Di Sessa Anna, D'Anna Josè Alberto, Melone Rosa, Forcina Gianmario, Capasso Giusy, Umano Giuseppina Rosaria, Miraglia Del Giudice Emanuele, Marzuillo Pierluigi
Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Int J Obes (Lond). 2025 Mar 23. doi: 10.1038/s41366-025-01752-2.
BACKGROUND/OBJECTIVES: The interplay of subclinical hypothyroidism (SH) with obesity has been well-documented, while an intriguing but still controversial association with kidney damage (KD) has recently emerged. Given the heightened cardiometabolic risk inherent to pediatric obesity, this might further impact on the overall health of children with obesity. Therefore, we aimed at evaluating the impact of SH on KD in children with obesity.
SUBJECTS/METHODS: We retrospectively examined 355 children with obesity stratified according to presence or absence of SH. KD was defined as reduced estimated glomerular filtration rate (eGFR<90 mL/min/1.73 m) and/or hypertension, and/or albuminuria (≥30 mg/g urinary creatinine), while SH was defined by thyroid stimulating hormone (TSH) > 4.5μ UI/ml with normal free triiodothyronine and free thyroxine levels.
Children with SH showed a higher KD prevalence than those without SH (p = 0.004). They also had lower eGFR levels than their counterparts without SH (p = 0.001) and showed an adjusted OR to have KD of 2.04 (95% CI: 1.15-3.61; p = 0.015). A general linear model for eGFR variance showed an inverse association of eGFR with TSH levels (p < 0.0001).
Although preliminary, our data suggested an increased risk of KD in children with obesity and SH.
背景/目的：亚临床甲状腺功能减退（SH）与肥胖之间的相互作用已有充分记录，而最近出现了一种有趣但仍有争议的与肾损伤（KD）的关联。鉴于儿童肥胖固有的心血管代谢风险增加，这可能会进一步影响肥胖儿童的整体健康。因此，我们旨在评估SH对肥胖儿童KD的影响。
对象/方法：我们回顾性研究了355名肥胖儿童，根据是否存在SH进行分层。KD定义为估计肾小球滤过率降低（eGFR<90 mL/min/1.73 m²）和/或高血压和/或蛋白尿（尿肌酐≥30 mg/g），而SH定义为促甲状腺激素（TSH）>4.5μ UI/ml且游离三碘甲状腺原氨酸和游离甲状腺素水平正常。
患有SH的儿童比没有SH的儿童KD患病率更高（p = 0.004）。他们的eGFR水平也低于没有SH的儿童（p = 0.001），并且调整后的KD发生风险比为2.04（95%CI：1.15 - 3.61；p = 0.015）。eGFR方差的一般线性模型显示eGFR与TSH水平呈负相关（p < 0.0001）。
尽管是初步研究，但我们的数据表明肥胖和SH儿童发生KD的风险增加。
