Obesity and Attenuated Adiposity Rebound in Children with Congenital Hypothyroidism. Normalization of BMI Values in Adolescents

Livadas, Sarantis; Magiakou, Maria Alexandra; Mengreli, Chryssanthi; Girginoudis, Panagiotis; Galani, Carmen; Smyrnaki, Penelope; Kanaka‐Gantenbein, Christina; Xekouki, Paraskevi; Chrousos, George P.; Dacou-Voutetakis, Catherine

doi:10.1055/s-2007-984396

Cited by 14 publications

(9 citation statements)

References 22 publications

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“…The higher total and central body fat mass of young and adult NIC offspring may be due, at least in part, to their possible hypothyroidism. An earlier adiposity has been reported in children with congenital hypothyroidism, suggesting that thyroid dysfunction during fetal and neonatal life affects body mass index during the first years of life (Livadas et al 2007).…”

Section: Discussionmentioning

confidence: 87%

Short- and long-term effects of maternal nicotine exposure during lactation on body adiposity, lipid profile, and thyroid function of rat offspring

Oliveira

Moura²,

Santos-Silva³

et al. 2009

Journal of Endocrinology

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Epidemiological studies show a higher prevalence of obesity in children from smoking mothers and smoking may affect human thyroid function. To evaluate the mechanism of smoking as an imprinting factor for these dysfunctions, we evaluated the programing effects of maternal nicotine (NIC) exposure during lactation. Two days after birth, osmotic minipumps were implanted in lactating rats, divided into: NIC (6 mg/kg per day s.c.) for 14 days; Control -saline. All the significant data were P!0 . 05 or less. Body weight was increased from 165 days old onwards in NIC offspring. Both during exposure (at 15 days old) and in adulthood (180 days old), NIC group showed higher total fat (27 and 33%). In addition, NIC offspring presented increased visceral fat and total body protein. Lipid profile was not changed in adulthood. Leptinemia was higher at 15 and 180 days old (36 and 113%), with no changes in food intake. Concerning the thyroid status, the 15-days-old NIC offspring showed lower serum-free tri-iodothyronine (FT 3 ) and thyroxine (FT 4 ) with higher TSH. The 180-days-old NIC offspring exhibited lower TSH, FT 3 , and FT 4 ). In both periods, liver type 1 deiodinase was lower (26 and 55%). We evidenced that NIC imprints a neonatal thyroid dysfunction and programs for a higher adiposity, hyperleptinemia, and secondary hypothyroidism in adulthood. Our study identifies lactation as a critical period to NIC programing for obesity, with hypothyroidism being a possible contributing factor.

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Section: Discussionmentioning

confidence: 87%

Short- and long-term effects of maternal nicotine exposure during lactation on body adiposity, lipid profile, and thyroid function of rat offspring

Oliveira

Moura²,

Santos-Silva³

et al. 2009

Journal of Endocrinology

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“…Body mass index and composition are generally normal in children and adult with CH (90,91,187), and comparable with that of the general population. However, earlier adiposity rebound (194)(195)(196) and increased risks of being overweight or obese have been reported in up to 37% of young adults with CH (47,71,114). Therefore, lifestyle interventions, including diet and physical exercise, should be encouraged to avoid metabolic abnormalities (1).…”

Section: Discussionmentioning

confidence: 99%

Congenital Hypothyroidism: A 2020–2021 Consensus Guidelines Update—An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology

Trotsenburg

Stoupa

Léger

et al. 2021

Thyroid

291

254

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Background: An ENDO-European Reference Network (ERN) initiative was launched that was endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology with 22 participants from the ENDO-ERN and the two societies. The aim was to update the practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). A systematic literature search was conducted to identify key articles on neonatal screening, diagnosis, and management of primary and central CH. The evidence-based guidelines were graded with the Grading of Recommendations, Assessment, Development and Evaluation system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Summary: The recommendations include the various neonatal screening approaches for CH as well as the etiology (also genetics), diagnostics, treatment, and prognosis of both primary and central CH. When CH is diagnosed, the expert panel recommends the immediate start of correctly dosed levothyroxine treatment and frequent follow-up including laboratory testing to keep thyroid hormone levels in their target ranges, timely assessment of the need to continue treatment, attention for neurodevelopment and neurosensory functions, and, if necessary, consulting other health professionals, and education of the child and family about CH. Harmonization of diagnostics, treatment, and follow-up will optimize patient outcomes. Lastly, all individuals with CH are entitled to a well-planned transition of care from pediatrics to adult medicine. Conclusions: This consensus guidelines update should be used to further optimize detection, diagnosis, treatment, and follow-up of children with all forms of CH in the light of the most recent evidence. It should be helpful in convincing health authorities of the benefits of neonatal screening for CH. Further epidemiological and experimental studies are needed to understand the increased incidence of this condition.

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“…Length and height increase within normal limits in patients with adequately treated CH ( 125 ). Patients may be overweight in early childhood and adulthood ( 46 , 126 ). Head circumference may be greater than normal, but this reflects bone rather than brain development ( 127 ).…”

Section: 0 Outcomes Of Treated Patientsmentioning

confidence: 99%

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Léger

Olivieri

Donaldson

et al. 2014

The Journal of Clinical Endocrinology &Amp; Metabolism

427

287

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Objective:The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH).Evidence:A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion.Consensus Process:Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement.Recommendations:The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy.

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Obesity and Attenuated Adiposity Rebound in Children with Congenital Hypothyroidism. Normalization of BMI Values in Adolescents

Cited by 14 publications

References 22 publications

Short- and long-term effects of maternal nicotine exposure during lactation on body adiposity, lipid profile, and thyroid function of rat offspring

Short- and long-term effects of maternal nicotine exposure during lactation on body adiposity, lipid profile, and thyroid function of rat offspring

Congenital Hypothyroidism: A 2020–2021 Consensus Guidelines Update—An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

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