Thyroid Function and Thyroid Autoimmunity in Relation to Weight Status and Cardiovascular Risk Factors in Children and Adolescents: A Population-Based Study

Abstract

Objective: In obese subjects, slight increases have been observed in thyrotropin [thyroid-stimulating hormone (TSH)] levels, but data in children are scarce. The aim of this study was to evaluate whether thyroid function and autoimmunity vary with weight status in a healthy population of children and adolescents and to determine whether hyperthyrotropinemia is associated with any cardiovascular risk factor.Methods: This cross-sectional epidemiological study was conducted in Almería (Spain) on a representative sample of 1317 healthy subjects aged 2-16 years. Thyroid function, thyroid autoimmunity and cardiovascular risk factors were measured. Chi-square test, analysis of variance and multiple linear regression were used in the statistical analyses.Results: The obese children and adolescents had thyrotropin levels (mean ± standard deviation) of 3.12±2.44 mU/L. These levels were higher than those of overweight subjects (2.79±1.51 mU/L) and of normal weight subjects (2.73±1.30 mU/L) (p=0.02). Levels of free thyroxine and urinary iodine did not differ significantly between the groups. The prevalence (95% confidence interval) of thyroid autoimmunity was lower in the individuals with normal weight (2.9%; 2.0-4.2) than in the overweight (6.3%; 3.9-9.9) and obese subjects (5.6%, 2.5-11.3) (p=0.02). TSH levels were associated with obesity (β=0.36; p<0.001) and thyroid autoimmunity (β=1.10; p<0.001). They were not associated with any cardiovascular risk factor.Conclusion: Obese children and adolescents had higher levels of thyrotropin than those who were overweight and of normal weight. The differences among the groups were of very little clinical significance and could possibly be linked to the higher prevalence of thyroid autoimmunity in obese subjects. The hyperthyrotropinemia in these subjects was not associated with any cardiovascular risk factor.

Mild subclinical hypothyroidism is associated with paediatric dyslipidaemia

“…While TSH in children has been found to be positively correlated with total cholesterol and non‐HDL cholesterol levels in some studies, others have not found any such relationship . The studies that have examined the relationship between mild SCH defined as TSH between 5 and 10 mIU/L and lipids in children have included only a small number of subjects .…”

Childhood thyroid autoimmunity and relation to islet autoantibodies in children at risk for type 1 diabetes in the diabetes prediction in skåne (DiPiS) study

“…When studying thyroid autoimmunity in children from the general population, frequencies vary between 0.4 and 3.7% in 8.8-12-year-old children, depending on population and which autoantibody that was tested [28][29][30]. In a study screening for thyroid autoimmunity and coeliac disease in 12-year-old Swedish children, 2.8% were tested positive for TPOAb in the healthy control group [30].…”

Sex Differences in the Associations of Obesity With Hypothyroidism and Thyroid Autoimmunity Among Chinese Adults

“…The influence of obesity on thyroid dysfunction, such as hypothyroidism has been studied in several epidemiological studies in Western countries (Rimm et al, 1975 ; Asvold et al, 2009 ; Gopinath et al, 2010 ; Marzullo et al, 2010 ; Ittermann et al, 2013 ; Garcia-Garcia et al, 2016 ). Some studies found that obesity could increase risk of hypothyroidism (Rimm et al, 1975 ; Asvold et al, 2009 ; Gopinath et al, 2010 ; Marzullo et al, 2010 ).…”