ESPE Abstracts

Introduction: Pediatric obesity (PO) is associated with hormonal dysfunctions contributing to an increased risk of cardiovascular disease and diabetes. Among these risks, thyroid disfunctions (TD) are the most common. The ethio-pathogenetic mechanisms underlying TD are not well known and include an adaptive response to a higher energy intake, hyperleptinemia, peripheral resistance to thyroid hormones, increased pro-inflammatory cytokines. Pediatric prevalence of TD in obesity is about 14%. In this study we correlated thyroid function with clinical and laboratory data of a group of obese Italian children living in the province of Salerno, Campania.

Materials and Methods: A retrospective study was conducted on 85 children (40M, 45F, age 5-16 years) with obesity (BMI z-score 2.59 ± 0.41) assessed at the pediatric endocrinology service of the Pediatric Unit - PO di Battipaglia - ASL Salerno from January 2016 to January 2020. All of them practiced: weight, height, BMI z score and blood pressure measurement; glucose, insulin (for calculating HOMA index), c-peptide, ALT, AST, gammaGT, total cholesterol, HDl, LDl, triglycerides, ESR, PCR blood dosages. They also followed the oral glucose tolerance test (OGTT). The correlation coefficient was calculated between TSH, FT3, FT4, antibodies antithyroperoxidase antibodies (AbTPO), antiantithyroglobulin antibodies (AbTG) and clinical/laboratory values identified.

Results: TSH significantly correlates with weight (r = 0.29495 P=0.02593) and BMI z-score (r = 0.28157 P=0.04760); ALT (r = 0.33858 P=0.00153), gamma GT (r = 0.32337 P=0.00286), HOMA index (r = 0.3268 P=0.00309) increase with TSH levels as well baseline (r = 0.38185 P=0.00037) and OGTT insulinemia (r = 0.67393 P=0.00420) after 120 minutes. C-peptide levels increments when FT4 (r = -0.41053 P=0.00415) and FT3 (r = -0.29266 P=0.04590) are decreased. Finally, there is a positive relationship between Ab TG and HbA1c (r = 0.30759 P=0.02506).

Conclusion: This study confirms the close relationship between TD and PO and demonstrates a possible role of TD also on hepatic metabolism and insulin secretion during OP. Autoantibodies can also be involved in glycemic homeostasis alterations but further studies are needed to confirm this hypothesis.