Objective To analyze the correlation between thyroid stimulating hormone (TSH) and overweight and obese children and adolescents, in order to provide reference for clinical intervention and treatment. Methods Children and adolescents aged 3-18 years who took health examination in the Second Affiliated Hospital of Wenzhou Medical University from April 2016 to April 2017 were selected into the study. Totally 385 children were enrolled, including 183 controls,116 overweight children and 83 obese children. Clinical data and thyroid functions of three groups were compared and analyzed. Results The levels of TSH, alanine aminotransferase(ALT), triglyceride(TG), cholesterol(TC),low density lipoprotein(LDL), uric acid(UA), fasting insulin(Fins), HOMA index (HOMA-β, HOMA-IR) gradually increased among control, overweight and obesity groups (P<0.05). Different degrees of thyroid dysfunction were found in 15.30% of the children with overweight and obesity. The obesity rate was significantly higher in high TSH group (P<0.01). With the increasing of TSH concentration, the incidences of ALT, GGT, TG showed gradually ascending trends respectively, while HDL decreased on the contrary. Multivariate Logistics regression analysis showed that TSH might not be an independent risk factor of overweight and obesity in children and adolescents. Conclusions In the children and adolescents with overweight or obesity, there were some metabolic abnormalities such as increasing level of liver enzymes, hyperlipidaemia, hyperuricemia. Meanwhile, obesity group tends to develop thyroid dysfunction, with higher level of TSH. Moreover, the increasing of TSH level might be an adaptive change after obesity.
Key words
overweight /
obesity /
children and adolescents /
thyroid stimulating hormone
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 王烁, 董彦会, 王政和, 等. 1985—2014年中国7~18岁学生超重与肥胖流行趋势[J]. 中华预防医学杂志, 2017,51(4):300-305.
[2] 中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[3] Hoermann R, Middley JEM, Larisch R. Homeostatic control of the thyroid-pituitary axis: perspectives for diagnosis and treatment[J]. Front Endocrinol (Lausanne),2015,6:177.
[4] Pacifico L, Anania C, Ferraro F, et al. Thyroid function in childhood obesity and metabolic comorbidity[J]. Clin Chim Acta,2012,413(3-4):396-405.
[5] 张海三, 张红星, 刘保平. 超重肥胖儿童血清甲状腺激素及瘦素水平研究[J].中国学校卫生,2014,35(7):1039-1041.
[6] Ghergherehchi RN. Thyroid hormonal status among children with obesity[J]. Ther Adv Endocrinol Metab,2015,6(2):51-55.
[7] Targher G, Montagnana M, Salvagno G, et al. Association between serum TSH, free T4 and serum liver enzyme activities in a large cohort of unselected outpatients[J].Clin Endocrinol (Oxf),2008,68(3):481-484.
[8] Pacifico L, Bonci E, Ferraro F, et al. Hepatic steatosis and thyroid function tests in overweight and obese children[J]. Int J Endocrinol,2013,2013:381014.
[9] Reinehr T, de Sousa G, Andler W. Hyperthyrotropinemia in obese children is reversible after weight loss and is not related to lipids[J]. J Clin Endocrinol Metab,2006,91(8):3088-3091.
[10] Shalitin S, Yackobovitch-Gavan M, Phillip M. Prevalence of thyroid dysfunction in obese children and adolescents before and after weight reduction and its relation to other metabolic parameters[J]. Horm Res,2009,71(3):155-161.
[11] Witte T, Ittermann T, Thamm M, et al. Association between serum thyroid-stimulating hormone levels and serum lipids in children and adolescents: a population-based study of german youth[J]. J Clin Endocrinol Metab,2015,100(5):2090-2097.
[12] Reinehr T. Obesity and thyroid function[J]. Mol Cell Endocrinol,2010,316(2):165-171.
[13] Pearce EN. Thyroid hormone and obesity[J]. Curr Opin Endocrinol Diabetes Obes,2012,19(5):408-413.
[14] Reinehr T, Isa A, de Sousa G, et al. Thyroid hormones and their relation to weight status[J]. Horm Res,2008,70(1):51-57.
PDF(554 KB)
