Subclinical hypothyroidism in children: updates for pediatricians

Metwalley, Kotb Abbass; Farghaly, Hekma Saad

doi:10.6065/apem.2040242.121

Cited by 15 publications

(12 citation statements)

References 46 publications

(109 reference statements)

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“…In this study, a higher BMI z-score and lower gestational age were associated with higher serum T3 levels in our sample of 6-year-old children. With regard to childhood obesity, the positive relationship between BMI and T3 levels can be explained by an adaptation process to increase resting energy expenditure or elevated deiodinase activity ( 30 – 32 ). The relationship between prematurity and childhood thyroid function has previously been reported, showing trends towards decrease in free T4 and an increase in T3 and TSH levels ( 33 , 34 ), although the underlying mechanisms remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Relationship of iodine excess with thyroid function in 6-year-old children living in an iodine-replete area

Lee

Cho²,

Lim³

et al. 2023

Front. Endocrinol.

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BackgroundAdequate iodine intake is essential for growing children, as both deficient and excessive iodine status can result in thyroid dysfunction. We investigated the iodine status and its association with thyroid function in 6-year-old children from South Korea.MethodsA total of 439 children aged 6 (231 boys and 208 girls) were investigated from the Environment and Development of Children cohort study. The thyroid function test included free thyroxine (FT4), total triiodothyronine (T3), and thyroid-stimulating hormone (TSH). Urine iodine status was evaluated using urine iodine concentration (UIC) in morning spot urine and categorized into iodine deficient (< 100 μg/L), adequate (100–199 μg/L), more than adequate (200–299 μg/L), mild excessive (300–999 μg/L), and severe excessive (≥ 1000 μg/L) groups. The estimated 24-hour urinary iodine excretion (24h-UIE) was also calculated.ResultsThe median TSH level was 2.3 μIU/mL, with subclinical hypothyroidism detected in 4.3% of patients without sex differences. The median UIC was 606.2 μg/L, with higher levels in boys (684 μg/L vs. 545 μg/L, p = 0.021) than girls. Iodine status was categorized as deficient (n = 19, 4.3%), adequate (n = 42, 9.6%), more than adequate (n = 54, 12.3%), mild excessive (n = 170, 38.7%), or severe excessive (n = 154, 35.1%). After adjusting for age, sex, birth weight, gestational age, body mass index z-score, and family history, both the mild and severe excess groups showed lower FT4 (β = − 0.04, p = 0.032 for mild excess; β = − 0.04, p = 0.042 for severe excess) and T3 levels (β = − 8.12, p = 0.009 for mild excess; β = − 9.08, p = 0.004 for severe excess) compared to the adequate group. Log-transformed estimated 24h-UIE showed a positive association with log-transformed TSH levels (β = 0.04, p = 0.046).ConclusionExcess iodine was prevalent (73.8%) in 6-year-old Korean children. Excess iodine was associated with a decrease in FT4 or T3 levels and an increase in TSH levels. The longitudinal effects of iodine excess on later thyroid function and health outcomes require further investigation.

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Section: Discussionmentioning

confidence: 99%

Relationship of iodine excess with thyroid function in 6-year-old children living in an iodine-replete area

Lee

Cho²,

Lim³

et al. 2023

Front. Endocrinol.

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“…On the other hand, obesity and being overweight can explain ScH in 10 of our cases with migraine, where studies indicate that ScH seems to be a result rather than a cause of weight gain [ 51 ]. Another explanation is iron-deficiency anemia, which is one of the causes of ScH, and its prevalence among our patients was about 45% in both cases and controls without significant difference.…”

Section: Discussionmentioning

confidence: 99%

Potential Association between Subclinical Hypothyroidism and Childhood Migraine

et al. 2022

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Background and Objectives: Migraine is caused by genetic susceptibility that is triggered by environmental as well as biological factors, and it is also linked to many somatic comorbidities, including clinical and subclinical hypothyroidism. We aimed to estimate the potential association between subclinical hypothyroidism (ScH) and migraine in children at our tertiary hospital. Materials and Methods: Using a case–control strategy, 200 children and adolescents were assigned to two equal groups: a case group (patients with migraine) of 100 patients and a control group of 100 patients without migraine. Clinical and biochemical parameters (TSH, FT4) were compared between the groups using statistical analysis. Results: Thyroid function comparison between the groups showed higher TSH but normal FT4 among children with migraine headache compared to the control group, which means more frequent ScH cases among the migraine group relative to the control (17% vs. 2%, p < 0.001). Obesity and overweight were more frequent among patients with migraine than the control group (8 and 5% vs. 2 and 1%, respectively). The (overweight/obese) patients with migraine had about 77% ScH and 15.4% overt hypothyroidism compared to 8% ScH and no overt hypothyroidism among normal body weight migraine patients (p < 0.001). No significant difference in the prevalence of nodular goiter between patients with migraine and controls was found. Conclusions: Based on our results, subclinical hypothyroidism is significantly linked to childhood migraine. Obesity and being overweight are more frequent among patients with migraine. Therefore, it may be logical to test the thyroid function in migraineur children, especially those with high BMI. Further studies are recommended to discover the mechanism of this association in children.

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“…12 Subclinical hypothyroidism was defined as increased thyroid-stimulating hormone in the presence of normal free FT4 concentrations. 13…”

Section: Methodsmentioning

confidence: 99%

Evaluation of subclinical atherosclerosis and cardiac functions in children of mothers with gestational diabetes and maternal obesity

Avci

Tosun

2022

Cardiol Young

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Background and aims: We aimed to evaluate the effects of maternal obesity or gestational diabetes on body composition, lipid, and glucose metabolism, arterial morphology, and functions in children, and to investigate these effects in terms of cardiometabolic diseases. Methods: The study group was composed of 48 children who had a history of gestational diabetes or maternal obesity, and the control group was composed of 33 children. Echocardiographic assessments were performed. Socio-economic status and education level of mothers were obtained. Results: In the study group, carotid intima-media thickness, epicardial adipose tissue thickness, and arterial stiffness values were found to be significantly higher compared to the control group (p < 0.001, p < 0.001, p = 0.003, respectively), while arterial distensibility and arterial strain values were found to be significantly lower (p = 0.003, p = 0.008, respectively). Among the children who had similar body mass index in both groups, children in the study group had higher carotid intima-media thickness and epicardial adipose tissue thickness values. Arterial stiffness values were significantly reduced (p = 0.028) and arterial distensibility and strain values were significantly increased (p = 0.039, p = 0.033, respectively) in the children whose mothers had gestational diabetes and high socio-economic status. Left ventricular mass and left ventricular end-diastolic internal thickness were found to be significantly increased in the children who had obese and unemployed mothers (p = 0.04, p = 0.03, respectively). Conclusion: Low socio-economic status was found to be associated with increased maternal obesity and gestational diabetes. Poor socio-economic status, poor glycaemic control and being overweight during pregnancy indicate negative cardiometabolic outcomes for children in the long term.

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Subclinical hypothyroidism in children: updates for pediatricians

Cited by 15 publications

References 46 publications

Relationship of iodine excess with thyroid function in 6-year-old children living in an iodine-replete area

Relationship of iodine excess with thyroid function in 6-year-old children living in an iodine-replete area

Potential Association between Subclinical Hypothyroidism and Childhood Migraine

Evaluation of subclinical atherosclerosis and cardiac functions in children of mothers with gestational diabetes and maternal obesity

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