ESPE Abstracts

Introduction: Thyroid hormones (THs) play a crucial role in growth, brain development and function and metabolic homeostasis. The sensitivity to TH indices seems to be associated with metabolic syndrome (MS), prediabetes and diabetes in adults. We evaluated the sensitivity to TH indices in a pediatric population with neuromotor disability in relationship with the MS presence, using a multivariate analysis (MVA).

Patients and Methods: We enrolled 55 children (36M/19F, median age 9 years) with neuromotor impairment (69.1% cerebral damage, 30.9% neuromuscular diseases). Clinical parameters, thyroid function with sensitivity to TH indices and the presence of metabolic syndrome (SM) were recorded. Thirty healthy subjects were included as controls. MVA was performed.

Results: SM was detected in 54.5% of children with neuromotor disability. Differences in metabolic parameters and the sensitivity of TH indices are evident for subjects with disability and MS compared to controls and patients without metabolic derangement. A decreased level of the sensitivity to TH indices was detected in subjects with MS. A difference in metabolic and sensitivity of TH indices (Particularly thyrotroph T3 resistance index, TT3RI) were also noted in subjects with cerebral damage compared to neuromuscular diseases. At the multinomial logistic regression model, the probability to be in a condition of neuromotor impairment and metabolic derangement increases as the TSH-index values decrease.

Conclusions: our clinical findings first contribute the clinical evidence the assessment of TH resistance on the crossroads of several evolving areas as treatment of disability, of metabolic disorders and prevention from diabetes and cardiovascular diseases. The interpretation of thyroid function cannot be based on simple diagnostic rules or laboratory tests. The altered sensitivity to TH indices may not only present a different sensitivity to hormone but also reflect an increased set-point of homeostasis. The role of thyroid status on the integrity of neural processes and a therapeutic role of THs could be also considered.