ESPE Abstracts

Background: Obesity in childhood and adolescence represents a major public health problem of our century and the leading cause of premature cardiovascular disease (CVD). A moderate elevation of thyroid-stimulating hormone (TSH) concentrations is frequently observed in obese children.

Aim: The aim of our study was to evaluate the association of TSH and free thyroxine (FT4) concentrations with the clustering of cardiometabolic risk factors in obese euthyroid children and adolescents with Metabolic Syndrome (MS) compared with their counterparts without MS.

Methods: One thousand four hundred (n = 1400) obese children and adolescents attending our ‘Out-patient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescents’ were evaluated in order to determine those fulfilling the International Diabetes Federation (IDF) criteria for MS. The study was approved by the local Committee on the Ethics of Human Research. All participants underwent clinical examination and standard anthropometric measurements were obtained by a single trained observer. A fasting blood sample for baseline biochemical and endocrinologic investigations was obtained at 08: 00h, and was followed by an oral glucose tolerance test.

Results: Seventy eight(n = 78) children and adolescents [mean age ± SD: 13.1 ± 1.9years; 46 males (59.0%) and 32 females (41.0%); 13 prepubertal (16.7%), 65 pubertal (83.3%), BMI 35.6 ± 4.6, SBP(mmHg) 126.8 ± 12.2, DBP(mmHg) 75.2 ± 1.1] were identified as having MS compared with fifty four (n = 54) obese children and adolescents without MS [mean age ± SD: 12.0 ± 2.1years; 33 males (61.1%) and 21 females (38.9%); 16 prepubertal (29.6%), 38 pubertal (70.4%), BMI 32.3 ± 3.8, SBP(mmHg) 115.6 ± 9.8, DBP(mmHg) 68.1 ± 1.2]. In the MS group, the variables FT4 and waist circumference appeared to have a statistically significant negative correlation (r = -0.246, p-value=0.031) after adjustment for possible confounders. Similar negative correlation was found between FT4 and BMI (r = -0.225, p-value=0.048) whereas in non MS group, a negative correlation was found between FT4 and insulin (r = -0.393, p-value=0.004). Simultaneously, comparable correlations adapted to age, sex and BMI were performed in both populations between TSH, FT4 and cardiometabolic risk factors and repeatedly FT4 had a negative correlation with insulin (r = -0.176, p-value=0.048). No significant correlation was found between TSH and other cardiometabolic risk factors. These results were comparable for the two patient groups with or without MS, indicating that the prevalence of MS didn’t affect to a greater extent the variables.

Conclusions: Our findings demonstrate that lower FT4, even within the reference ranges, may be related to increased cardiometabolic risk factors in obese children and adolescents with or without MS.