Natural History of Thyroid Function Tests over 5 Years in a Large Pediatric Cohort

Lazar, Liora; Frumkin, Rachel Ben-David; Battat, Erez; Lebenthal, Yael; Phillip, Moshe; Meyerovitch, Joseph

doi:10.1210/jc.2008-2615

Cited by 143 publications

(125 citation statements)

References 25 publications

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“…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: 70%

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: 70%

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

Ekinci¹,

Uzuner²,

Demet³

et al. 2015

MMJ

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“…In pediatric age, SH is detected with increasing frequency, as thyroid function tests are routinely performed in children with very different clinical problems (2,3). SH may be possibly caused by the same thyroid disorders that result in overt thyroid function impairment, in particular, Hashimoto's thyroiditis (HT) (4).…”

Section: Introductionmentioning

confidence: 99%

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Waśniewska

Aversa

Salerno

et al. 2015

European Journal of Endocrinology

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Aim: To follow-up for 5 years thyroid status evolution in 127 girls with mild (TSH 5-10 mU/l) subclinical hypothyroidism (SH) of different etiologies. Patients: The population was divided into two age-matched groups of 42 and 85 girls with either idiopathic (group A) or Hashimoto's thyroiditis (HT)-related SH (group B). Group B was in turn divided into three subgroups, according to whether SH was either isolated or associated with Turner syndrome (TS) or Down syndrome (DS). Results: At the end of follow-up the rate of girls who became euthyroid was higher in group A (61.9% vs 10.6%), whereas the rates of patients who remained SH (55.3% vs 26.2%), became overtly hypothyroid (30.6% vs 11.9%) or required levothyroxine (L-T 4 ) therapy (63.5% vs 23.8%) were higher in group B. Among the girls of group B, the risk of remaining SH or developing overt hypothyroidism was higher in the subgroups with TS or DS than in those with isolated HT. Conclusions: Long-term prognosis of mild and idiopathic SH is frequently benign, even though a L-T 4 treatment may be needed throughout follow-up in almost a quarter of cases; long-term prognosis is different in the girls with either idiopathic or HT-related SH; and the association with either TS or DS impairs the outcome of HT-related SH.

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“…Genel olarak yayınlarda ise çocuklarda %2 erişkinlerde ise %1-10 arasın-da tespit edilmiştir [4,13,16]. Hindistan'da Marwaha'nın 39961 çocuk ile yaptığı çalışmada %6,1 SH tespit edilmiş-tir [12].…”

Section: Epidemiyolojiunclassified

“…Lazar ve ark. retrospektif analizlerinde 6 ay ve 6 yaş arasında TSH değeri 5,5-10 mIU/L olan çocukların oranı %2,9 olarak bulunmuştur [16].…”

Section: Epidemiyolojiunclassified

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Insidious danger in childhood era's: subclinical hypothyroidism

2017

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Insidious danger in childhood era's; subclinical hypothyroidism erleme d Öz Tiroid hormonları; santral sinir sistemi gelişimi, büyüme, gelişme, vücut ısısı regülasyonu, lipit, karbonhidrat ve enerji metabolizması, iskelet sistemi üzerinde önemli role sahiptir. Diğer yönden çocukluk çağında santral sinir sistemi myelinizasyonunda görevli olduğu için önemi farklıdır. Subklinik hipotiroidi, serum tiroid stimulan hormon seviyesinin orta düzeyde artması ile birlikte serum tiroid hormon seviyelerinin normal referans laboratuvar aralı-ğında olmasıdır. Çocuklarda %2 oranında görülmektedir. Etiyolojisinin büyük bir kısmını otoimmün tiroidit ve iyot eksikliği oluşturmaktadır. Asemptomatik olguların zamanında tanımlanması ve tedavisi önemlidir. Olgularda guatr, büyüme-gelişme geriliği veya duraksaması, ders başarısında azalma, negativizm, depresyon, obezite, demir eksikliği anemisi, dislipidemi, kemik yaşı geriliğinde levotiroksin tedavisi başlanması uygundur. Anahtar sözcükler: Çocukluk çağı, subklinik hipotiroidizm AbstractThyroid hormones have an important role on the central nervous system, growth, development, body temperature regulation, metabolism of lipid, carbohydrate and energy, musculoskeletal system. The other hand, it has a different importance for its role in the myelinization of the central nervous system during the childhood period. Subclinical hypothyroidism (SH), is diagnosed when peripheral thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone levels are mildly elevated. Prevalance of subclinical hypothyroidism in chilhood is seen about %2. The majority of its etiology is due to the autoimmune thyroiditis and iodine deficiency. It is important to diagnose and treat the asymptomatic cases in a timely manner. Thyroxin treatment should be started if goiter, growth velocity is slowed down, decline in school success, negativism, depression, obesity, refractory iron deficiency anemia dyslipidemia, bone age retardation.

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Natural History of Thyroid Function Tests over 5 Years in a Large Pediatric Cohort

Abstract: In the pediatric population, initial normal or slightly elevated TSH levels are likely to remain normal or spontaneously normalize without treatment. Patients with initial levels greater than 7.5 mIU/liter, particularly girls, are at a greater risk for sustained abnormal TSH levels.

Cited by 143 publications

References 25 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

Five-year prospective evaluation of thyroid function in girls with subclinical mild hypothyroidism of different etiology

Insidious danger in childhood era's: subclinical hypothyroidism

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