Impact of body mass index on thyroid functions in Indian children

Marwaha, Raman K.; Tandon, Nikhil; Garg, MK; Ganie, Mohd Ashraf; Narang, Amit; Mehan, Neena; Bhadra, Kuntal

doi:10.1111/cen.12148

Cited by 37 publications

(37 citation statements)

References 39 publications

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“…In different studies, obese subjetcs had high or normal TT3 and TT4 levels respect to control groups, also TT4 and fT4 levels were inversely coorelated with body weight (6,15,(19)(20)(21)(22)(23)(24), but we didnt't find any difference in fT3, fT4, TT4 between obese and control group.…”

Section: Discussioncontrasting

confidence: 63%

Subklinik Hipotroidi Çocuklarda Egzojen Obeziteyi Artırıyor mu?

Kırşaçlıoğlu¹,

Şıklar²,

Dallar³

2015

J Contemp Med

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ÖZETAmaç: Obez çocuklarda tiroid fonksiyonları ve subklinik hipotroidi değerlendirilmesi amaçlandı.Gereç ve yöntemler: Kırküç obez çocuk ve kontrol grubu olarak benzer yaştaki 17 idiopatik boy kısalığı olan çocuk, antropometrik ölçümler, bazal tiroid stimule edici hormon (TSH), serbest triiodotronin (sT3), serbest tiroksin (sT4), total tiroksin (TT4), total triiodotronin (TT3) düzeyleri ve tirotropin salgılatıcı hormon (TRH) uyarı testine TSH yanıtı ile değerlendirildi.Sonuçlar: Obez ve kontrol grubunun, yaş, kemik yaşı, bazal TSH, sT3, sT4, TT4 düzeyleri arasında fark saptanmadı. Obez grubun TT3 düzeyleri kontrol grubundan anlamlı olarak yüksekti(p=0.009). TSH düzeylerinin maksimum artışı ve pik TSH düzeyleri, obez grupta, kontrol grubuna göre anlamlı olarak düşüktü (sırasıyla p=0.021, p=0.04). Obez grup, TSH yanıtına göre değerlendirildiğinde; Grup 1 (Anormal artış gösteren TSH yanıtı olanlar) ve grup 2 (TSH yanıtı normal olanlar) olarak ikiye ayrıldı. Grup 1'in bazal TSH'sı, grup 2'den anlamlı olarak yüksekti (p<0.001).Karar: Bazal TSH düzeyleri yüksek olan obez çocuklarda TRH uyarı testi subklinik hipotroidizmi belirlemede yardımcı olabilir.Anahtar Kelimeler: Çocuklar, obezite, subklinik hipotroidi, tirotropin salgılatıcı hormon uyarı testi. ABSTRACT Background:We aimed to evaluate thyroid functions and subclinical hypothyroidism in obese children.Methods: Fourty three children with exogenous obesity and 17 aged matched idiopathic short stature children (control group) were studied with anthropometric indices and basal thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), total thyroxine (TT4) and total triiodothyronine (TT3) levels and they all underwent thyrotropin releasing hormone (TRH) stimulation test to determine TSH response.Results: There were no significant difference in age, bone age, basal TSH, fT3, fT4, TT4 levels between obese and control group. Total triiodothyronine levels of obese group were significantly higher than control group (p=0.009). The maximum increment of antly lower than the control group (p=0.021, p=0.04 respectively). We evaluated obese children for TSH response and divided them into two groups; obese group 1 ( TSH response abnormally elevated) and obese group 2 (TSH response were normal), basal TSH levels of group 1 were found significantly higher than group 2 (p<0.001).Conclusion: Thyrotropin releasing hormone stimulation test may be helpful to determine subclinical hypothyroidism in exogen obese children, if basal TSH levels were elevated.

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Section: Discussioncontrasting

confidence: 63%

Subklinik Hipotroidi Çocuklarda Egzojen Obeziteyi Artırıyor mu?

Kırşaçlıoğlu¹,

Şıklar²,

Dallar³

2015

J Contemp Med

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show abstract

“…In a cohort study of 88 children and adolescents with SCH, 28.4% were found to be overweight or obese, although this high prevalence may be due to selection bias [126]. However, a large community-based study has also shown a significantly higher prevalence of SCH in obese children as compared to non-obese children (9 vs. 6.5%) [148]. In another large cohort study of 22,747 children and adolescents with type 1 diabetes, 1,638 (7.2%) were found to have SCH.…”

Section: Sch In Childhoodmentioning

confidence: 99%

2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children

Lazarus¹,

Brown²,

Daumerie³

et al. 2014

Eur Thyroid J

601

457

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This guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.5th centile of the pregnancy-related reference range with a normal TSH level) is also recognized in pregnancy. In the majority of SCH the cause is autoimmune thyroiditis but may also be due to iodine deficiency. The cause of isolated hypothyroxinaemia is usually not apparent, but iodine deficiency may be a factor. SCH and isolated hypothyroxinaemia are both associated with adverse obstetric outcomes. Levothyroxine therapy may ameliorate some of these with SCH but not in isolated hypothyroxinaemia. SCH and isolated hypothyroxinaemia are both associated with neuro-intellectual impairment of the child, but there is no evidence that maternal levothyroxine therapy improves this outcome. Targeted antenatal screening for thyroid function will miss a substantial percentage of women with thyroid dysfunction. In children SCH (serum TSH concentration >5.5-10 mU/l) normalizes in >70% and persists in the majority of the remaining patients over the subsequent 5 years, but rarely worsens. There is a lack of studies examining the impact of SCH on the neuropsychological development of children under the age of 3 years. In older children, the evidence for an association between SCH and impaired neuropsychological development is inconsistent. Good quality studies examining the effect of treatment of SCH in children are lacking.

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“…Nevertheless, modest alterations in thyroid function are more common among obese compared to lean children, including elevated serum concentrations of thyroid-stimulating hormone (TSH) combined with normal serum concentrations of free thyroxine (fT 4 )-often termed subclinical hypothyroidism (SH) (4,5,6,7,8,9). SH is a diagnosis of exclusion which does not cause any clinical symptoms of hypothyroidism.…”

Section: Introductionmentioning

confidence: 99%

“…Likewise, central fat accumulation in obese children is associated with a range of metabolic comorbidities and development of cardiovascular complications (15). Although there exist various studies evaluating thyroid status in children with obesity, most studies have focused on body mass index (BMI) standard deviation score (SDS) as the anthropometric measure to describe the degree of obesity (5,6,7,14). Few studies have investigated associations with other anthropometric measures such as waist circumference (WC) (16,17) and waist-hip ratio (17).…”

Section: Introductionmentioning

confidence: 99%

Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents

Dahl¹,

Ohrt²,

Fonvig³

et al. 2017

Jcrpe

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Objective:Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children and adolescents.Methods:In this cross-sectional study, we included 3006 children and adolescents, aged 6-18 years, from the Registry of the Danish Childhood Obesity Biobank. The overweight/obese group (n=1796) consisted of study participants with a body mass index (BMI) standard deviation score (SDS) ≥1.28. The control group (n=1210) comprised lean children with a BMI SDS <1.28. All participants were characterized by anthropometrics (weight, height, and waist circumference) and fasting serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine, and free thyroxine (fT4) at baseline.Results:The prevalence of SH was higher among overweight/obese compared to lean study participants (10.4% vs. 6.4%, p=0.0001). In the overweight/obese group, fasting serum TSH concentrations were associated positively with BMI SDS (p<0.0001) and waist-height ratio (WHtR) (p<0.0001) independent of age, sex, and pubertal developmental stage, whereas fasting serum fT4 concentrations were associated positively only with WHtR. The odds ratio of exhibiting SH was 1.8 when being overweight/obese compared with lean (p=0.0007) and 1.8 when presenting with a WHtR >0.5 (p=0.0003).Conclusion:The prevalence of SH was higher among overweight/obese study participants. The positive correlations of circulating TSH and fT4 with WHtR suggest that central obesity, independent of the overall degree of obesity, augments the risk of concurrent thyroid abnormalities in children and adolescents with obesity.

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Impact of body mass index on thyroid functions in Indian children

Abstract: Serum FT3 and TSH were positively while FT4 was negatively associated with BMI in apparently healthy euthyroid children.

Cited by 37 publications

References 39 publications

Subklinik Hipotroidi Çocuklarda Egzojen Obeziteyi Artırıyor mu?

Subklinik Hipotroidi Çocuklarda Egzojen Obeziteyi Artırıyor mu?

2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children

Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents

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