Background: Several studies suggested that hypothyroidism, especially subclinical hypothyroidism (SH), is rather a consequence than one of the causes of excessive weight.
Objective and Hypotheses: We analyzed if there is a correlation between serum TSH, free thyroxine (FT4) and anthropometric measures in a group of overweight and obese children.
Method: The study included 92 children (46 girls and 46 boys), mean age: 11.79±3.40 years, evaluated for obesity in 20102013. The first evaluation included: anthropometric indexes (weight, height, BMI, waist circumference), complete clinical exam, biochemical tests (glucose and lipid metabolism, TSH, FT4, anti Tg and anti TPO antibodies in selected cases).
Results: Three age groups were formed: Ist: <10 years (n=32), IInd: 10.113 years (n=26), IIIrd: 13.118 years (n=34). Hypothyroidism was found in three children (3.26%), two girls and one boy, one from each group. Anti Tg and anti TPO auto-antibodies were found positive in two of these cases. 18.75% of children from the first group, 30.76% from the second and 35.29% from the third were with SH. So, 26 children (28.26%) had slightly high TSH levels (mean: 4.66±0.77 μU/ml) but with FT4 in normal range. Another five children had TSH level near the upper limit. We couldnt find a positive correlation (P>0.05) between BMI and serum TSH and FT4 levels. We observed, in the SH group, that children with severe obesity had lower TSH levels than one with mild obesity.
Conclusion: There is no general recommendation for treatment with (L-thyroxin) in obese children with SH. The standard evaluation for overweight and obese children should include thyroid function evaluation even if there are no clinical signs. Evaluation of TSH and FT4 levels should be also included in the follow-up protocol for these children.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology