Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece.
Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece.
Nutrients. 2024 Aug 11;16(16):2650. doi: 10.3390/nu16162650.
Thyroid hormones regulate metabolism and have a major impact in maintaining cardiovascular homeostasis. The purpose of our study was to examine the relation of thyrotropin (TSH) and thyroid hormones with cardiometabolic parameters in children and adolescents with obesity, overweight, and normal body mass index (BMI) before and after the implementation of a comprehensive, multidisciplinary, personalized, lifestyle intervention program for 1 year. One thousand three hundred and eleven (n = 1311) children and adolescents aged 2 to 18 years (mean age ± SD: 10.10 ± 2.92 years) were studied prospectively. Patients were categorized as having obesity (n = 727, 55.45%), overweight (n = 384, 29.29%) or normal BMI (n = 200, 15.26%) according to the International Obesity Task Force (IOTF) cutoff points. All patients received personalized guidance on diet, sleep, and physical activity at regular intervals throughout the 1-year period. Detailed clinical evaluation and hematologic, biochemical and endocrinologic investigations were performed at the beginning and the end of the study. Subjects with obesity had a more adverse cardiometabolic risk profile than subjects with overweight and normal BMI on both assessments. At initial evaluation, total T3 concentrations were positively associated with uric acid and HbA1C, and free T4 concentrations were negatively associated with insulin concentrations, while there was no association between TSH concentrations and cardiometabolic risk parameters. Following the 1 year of the multidisciplinary, lifestyle intervention program, the concentrations of lipids, HbA1C, ALT, and γGT improved significantly in all subjects. Changes in TSH concentrations were positively associated with changes in systolic blood pressure (SBP), glucose, triglycerides, and cholesterol concentrations. Changes in free T4 concentrations were negatively associated with changes in cholesterol and insulin concentrations. Furthermore, changes in T3 concentrations were positively associated with changes in HbA1C, glucose, uric acid, and triglyceride concentrations. These findings indicate that in children and adolescents with overweight and obesity, thyroid hormones are associated with indices conferring cardiometabolic risk.
甲状腺激素调节新陈代谢，对维持心血管稳态有重要影响。我们的研究目的是在实施为期 1 年的综合、多学科、个性化、生活方式干预方案前后，检查甲状腺刺激素（TSH）和甲状腺激素与肥胖、超重和正常体重指数（BMI）儿童和青少年的心血管代谢参数之间的关系。我们前瞻性地研究了 1311 名 2 至 18 岁（平均年龄 ± 标准差：10.10 ± 2.92 岁）的儿童和青少年。根据国际肥胖工作组（IOTF）切点，患者被归类为肥胖（n = 727，55.45%）、超重（n = 384，29.29%）或正常 BMI（n = 200，15.26%）。所有患者在 1 年内定期接受关于饮食、睡眠和体育活动的个性化指导。在研究开始和结束时进行详细的临床评估和血液学、生物化学和内分泌学检查。在两次评估中，肥胖组的心血管代谢风险特征均比超重和正常 BMI 组更差。在初始评估时，总 T3 浓度与尿酸和 HbA1C 呈正相关，游离 T4 浓度与胰岛素浓度呈负相关，而 TSH 浓度与心血管代谢风险参数之间无关联。在多学科生活方式干预方案实施 1 年后，所有患者的血脂、HbA1C、ALT 和 γGT 浓度均显著改善。TSH 浓度的变化与收缩压（SBP）、血糖、甘油三酯和胆固醇浓度的变化呈正相关。游离 T4 浓度的变化与胆固醇和胰岛素浓度的变化呈负相关。此外，T3 浓度的变化与 HbA1C、血糖、尿酸和甘油三酯浓度的变化呈正相关。这些发现表明，在超重和肥胖的儿童和青少年中，甲状腺激素与心血管代谢风险相关的指标有关。
