Background: Thyroid dysfunction is a common condition in children and has been associated with metabolic syndrome, hypertension, cardiovascular disease and mortality. Due to the obesity epidemic in paediatric population exists a higher prevalence of nonalcoholic fatty liver disease (NAFLD), a condition associated with insulin resistance and metabolic syndrome. In adults it has been observed that elevated TSH, even within the normal range, are positively correlated with increased biochemical markers of NAFLD. In pediatric population there is no evidence of this association.
Objective and hypotheses: To determine association between thyroid function and biochemical markers of NAFLD in paediatric population.
Method: 82 children 57% (female), 13.5 years old (6.118.9 year) were studied. Anthropometry, Sistolic and Diastolic blood pression, and TSH, fT4, AST, ALT, GGT, glucose and lipid profile were deternined. Variables were transformed to log10 prior Pearson correlation. To perform statistical analysis we used STATA SE 12.0 for windows.
Results: TSH and fT4 average was 3.16±2.06 uU/ml and 1.26±0.19. A positive association between ALT (r: 0.35; P<0.01) and GGT (r: 0.24; P<0.05) with TSH, but not with AST were seen. The relationship persists after adjusting for BMI. There were no associations between liver enzymes with fT4 levels. A positive association between triglycerides and TSH (r: 0.42; P<0.001) and a negative association between HDL and TSH (r: −0.33; P<0.001) were seen.
Conclusion: TSH elevated levels are associated with markers of NAFLD in the paediatric population. The relationship persists after adjusting for BMI, suggesting that the thyroid dysfunction could have a direct effect on liver parenchyma independent of nutritional stage. More studies are needed to assess the causality of this association and the effect of treatment of thyroid dysfunction in the development of liver disease.
Funding: This work was supported by Fondecyt 1130427 and 1150437, CORFO 13CTI-21526-P1, IMII P09/016-F(ICM) Chilean Grants.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology