Introduction: Due to the widespread occurrence of both obesity and hypothyroidism, physicians need to be especially attentive to the possible thyroid dysfunction in obese patients. The relationship between thyroid hormones and obesity in combination with insulin resistance in young people is not fully understood.
Materials and Methods: In order to study of thyroid status in young people with overweight and obesity in combination with insulin resistance 68 patients 16 ± 2,1 y.o. were examined. 32 - overweight - group 1 and 36 - obese - group 2, HOMA insulin resistance index above 2.77. Control group were 15 healthy adolescents. Ultrasonography of the thyroid gland, TSH, free thyroxine (fT4.), free triiodothyronine (fT3), thyroglobulin antibodies and AT-TPO were carried out. Statistic analysis was made using the program Statistika (ver 2009 for Windows), criteria Mann-Whitney, Wilkinson and χ².
Results and Discussion: On thyroid ultrasonography the enlargment of size and echogenicity change of thyroid tissue (p>0.05) were established. In the 1 group nonsignificant (p>0.05) increase of TSH were found. In 2 group the concentration of fT4 was significantly reduced and a TSH was significantly increased (P<0.05). The nonsignificant increase (p>0.05) of AT-TPO in patients who are overweight and a significant (P<0.05) in patients with obesity were established. This trend did not concern to thyroglobulin antibodies. Positive correlation between the concentration of TSH and BMI and insulin resistance index HOMA-IR was registered. It was also established correlative relationship between SH, leptin and adiponectin. Significantly lower concentrations of adiponectin are detected in patients of 2 group compared with the 1 group and the control group, respectively 6,1 ± 3,9mkg/ml, 8,9 ± 4,2mkg/ml and 17,1 ± 4,9 mg/ml (P <0.05). In 22.7% of young people with obesity and insulin resistance recorded a significant increase in thyroid stimulating hormone combined with relative reduction of free thyroxine, which is the sign of hypothyroidism.
Conclusion: Revealed thyroid insufficiency, combined with the stimulation of antibody production is probably one of the mechanisms of development and progression of not only obesity, but also insulin resistance in young people, dictating the need for its early detection and appropriate correction.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology