ESPE2022 Free Communications Thyroid (6 abstracts)
Children at cardio-metabolic risk raise their circulating concentrations of TSH and free T3
Gemma Carreras-Badosa 1 , Berta Mas-Parés 2 , Ariadna Gómez-Vilarrubla 3 , Elsa Puerto-Carranza 4 , Jose-María Martinez-Calcerrada 5 , Elena Riera-Pérez 6 , Francis de Zegher 7 , Lourdes Ibañez 8,9 , Judit Bassols 3 & Abel López-Bermejo 2,4,10
1Pediatric Endocrinology Group, Girona Institute for Biomedical Research (IDIBGI), Girona, Spain; 2Pediatric Endocrinology Group, Girona Institute for Biomedical Research (IDIBGI), Girona, Spain; 3Maternal-Fetal Metabolic Group, Girona Institute for Biomedical Research (IDIBGI), Girona, Spain; 4Pediatrics, Dr. JosepTrueta Hospital, Girona, Spain; 5Institute of Legal Medicine of Catalonia, Girona, Spain; 6Pediatrics, Salut Emporda Fundation, Figueres, Spain; 7Department of Development & Regeneration, University of Leuven, Leuven, Belgium; 8Sant Joan de DéuChildren’s Hospital Pediatric Institute, University of Barcelona, Barcelona, Spain; 9CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain; 10Department of Medical Sciences, University of Girona, Girona, Spain
Introduction: Thyroid hormones regulate body composition and metabolism, and are among the key drivers of body growth and maturation. In children, associations of cardio-metabolic measures with the circulating prohormone thyroxine (T4) have been extensively studied, but not with active triiodothyronine (T3). In apparently healthy children, we studied whether circulating free T3 (fT3) [and its ratio with free T4 (fT3/fT4)] associates with cardio-metabolic measures at age 8 ± 2 years (baseline), and with the same measures approximately 4 years later (follow-up)
Methods: At baseline, the study cohort consisted of 600 apparently healthy school-age children (49% girls) and, at follow-up, of 271 children (52% girls). Circulating concentrations of TSH, fT3, and fT4 were measured, and cardio-metabolic risk was assessed by calculating BMI and by measuring waist circumference, visceral fat (by ultrasound), blood pressure and circulating HDL-cholesterol and triglyceride levels, and by deriving the HOMA-IR index
Results: All children had TSH, fT3 and fT4 values within euthyroid range. Circulating fT3 – and also fT3/fT4 – associated positively with BMI, waist circumference, visceral fat, blood pressure, triglycerides and HOMA-IR index, not only at baseline but also at follow-up (all P˂0.05). Multivariate regression analysis, adjusting for sex and for baseline age and BMI, showed independent longitudinal associations between baseline fT3 and follow-up BMI, systolic blood pressure, pulse pressure, HOMA-IR and HDL-to-HOMA-IR ratio (adjusted R2 model from 0.216 to 0.484). Further analysis by tertile of baseline TSH showed that the longitudinal associations between baseline fT3 and follow-up BMI, systolic blood pressure, pulse pressure, HOMA-IR and HDL-to-HOMA-IR ratio were more robust in children with a TSH level in the upper tertile, who were also characterized as being heavier, and having higher fT3 and higher fT3/fT4 than the rest of the children
Conclusion: Apparently healthy children at higher cardio-metabolic risk were found to raise – still within normal range – their circulating TSH and free T3 concentrations, conceivably to accelerate their tempo of growth and maturation, in a homeostatic attempt to reduce such risk.
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