Abstract
Background
Obesity is a worldwide epidemic. In recent years, increasing attention has been focused on thyroid function in obesity.
Objectives
To establish the prevalence of elevated thyroid-stimulating hormone (TSH) levels in obese children and adolescents, and identify the relationship between TSH levels and other metabolic and hormonal variables before and after weight reduction.
Materials and methods
We evaluated 150 obese subjects (aged 3–17 years) for anthropometric, biochemical, metabolic and hormonal variables. Measurements were taken at baseline and, in a subgroup of children with hyperthyrotropinemia, after a 6-month intervention program based on exercise, behavior therapy, and nutrition education.
Results
At baseline, 23 participants (15.3 %) had hyperthyrotropinemia, and 21 of these patients completed the weight reduction intervention. Among these 21 patients, 14 had substantial weight loss and a significant decrease in TSH and free T3 levels.
Conclusion
We conclude that TSH and T3 levels are significantly increased in childhood obesity; in most cases, however, these increases cannot be elucidated by thyroid autoimmunity or iodine deficiency. If thyroid disorders are excluded beforehand, an elevated TSH with normal thyroid hormone levels in obese children seems rather a consequence than a cause of obesity since weight loss leads to a normalization of elevated TSH levels. In this context, thyroid hormone alterations in obesity suggest an adaptation process.
References
Lifshitz F (2008) Obesity in children. J Clin Res Pediatr Endocrinol 1:53–60
Sokol RJ (2000) The chronic disease of childhood obesity: the sleeping giant has awakened. J Pediatr 136:711–713
Ogden CL, Flegal KM, Carroll MD et al (2002) Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 288:1728–1732
Ebbeling CB, Pawlak DB, Ludwig DS (2002) Childhood obesity: public-health crisis, common sense cure. Lancet 360:473–482
Reinehr T (2010) Obesity and thyroid function. Mol Cell Endocrinol 316:165–171
Reinehr T, de Sousa S, Andler W (2006) Hyperthyrotropinemia In obese children is reversible after weight loss and is not related to lipids. J Clin Endocrinol Metab 91:3088–3091
Reinher T, Andler W (2002) Thyroid hormones before and after weight loss in obesity. Arch Dis Child 87:320–323
Shalitin S, Yackobovitch-Gavan M, Philip M (2009) Prevalence of thyroid dysfunction in obese children and adolescents before and after weight reduction and its relation to other metabolic parameters. Horm Res 71:155–161
Grandone A, Santoro N, Coppola F et al (2010) Thyroid function derangement and childhood obesity: an Italian experience. BMC Endocr Disord 10:1–8
Matthews DR, Hosker JP, Rudenski AS et al (1985) Homeostasis model assessment: insulin resistance and _beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419
Aycan Z, Berberoğlu M, Ocal G et al (2005) Relationship between plasma leptin, insulin and tumor necrosis factor alpha in obese children. J Pediatr Endocrinol Metab 18:275–284
Winter WE, Signorio MR (2001) Review: molecular thyroidology. Ann Clin Lab Sci 31:221–244
Sari R, Balci MK, Altunbas H et al (2003) The effect of body weight and weight loss on thyroid volume and function in obese women. Clin Endocrinol 59:258–262
Kok P, Roelfsema F, Langendonk JG et al (2005) High circulating thyrotropin levels in obese women are reduced after body weight loss induced by caloric restriction. J Clin Endocrinol Metab 90:4659–4663
Radetti G, Kleon W, Buzi F et al (2008) Thyroid function and structure are affected in childhood obesity. J Clin Endocrinol Metab 93:4749–4754
Rotondi M, Cappelli C, Leporati P et al (2010) A hypoechoic pattern of the thyroid at ultrasound does not indicate autoimmune thyroid diseases in patients with morbid obesity. Eur J Endocrinol 163:105–109
Rotondi M, Magri F, Chiovato L (2011) Thyroid and obesity: not a one-way interaction. J Clin Endocrinol Metab 96:344–346
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The authors declare that they have no conflict of interest.
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Baş, V.N., Aycan, Z., Ağladıoğlu, S.Y. et al. Prevalence of hyperthyrotropinemia in obese children before and after weight loss. Eat Weight Disord 18, 87–90 (2013). https://doi.org/10.1007/s40519-013-0008-0
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DOI: https://doi.org/10.1007/s40519-013-0008-0