Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study

Santos, Maria Inês; Limbert, Catarina; Marquês, Filipa; Rosário, Frederico; Lopes, Lurdes

doi:10.1515/jpem-2014-0319

Cited by 22 publications

(32 citation statements)

References 29 publications

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“…As shown in our study and in other studies by losing weight TSH levels decreased significantly [9,20,25]. However some studies found no relationship between weight loss and normalization of TSH values [26,27]. Our current knowledge does not support the use of thyroxine treatment for elevated TSH in obese children [28,29].…”

Section: Discussioncontrasting

confidence: 75%

Thyroid hormones and BMI in obese children: One year follow up results

Ekinci¹,

Uzuner²,

Demet³

et al. 2015

MMJ

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Objectives: The aim of this study was to investigate the relationship between thyroid hormone levels and obesity, lipid levels and weight changes. Patients and Methods:Five to eleven year old normal weight, overweight and obese children underwent measurements of thyroid stimulating hormone (TSH), free thyroxine (fT4), lipid profile and autoimmune thyroid antibodies. Children with high TSH were reevaluated one year later without any intervention.Results: Three hundred children (126 obese, 74 overweight, 100 normal weight) were evaluated in the study. The rates of high TSH levels were 1.0% in normal weight, 9.5% in overweight and 11.9% in obese group (p=0.007). fT4 levels of all the children enrolled in the study were in normal range. None of the children had autoimmune antibody positivity. Obese children with high TSH had higher triglyceride levels than children with normal TSH (p=0.028). One year later, a significant decrease in body mass index (BMI) was accompanied by a significant decrease in TSH levels.Conclusion: TSH levels can be high in obese and overweight children. Obese and overweight children with elevated levels of TSH do not need to be treated pharmacologically, losing weight decreases TSH levels significantly.Keywords: TSH, BMI, Child, Obesity, Overweight, Thyroid ÖZET Amaç: Bu çalışmanın amacı tiroid hormon düzeyleri ile obezite, lipid düzeyleri ve ağırlık değişiklikleri arasındaki ilişkiyi araştırmaktır. Hastalar ve Yöntemler:Beş ve onbir yaş aralığında normal, fazla kilolu ve obez çocukların TSH, sT4, lipid profili ve otoimmün antikor değerlerine bakılmıştır. TSH düzeyi yüksek olan çocuklar herhangi bir müdahale yapılmadan bir yıl sonra yeniden değerlendirilmiştir.Bulgular: Çalışmada 300 çocuk (126 obez, 74 fazla kilolu, 100 normal kilolu) değerlendirilmiştir. Yüksek TSH düzeyi sıklığı normal kilolu grupta %1.0, fazla kilolu grupta %9.5 ve obez grupta %11.9'dur (p=0.007). Bütün gruplarda sT4 düzeyleri normal bulunmuştur. Çocukların hiçbirinde otoimmun antikorlar pozitif değildir. Yüksek TSH'lı çocuklar normal TSH'lı çocuklara göre daha yüksek trigliserid düzeylerine sahiptir (p=0.028). Bir yıl sonra yapılan değerlendirmede, VKİ'de anlamlı düşüşle birlikte TSH düzeyinde de anlamlı bir düşüş saptanmıştır.Sonuç: TSH düzeyleri obez ve fazla kilolu çocuklarda yüksek olabilir. TSH yüksekliği olan obez ve fazla kilolu çocukların farmakolojik olarak tedavi edilmesine gerek yoktur, kilo vermek TSH düzeylerinin anlamlı olarak azalmasını sağlar.

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Section: Discussioncontrasting

confidence: 75%

Thyroid hormones and BMI in obese children: One year follow up results

Ekinci¹,

Uzuner²,

Demet³

et al. 2015

MMJ

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“…In some studies, weight loss has been reported to normalize TSH levels as well as metabolic parameters of glucose metabolism and lipid profile [22, 23], whereas 1 study did not find an association of TSH with lipid parameters even though TSH was reduced after weight loss [24]. However, despite a large number of studies, it is still unclear whether high TSH levels are compensatory to maintain normal thyroid hormone levels, and it is also unclear whether TSH is associated with metabolic disturbances in children with obesity since previously published research are inconsistent [25].…”

Section: Introductionmentioning

confidence: 99%

Thyroid-Stimulating Hormone, Degree of Obesity, and Metabolic Risk Markers in a Cohort of Swedish Children with Obesity

et al. 2017

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Background/Aims: Thyroid-stimulating hormone (TSH) is affected in obesity and might influence metabolic risk. It is unclear what mechanisms cause elevated TSH in obesity. We aimed to investigate TSH status within the normal range and the association of TSH with degree of obesity and metabolic parameters in children with obesity. Methods: A total of 3,459 children, aged 3.0–17.9 years, were identified in the Swedish Childhood Obesity Treatment Registry, BORIS. Age, gender, TSH, free triiodothyronine (fT3), free thyroxine (fT4), body mass index standard deviation scores (BMI SDS), as well as variables of lipid and glucose metabolism were examined. Results: Children with high-normal TSH (>3.0 mU/L) (28.8%) had higher BMI SDS compared to children with low-normal TSH (<3.0 mU/L) (p < 0.001). Multivariable regression analysis adjusted for age and gender showed that TSH levels were associated with BMI SDS (β: 0.21, 95% CI: 0.14–0.28, p < 0.001). Associations of thyroid hormones with markers of lipid and glucose metabolism were observed, where TSH was associated with fasting insulin, HOMA (homeostatic model assessment of insulin resistance), total cholesterol, and triglycerides. Conclusions: A positive association between TSH levels and BMI SDS was seen in children with obesity. Associations of TSH and free thyroid hormones with glucose metabolism indicated that TSH might be one of several factors acting to determine body weight and obesity co-morbidities, although the underlying mechanism remains unclear.

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“…This leads us to consider the condition a physiological one and to discard the possibility of using levothyroxine to lower TSH levels in overweight or obese children and adolescents in order to reduce associated comorbidities. On the other hand, there are studies which report a significant association between thyrotropin and metabolic syndrome (38,39), carbohydrate intolerance (24), elevated total and LDL cholesterol (21,40), and elevated triglycerides (24,29,33,40) as well as between low levels of free T4 and increased insulin concentration (34). …”

Section: Discussionmentioning

confidence: 99%

Thyroid Function and Thyroid Autoimmunity in Relation to Weight Status and Cardiovascular Risk Factors in Children and Adolescents: A Population-Based Study

García-García

Vázquez-López²,

Garcı́a-Fuentes³

et al. 2016

Jcrpe

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Objective: In obese subjects, slight increases have been observed in thyrotropin [thyroid-stimulating hormone (TSH)] levels, but data in children are scarce. The aim of this study was to evaluate whether thyroid function and autoimmunity vary with weight status in a healthy population of children and adolescents and to determine whether hyperthyrotropinemia is associated with any cardiovascular risk factor.Methods: This cross-sectional epidemiological study was conducted in Almería (Spain) on a representative sample of 1317 healthy subjects aged 2-16 years. Thyroid function, thyroid autoimmunity and cardiovascular risk factors were measured. Chi-square test, analysis of variance and multiple linear regression were used in the statistical analyses.Results: The obese children and adolescents had thyrotropin levels (mean ± standard deviation) of 3.12±2.44 mU/L. These levels were higher than those of overweight subjects (2.79±1.51 mU/L) and of normal weight subjects (2.73±1.30 mU/L) (p=0.02). Levels of free thyroxine and urinary iodine did not differ significantly between the groups. The prevalence (95% confidence interval) of thyroid autoimmunity was lower in the individuals with normal weight (2.9%; 2.0-4.2) than in the overweight (6.3%; 3.9-9.9) and obese subjects (5.6%, 2.5-11.3) (p=0.02). TSH levels were associated with obesity (β=0.36; p<0.001) and thyroid autoimmunity (β=1.10; p<0.001). They were not associated with any cardiovascular risk factor.Conclusion: Obese children and adolescents had higher levels of thyrotropin than those who were overweight and of normal weight. The differences among the groups were of very little clinical significance and could possibly be linked to the higher prevalence of thyroid autoimmunity in obese subjects. The hyperthyrotropinemia in these subjects was not associated with any cardiovascular risk factor.

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Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study

Cited by 22 publications

References 29 publications

Thyroid hormones and BMI in obese children: One year follow up results

Thyroid hormones and BMI in obese children: One year follow up results

Thyroid-Stimulating Hormone, Degree of Obesity, and Metabolic Risk Markers in a Cohort of Swedish Children with Obesity

Thyroid Function and Thyroid Autoimmunity in Relation to Weight Status and Cardiovascular Risk Factors in Children and Adolescents: A Population-Based Study

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