Subclinical hypothyroidism in children and adolescents as mild dysfunction of the thyroid gland: a single-center study

Szeliga, Kamila; Antosz, Aleksandra; Skrzynska, Karolina; Kalina-Faska, Barbara; Gawlik, Aneta

doi:10.5114/pedm.2023.124266

Cited by 3 publications

(4 citation statements)

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“…Our data also support the findings from other studies, that treatment with levothyroxine does not decrease weight in individuals with obesity and no thyroid disease ( 28 – 31 ). This could be partially explained by our findings, with higher FT4 levels predisposing weight gainMore complicated is the situation in individuals with obesity and concomitant Hashimoto thyroiditis.…”

Section: Discussionsupporting

confidence: 92%

Thyroid hormone levels and BMI-SDS changes in adolescents with obesity

Staníková,

Krajčovičová,

Lobotková

et al. 2023

Front. Endocrinol.

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BackgroundThyroid hormones play an important role in energy metabolism and weight control, explained mostly by inducing thermogenesis and increasing basal metabolic rate. It has recently been shown that FT4 levels are associated with food preferences, which might also play a role in modulating body weight. The aim of this longitudinal follow-up study was to analyze the relationship of thyroid hormones levels (FT4, TSH) at baseline with weight/BMI-SDS changes in children and adolescents with obesity.MethodsThree hundred seventy-seven children and adolescents have been enrolled to this study and followed up without a systematic intervention program for 5.59 ± 1.85months. Children and adolescents were divided into three subgroups: 1) 144 adolescents with obesity (15-19 years), 2) 213 children with obesity (10-14.9 years), and 3) 20 lean adolescents (15-19 years). Thyroid hormones were measured at the baseline, and anthropometry was performed at the baseline and during the follow-up. For further analyses, participants were divided according to the BMI-SDS change into two groups: 1. with BMI-SDS decrease, and 2. with BMI-SDS increase.ResultsAdolescents with obesity from the BMI-SDS decrease group had significantly lower baseline serum levels of TSH compared to the BMI-SDS increase group (2.4 ± 1.0 vs. 3.2 ± 2.0mIU/l; p=0.005). Similar difference was found for FT4 levels (14.7 ± 2.2 in the BMI-SDS decrease group vs. 15.5 ± 2.7pmol/l in the BMI-SDS increase group, p=0.048). Moreover, the BMI-SDS decrease was present in significantly higher percentage of adolescents with obesity with lower than median TSH level compared to those with higher than median TSH level at baseline (61.1% vs 38.6%, p=0.011). Likewise, the BMI-SDS decrease was present in significantly higher percentage of adolescent females with obesity and lower than median FT4 compared to those with higher than median FT4 level at baseline (70.6% vs. 23.5%, p<0.001). No associations of baseline thyroid hormones with the BMI-SDS change were observed in children with obesity or lean adolescents.ConclusionAdolescents with obesity and increased BMI-SDS during the follow-up had significantly higher baseline levels of both TSH and FT4 compared to BMI-SDS decrease group. These results support the previous findings that higher FT4 in individuals with obesity may influence weight gain.

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Section: Discussionsupporting

confidence: 92%

Thyroid hormone levels and BMI-SDS changes in adolescents with obesity

Staníková,

Krajčovičová,

Lobotková

et al. 2023

Front. Endocrinol.

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“…While its mild form is relatively benign (if not connected to Hashimoto’s thyroiditis) in the pediatric population, it has been shown that isolated elevation of TSH levels may be related to an increased risk of developing or progressing cardiovascular disease and non-alcoholic fatty liver disease (NAFLD) in children and adolescents suffering from obesity [ 109 ]. Furthermore, it has been also demonstrated that overweight and obesity in children carry a risk of progression from subclinical to overt hypothyroidism [ 110 ]. In spite of this, there is limited information regarding the treatment of thyroid disorders co-occurring with obesity in children [ 109 ].…”

Section: Non-metabolic Complications Of Obesity In Childrenmentioning

confidence: 99%

“…It is advisable to reassess thyroid function after losing weight [ 111 ] because previous reports indicate that weight loss might lead to the normalization of TSH levels [ 69 , 108 ]. Treatment of subclinical hypothyroidism with levothyroxine has not been proven to contribute to weight loss or normalization of lipid and thyroid parameters in children dealing with obesity [ 109 , 110 ]. Thus, if there are no clinical and laboratory indications of overt hypothyroidism, levothyroxine treatment is not required in such a group of patients [ 110 ].…”

Section: Non-metabolic Complications Of Obesity In Childrenmentioning

confidence: 99%

“…Treatment of subclinical hypothyroidism with levothyroxine has not been proven to contribute to weight loss or normalization of lipid and thyroid parameters in children dealing with obesity [ 109 , 110 ]. Thus, if there are no clinical and laboratory indications of overt hypothyroidism, levothyroxine treatment is not required in such a group of patients [ 110 ].…”

Section: Non-metabolic Complications Of Obesity In Childrenmentioning

confidence: 99%

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Not Only Metabolic Complications of Childhood Obesity

Ciężki,

Odyjewska,

Bossowski

et al. 2024

Nutrients

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The increasing incidence of obesity in the pediatric population requires attention to its serious complications. It turns out that in addition to typical, well-known metabolic complications, obesity as a systemic disease carries the risk of equally serious, although less obvious, non-metabolic complications, such as cardiovascular diseases, polycystic ovary syndrome, chronic kidney disease, asthma, thyroid dysfunction, immunologic and dermatologic conditions, and mental health problems. They can affect almost all systems of the young body and also leave their mark in adulthood. In addition, obesity also contributes to the exacerbation of existing childhood diseases. As a result, children suffering from obesity may have a reduced quality of life, both physically and mentally, and their life expectancy may be shortened. It also turns out that, in the case of obese pregnant girls, the complications of obesity may also affect their unborn children. Therefore, it is extremely important to take all necessary actions to prevent the growing epidemic of obesity in the pediatric population, as well as to treat existing complications of obesity and detect them at an early stage. In summary, physicians treating a child with a systemic disease such as obesity must adopt a holistic approach to treatment.

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Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years

Moreira Esteves,

Aldeia da Silva,

Oliveira Pereira

et al. 2025

Journal of Pediatric Endocrinology and Metabolism

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Objectives Subclinical hypothyroidism (SCH) is defined by elevated thyroid-stimulating hormone (TSH) levels (>5 mUI/L) and normal total and free thyroxine levels (fT4). There is ongoing debate over whether mild SCH should be treated. This study aims to assess the clinical course of normoponderal pediatric patients with SCH. Methods Retrospective study, involving normoponderal children and adolescents with SCH, followed at the Pediatrics Department of Hospital de Braga, from December 2007 to December 2022. Results We identified 47 children and adolescents with confirmed SCH. No sex predominance was found. The median age at diagnosis was 11 years. Most cases were idiopathic (59.6 %) and diagnosed during puberty (57.5 %). The majority (46.8 %) experienced spontaneous remission, while 38.3 % required levothyroxine (LT) therapy. Discharged patients were followed for a median of 25 months. No significant differences were seen in body mass index z-score, fT4 levels, heart rate, blood pressure, or lipid parameters. Significant differences were found in TSH levels and LT dosage. Thyroid peroxidase antibody (TPOAb) positivity was significantly correlated with SCH’s natural history. Although initial TSH levels were not significantly associated with SCH’s natural course, they predict treatment need. Individuals with initial TSH levels >6.47 mUI/L were more likely to require therapy. In the third year of follow-up, a significant strong negative correlation was found between TSH levels and high-density lipoprotein cholesterol. Conclusions SCH was self-limiting and benign in most cases. TPOAb positivity was a predictor of SCH’s natural history, and the need for treatment was predicted by initial TSH levels.

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Subclinical hypothyroidism in children and adolescents as mild dysfunction of the thyroid gland: a single-center study

Cited by 3 publications

References 38 publications

Thyroid hormone levels and BMI-SDS changes in adolescents with obesity

Thyroid hormone levels and BMI-SDS changes in adolescents with obesity

Not Only Metabolic Complications of Childhood Obesity

Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years

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