The prevalence of subclinical hypothyroidism in obese children and adolescents and its effects on metabolic parameters

Abstract

To compare cardiovascular risk factors in obese patients with or without Subclinical Hypothyroidism (SH), also to estimate the prevalence of SH in obese children and adolescents. Method: A total of 226 obese children and adolescents aged 6-18 years were included in the study. Two groups were created as euthyroid group (n=195) and SH group (n=31). After an 8-12 hour overnight fasting, serum blood glucose, insulin, HDL, LDL, cholesterol, triglyceride TSH, free T4, ALT, AST levels were measured. HOMA-IR and atherogenic index (AI) were calculated. Results: Prevalence of SH was estimated as 14.1 %. The values of fasting glucose, fasting insülin, ALT, AST, TSH, HOMA-IR levels were significantly higher ın SH group than euthyroid group. There was a positive correlation between TSH and fasting glucose, insülin, triglyceride, ALT, AST, HOMA-IR, AI. It was also demonstrated that the TSH level was significantly and independently related to HOMA-IR value ın multiple regression analysis (p=0.001). Conclusions: Obese patients with SH may be more susceptible to metabolic complications than euthyroid subjects.

The Frequency of Subclinical Hypothyroidism in Obese Children and Adolescents and Its Relationship with Metabolic Parameters and Atherogenic Index

“…In some studies, ALT elevation was higher in obese children with SH than in obese children without SH. 9 , 39 In our study, we found higher AST and ALT levels in obese patients with SH. We also found a positive correlation between ALT levels and TSH levels in obese people with SH.…”

“… 13 , 16 The prevalence of SH in Turkish obese children and adolescents was reported in the range of 9.2–36%. 8 , 9 , 17 The prevalence of SH is high in obese children, and the necessity of L-thyroxine therapy is still an important debate.…”

Predictive Markers of Metabolically Healthy Obesity in Children and Adolescents: Can AST/ALT Ratio Serve as A Simple and Reliable Diagnostic Indicator?

“…Because thyroid hormones are mainly responsible for maintaining energy homeostasis and regulating lipid and carbohydrate metabolism [30], TSH and fT4 levels have been investigated in obese children and adolescents in many studies. The frequency of elevated serum TSH levels in the presence of normal serum fT4 levels (subclinical hypothyroidism) has been reported to be 10 times higher in obese children than in healthy lean children (1.5-3% vs 10-23%) [31,32]. So, we compared thyroid function tests between metabolically healthy and unhealthy obese groups; the fT4 level was higher only in the MHO group according to the 2023 criteria, while it was similar according to the 2018 criteria.…”