypothyroid children. There was no correlation between IR and either leptin or adiponectin levels. Leptin and adiponectin levels correlated well with BMI in hypothyroid children and adolescents with obesity.
CONCLUSION
Insulin resistance and leptin levels are increased in hypothyroid children and adolescents; more in those with obesity. IR is not related to leptin and adiponectin levels, however, leptin and adiponectin levels correlate well with BMI in hypothyroid children and adolescents with obesity.
IMPACT
Insulin resistance (IR) and leptin levels increase in hypothyroid children and adolescent; more with obesity. IR is not related to leptin and adiponectin levels, however leptin and adiponectin levels correlated well with BMI in hypothyroid children and adolescents with obesity.
背景
肥胖通常会使甲状腺功能减退复杂化。脂肪组织分泌的瘦素和脂联素等脂肪因子调节胰岛素抵抗（IR）、食欲和肥胖。脂肪因子、IR 和甲状腺激素之间的关联在儿童中尚未得到充分研究。我们研究了瘦素和脂联素以及 IR 及其与甲状腺激素在肥胖的瘦素和甲状腺功能减退儿童和青少年中的关系。
方法
本研究纳入了 30 名单纯性甲状腺功能减退的肥胖儿童、30 名甲状腺功能减退的肥胖儿童和青少年以及 30 名健康的瘦儿童作为对照组。所有参与者均检测血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、空腹血糖、空腹胰岛素、稳态模型评估法胰岛素抵抗指数（HOMA-IR）、瘦素和脂联素水平。
结果
与对照组相比，甲状腺功能减退的儿童空腹胰岛素、HOMA-IR 和瘦素水平显著升高；甲状腺功能减退的肥胖儿童更高。相反，与单纯性甲状腺功能减退的儿童和对照组相比，甲状腺功能减退的肥胖儿童的脂联素水平显著降低。甲状腺功能减退儿童的 HOMA-IR 与 TSH 和 BMI 呈正相关，与 fT3 和 fT4 呈负相关。IR 与瘦素和脂联素水平无关。瘦素和脂联素水平与甲状腺功能减退的肥胖儿童和青少年的 BMI 相关良好。
结论
甲状腺功能减退的儿童和青少年胰岛素抵抗和瘦素水平升高；肥胖者更明显。IR 与瘦素和脂联素水平无关，但在甲状腺功能减退的肥胖儿童和青少年中，瘦素和脂联素水平与 BMI 相关良好。
影响
甲状腺功能减退的儿童和青少年胰岛素抵抗（IR）和瘦素水平升高；肥胖者更明显。IR 与瘦素和脂联素水平无关，但在甲状腺功能减退的肥胖儿童和青少年中，瘦素和脂联素水平与 BMI 相关良好。
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