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Exp Clin Endocrinol Diabetes 2014; 122(09): 548-552
DOI: 10.1055/s-0034-1377046
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Thyroid Function and Metabolic Risk Factors in Obese Youth. Changes during Follow-up: A Preventive Mechanism?

D. Bouglé
1   Service de Pédiatrie, CHU de Caen, France
,
R. Morello
2   Unité de biostatistique et recherche clinique, CHU de Caen, France
,
J. Brouard
1   Service de Pédiatrie, CHU de Caen, France
› Author Affiliations
Further Information

Publication History

received 11 December 2013
first decision 14 April 2014

accepted 21 May 2014

Publication Date:
20 August 2014 (online)

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Abstract

Objectives:  High TSH levels often observed in overweight subjects are associated with metabolic risk. Thyroid hormones which are involved in fat and carbohydrates metabolism are more rarely studied; their blood levels were measured to more precisely explain the relationships between thyroid function and obesity, in healthy overweight youth. This correlation was studied at baseline and during follow-up of some patients.

Materials/Methods:  Data collected were BMI and BMI z score, thyroid hormones (TSH, fT4, fT3), fasting blood glucose, HOMA-IR, lipids (triglycerides, HDL and LDL cholesterol), transaminase activity, fibrinogen, leptin, IGF-I; body composition (biphotonic absorptiometry). Data collected in a sample of the group after 6–18 months of medical intervention could also be studied.

Results:  At baseline, 13% of the 528 obese subjects (55% girls; 11.3±2.4 years, range 4.1-17.9; BMI z score: 5.4±2.4) had TSH>4mUI/l; fT3 levels were associated with age and transaminase activity; using multivariate regression analysis, with z-score and age as covariates, fT4 showed correlations with TSH, insulin, HOMA IR, blood lipids, and fibrinogen. No correlations were found with leptin, iodine excretion, IGF-I.

In 79 patients followed for 52±15 wk (45% girls; age range 8–18.3 years), univariate regression showed a positive correlation between changes in TSH and HOMA-IR, and between changes in fT4 and HDL. Multivariate regression analysis with z score as covariate showed that baseline TSH was associated with negative changes in HOMA-IR.

Conclusions:  Increased TSH may be predictive of a decrease in insulin resistance, it should be measured with thyroid hormones; fT4 was associated with a low metabolic risk. Changes in thyroid function could protect against the occurrence of obesity-associated metabolic diseases.

Key words

obesity - TSH - T4 - T3 - metabolic syndrome
 

  • References

  • 1 Michalaki MA, Vagenakis AG, Leonardou AS et al. Thyroid function in humans with morbid obesity. Thyroid 2006; 16: 73-78
    CrossrefPubMedGoogle Scholar
  • 2 de Moura Souza A, Sichieri R. Association between serum TSH concentration within the normal range and adiposity. Eur J Endocrinol 2011; 165: 11-15
    CrossrefPubMedGoogle Scholar
  • 3 Pearce EN. Thyroid hormone and obesity. Curr Opin Endocrinol Diabetes Obes 2012; 19: 408-413
    CrossrefPubMedGoogle Scholar
  • 4 Reinehr T. Thyroid function in the nutritionally obese child and adolescent. Curr Opin Pediatr 2011; 23: 415-420
    CrossrefPubMedGoogle Scholar
  • 5 Gertig AM, Niechcial E, Skowronska B. Thyroid axis alterations in childhood obesity. Pediatr Endocrinol Diabetes Metab 2012; 18: 116-119
    PubMedGoogle Scholar
  • 6 Baş VN, Aycan Z, Ağladıoğlu SY et al. Prevalence of hyperthyrotropinemia in obese children before and after weight loss. Eat Weight Disord 2013; 18: 87-90
    CrossrefPubMedGoogle Scholar
  • 7 Pacifico L, Anania C, Ferraro F et al. Thyroid function in childhood obesity and metabolic comorbidity. Clin Chim Acta 2012; 413: 396-405
    CrossrefPubMedGoogle Scholar
  • 8 Santos-Palacios S, Brugos-Larumbe A, Guillén-Grima F et al. A cross-sectional study of the association between circulating TSH level and lipid profile in a large Spanish population. Clin Endocrinol 2013; DOI: 10.1111/cen.12216.
    PubMedGoogle Scholar
  • 9 De Pergola G, Ciampolillo A, Paolotti S et al. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic para­meters and blood pressure in overweight and obese women. Clin Endocrinol 2007; 67: 265-259
    CrossrefPubMedGoogle Scholar
  • 10 Nader NS, Bahn RS, Johnson MD et al. Relationships between thyroid function and lipid status or insulin resistance in a pediatric population. Thyroid 2010; 20: 1333-1339
    CrossrefPubMedGoogle Scholar
  • 11 Muscogiuri G, Sorice GP, Mezza T et al. High-normal TSH values in obesity: Is it insulin resistance or adipose tissue’s guilt?. Obesity 2013; 21: 101-106
    CrossrefPubMedGoogle Scholar
  • 12 Maratou E, Hadjidakis DJ, Kollias A et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 2009; 160: 785-90
    CrossrefPubMedGoogle Scholar
  • 13 Aeberli I, Jung A, Murer SB et al. During rapid weight loss in obese children, reductions in TSH predict improvements in insulin sensitivity independent of changes in body weight or fat. J Clin Endocrinol Metab 2010; 95: 5412-5418
    CrossrefPubMedGoogle Scholar
  • 14 Pearce EN. Update in lipid alterations in subclinical hypothyroidism. J Clin Endocrinol Metab 2012; 97: 326-333
    CrossrefPubMedGoogle Scholar
  • 15 Wang C. The relationship between type 2 diabetes mellitus and related thyroid diseases. J Diab Res 2013; ID 390534
    PubMedGoogle Scholar
  • 16 Roelfsema F, Veldhuis JD. Thyrotropin secretion patterns in health and disease. Endocr Rev DOI: 10.1210/er.2012-1076.
    PubMedGoogle Scholar
  • 17 Amin A, Dhillo WS, Murphy KG. The central effects of thyroid hormones on appetite. J Thyroid Res 2010; ID306510
    PubMedGoogle Scholar
  • 18 Butte NF, Puyau MR, Vohra FA et al. Body size, body composition, and metabolic profile explain higher energy expenditure in overweight children. J Nutr 2007; 137: 2660-2667
    PubMedGoogle Scholar
  • 19 Nannipieri M, Cecchetti F, Anselmino M et al. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss. Int J Obes 2009; 33: 1001-1006
    CrossrefPubMedGoogle Scholar
  • 20 Bouglé D, Zunquin G, Sesbouë B et al. Relationships of cardiorespiratory fitness with metabolic risk factors, inflammation, and liver transaminases in overweight youth. Int J Pediatr 2010; ID 580897
    PubMedGoogle Scholar
  • 21 Rolland-Cachera MF, Cole TJ, Sempé M et al. Body Mass Index variations: Centiles from birth to 87 years. Eur J Clin Nutr 1991; 45: 13-21
    PubMedGoogle Scholar
  • 22 Kitahara CM, Platz EA, Ladenson PW et al. Body fatness and markers of thyroid function among U.S. men and women. PLoS One 2012; 7: e34979
    CrossrefPubMedGoogle Scholar
  • 23 Ortega FJ, Jílková ZM, Moreno-Navarrete JM et al. Type I iodothyronine 5'-deiodinase mRNA and activity is increased in adipose tissue of obese subjects. Int J Obes 2012; 36: 320-324
    CrossrefPubMedGoogle Scholar
  • 24 Dekelbab BH, Abou Ouf HA, Jain I. Prevalence of elevated thyroid-stimulating hormone levels in obese children and adolescents. Endocr Pract 2010; 16: 187-190
    CrossrefPubMedGoogle Scholar
  • 25 Bhowmick SK, Dasari G, Levens KL et al. The prevalence of elevated serum thyroid-stimulating hormone in childhood/adolescent obesity and of autoimmune thyroid diseases in a subgroup. J Natl Med Assoc 2007; 99: 773-776
    PubMedGoogle Scholar
  • 26 Soriguer F, Valdes S, Morcillo S et al. Thyroid hormone levels predict the change in body weight: a prospective study. Eur J Clin Invest 2011; 41: 1202-1209
    CrossrefPubMedGoogle Scholar
  • 27 Proces S, Delgrange E, Vander Borght TV et al. Minor alterations in thyroid-function tests associated with diabetes mellitus and obesity in outpatients without known thyroid illness. Acta Clin Belg 2001; 56: 86-90
    CrossrefPubMedGoogle Scholar
  • 28 Stichel H, l’Allemand D, Gruters A. Thyroid function and obesity in children and adolescents. Horm Res 2000; 54: 14-19
    CrossrefPubMedGoogle Scholar
  • 29 Daniels SR, Arnett DK, Eckel RH et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005; 111: 1999-2012
    CrossrefPubMedGoogle Scholar
  • 30 Andersen LB, Bugge A, Dencker M et al. The association between physical activity, physical fitness and development of metabolic disorders. Int J Pediatr Obes 2011; 6 (Suppl. 01) 29-34
    CrossrefPubMedGoogle Scholar
  • 31 Wolters B, Lass N, Reinehr T. TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children. Eur J Endocrinol 2013; 168: 323-329
    CrossrefPubMedGoogle Scholar
  • 32 Fox CS, Pencina MJ, D’Agostino RB et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med 2008; 168: 587-592
    CrossrefPubMedGoogle Scholar