Prevalence of Elevated Thyroid-Stimulating Hormone Levels in Obese Children and Adolescents

Dekelbab, Bassem; Ouf, Hanaa A. Abou; Jain, I.P.

doi:10.4158/ep09176.or

Cited by 36 publications

(38 citation statements)

References 22 publications

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“…A moderate elevation of TSH concentrations, which is associated with triiodothyronine (T 3 ) values in or slightly above the upper normal range, is frequently found in obese humans (1,2,3,4,5,6,7,8,9). These changes are reversible in weight loss independent of whether weight loss is obtained through diet or bariatric surgery (2,7,8,10,11,12).…”

Section: Introductionmentioning

confidence: 99%

TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children

Wolters

Lass

Reinehr

2013

European Journal of Endocrinology

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Objective: The impact of thyroid hormones on weight loss in lifestyle interventions and on weight regain afterwards is unknown. Therefore, we studied the relationships between TSH, free triiodothyronine (fT 3 ), free thyroxine (fT 4 ), and weight status, as well as their changes during and after a lifestyle intervention in obese children. Materials and methods: We evaluated the weight status as BMI-SDS in 477 obese children (mean age 10.6G2.7 years, 46% male, mean BMI 28.1G4.5 kg/m 2 ) participating in a 1-year lifestyle intervention in a 2-year longitudinal study. Changes in BMI-SDS at 1 and 2 years were correlated with TSH, fT 3 , and fT 4 concentrations at baseline and their changes during the intervention. Results: A decrease in BMI-SDS during the intervention period (K0.32G0.38; P!0.001) was significantly positively associated with baseline TSH and fT 3 in multiple linear regression analyses adjusted for age, sex, pubertal stage, and baseline BMI-SDS. An increase in BMI-SDS after the end of the intervention (C0.05G0.36; PZ0.011) was significantly related to the decreases in TSH and fT 3 during the intervention in multiple linear regression analyses adjusted for change in BMI-SDS during the intervention. In contrast to children with weight maintenance, children with weight regain after the end of the intervention demonstrated a decrease in their TSH levels (K0.1G1.6 vs C0.2G 1.6 mU/l; PZ0.03) and fT 3 (K0.2G1.1 vs C0.3G1.6 pg/ml; P!0.001) during the intervention. Conclusions: The decreases in TSH and fT 3 concentrations during the lifestyle intervention were associated with weight regain after the intervention. Future studies should confirm that the decreases in TSH and fT 3 levels associated with weight loss are related to the change in metabolism such as resting energy expenditure.

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Section: Introductionmentioning

confidence: 99%

TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children

Wolters

Lass

Reinehr

2013

European Journal of Endocrinology

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“…In children with obesity, TSH and thyroid hormone concentrations are shown to be high [Aypak et al 2013;Dekelbab et al 2010;Gertig et al 2012;Nyrnes et al 2006], which is accompanied by some abnormalities in this population, including weight gain, increased cholesterol levels, impaired growth velocity, anemia, sleepiness, weakness, and impaired psychomotor and cognitive development [Aijaz et al 2006;Wu et al 2006]. Although there are various studies evaluating the thyroid hormone and TSH levels in children with obesity and possible related complications [Chen et al 2013;Marras et al 2010;Marwaha et al 2013], the findings are inconsistent [Danese et al 2000;Knudsen et al 2005].…”

Section: Introductionmentioning

confidence: 99%

Thyroid hormonal status among children with obesity

Ghergherehchi

Hazhir

2015

Therapeutic Advances in Endocrinology

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Background: It is presumed that free T4 and thyroid-stimulating hormone (TSH) levels are related to obesity, but the findings are inconsistent. In this study we evaluated T4 and TSH concentrations between normal children and those with obesity and possible correlations between body mass index (BMI) and these markers. Methods: In this prospective study, 190 children who were overweight and obese and 133 children without obesity of the same age and sex were evaluated. Thyroid function tests (TSH, total T4, free T4 and free T3) were measured in all subjects in both groups. Thyroid antibodies (thyroid peroxidase and thyroglobulin) were determined among those with elevated TSH levels. Results: Levels of TSH and total T4 were significantly higher in children with obesity compared with the control group. Subclinical hypothyroidism was significantly higher in children with obesity (14.7%) compared with normal subjects (6.8%, p = 0.02). Among children with obesity and increased TSH levels, 10.7% had positive thyroid peroxidase and thyroglobulin antibodies. There was significantly positive correlation between BMI z score and TSH level (r = 0.198, p < 0.001) and T4 level (r = 0.18, p = 0.001). Conclusion: TSH and total T4 levels are increased in children who are overweight or obese and are a common finding in these children, but the incidence of thyroid antibodies is low in these patients and so could not be accounted for by thyroid autoimmunity. Due to these findings it is possible that increased TSH and total T4 levels are a consequence of obesity and could be reduced by decreasing BMI.

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“…Dekelbab et al, detected 3% autoimmune thyroiditis in their study with obese and non obese children with high TSH [5]; Grandone et al's study result was 7% in 938 obese children and adolescents [9]; in our study none of the children were positive for thyroid autoantibodies.…”

Section: Discussionmentioning

confidence: 45%

“…Despite the results of some studies, a direct relationship between elevated TSH levels and obesity, as well as lipid profile and weight changes in children has not been established yet [3][4][5][6][7][8].…”

Section: Thyroid Hormones and Bmi In Obese Children: One Year Follow mentioning

confidence: 99%

Thyroid hormones and BMI in obese children: One year follow up results

Ekinci¹,

Uzuner²,

Demet³

et al. 2015

MMJ

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Objectives: The aim of this study was to investigate the relationship between thyroid hormone levels and obesity, lipid levels and weight changes. Patients and Methods:Five to eleven year old normal weight, overweight and obese children underwent measurements of thyroid stimulating hormone (TSH), free thyroxine (fT4), lipid profile and autoimmune thyroid antibodies. Children with high TSH were reevaluated one year later without any intervention.Results: Three hundred children (126 obese, 74 overweight, 100 normal weight) were evaluated in the study. The rates of high TSH levels were 1.0% in normal weight, 9.5% in overweight and 11.9% in obese group (p=0.007). fT4 levels of all the children enrolled in the study were in normal range. None of the children had autoimmune antibody positivity. Obese children with high TSH had higher triglyceride levels than children with normal TSH (p=0.028). One year later, a significant decrease in body mass index (BMI) was accompanied by a significant decrease in TSH levels.Conclusion: TSH levels can be high in obese and overweight children. Obese and overweight children with elevated levels of TSH do not need to be treated pharmacologically, losing weight decreases TSH levels significantly.Keywords: TSH, BMI, Child, Obesity, Overweight, Thyroid ÖZET Amaç: Bu çalışmanın amacı tiroid hormon düzeyleri ile obezite, lipid düzeyleri ve ağırlık değişiklikleri arasındaki ilişkiyi araştırmaktır. Hastalar ve Yöntemler:Beş ve onbir yaş aralığında normal, fazla kilolu ve obez çocukların TSH, sT4, lipid profili ve otoimmün antikor değerlerine bakılmıştır. TSH düzeyi yüksek olan çocuklar herhangi bir müdahale yapılmadan bir yıl sonra yeniden değerlendirilmiştir.Bulgular: Çalışmada 300 çocuk (126 obez, 74 fazla kilolu, 100 normal kilolu) değerlendirilmiştir. Yüksek TSH düzeyi sıklığı normal kilolu grupta %1.0, fazla kilolu grupta %9.5 ve obez grupta %11.9'dur (p=0.007). Bütün gruplarda sT4 düzeyleri normal bulunmuştur. Çocukların hiçbirinde otoimmun antikorlar pozitif değildir. Yüksek TSH'lı çocuklar normal TSH'lı çocuklara göre daha yüksek trigliserid düzeylerine sahiptir (p=0.028). Bir yıl sonra yapılan değerlendirmede, VKİ'de anlamlı düşüşle birlikte TSH düzeyinde de anlamlı bir düşüş saptanmıştır.Sonuç: TSH düzeyleri obez ve fazla kilolu çocuklarda yüksek olabilir. TSH yüksekliği olan obez ve fazla kilolu çocukların farmakolojik olarak tedavi edilmesine gerek yoktur, kilo vermek TSH düzeylerinin anlamlı olarak azalmasını sağlar.

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Prevalence of Elevated Thyroid-Stimulating Hormone Levels in Obese Children and Adolescents

Cited by 36 publications

References 22 publications

TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children

TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children

Thyroid hormonal status among children with obesity

Thyroid hormones and BMI in obese children: One year follow up results

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