Increasing thyroid-stimulating hormone is associated with impaired glucose metabolism in euthyroid obese children and adolescents
-
Nalini N.E. Radhakishun
,
Mariska van Vliet
Abstract
Background: Contrasting data exist regarding the relationship between thyroid-stimulating hormone (TSH) and obesity-related risk factors in children. In the present study, we investigated the association between TSH, free T4 (fT4) and cardiometabolic risk factors in euthyroid obese children and adolescents.
Methods: A retrospective analysis of patient records was performed on data from 703 multi-ethnic obese children and adolescents who visited an obesity-outpatient clinic. We performed anthropometric measurements, an oral glucose tolerance test, and measured serum TSH, fT4 and lipid levels.
Results: A positive association between TSH and the standard deviation score of the body mass index (BMI-Z) was found. After adjustment for ethnicity, sex, pubertal stage and BMI-Z, logistic regression analysis showed significant associations between TSH levels and impaired fasting glucose, impaired glucose tolerance, high total cholesterol, high low-density lipoprotein cholesterol and high triglycerides. No significant associations between fT4 levels and cardiometabolic risk factors were found in linear/logistic regression analysis.
Conclusion: In our multi-ethnic cohort of euthyroid obese children and adolescents increasing TSH was associated with impaired glucose metabolism and dyslipidemia.
References
1. Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatr Obesy 2006;1:26–32.Suche in Google Scholar
2. Reinehr T, Hinney A, de Sousa G, Austrup F, Hebebrand J, et al. Definable somatic disorders in overweight children and adolescents. J Pediatr 2007;150:618–22.e5.Suche in Google Scholar
3. Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine 2004;24:1–13.Suche in Google Scholar
4. Asvold BO, Vatten LJ, Nilsen TI, Bjoro T. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study. Eur J Endocrinol 2007;156:181–6.Suche in Google Scholar
5. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol (Oxf) 2005;62:487–91.Suche in Google Scholar
6. Grandone A, Santoro N, Coppola F, Calabro P, Perrone L, et al. Thyroid function derangement and childhood obesity: an Italian experience. BMC Endocr Disord 2010;10:8.Suche in Google Scholar
7. Reinehr T, de Sousa G, Andler W. Hyperthyrotropinemia in obese children is reversible after weight loss and is not related to lipids. J Clin Endocrinol Metab 2006;91:3088.Suche in Google Scholar
8. Stichel H, l’Allemand D, Gruters A. Thyroid function and obesity in children and adolescents. Horm Res 2000;54:14–9.Suche in Google Scholar
9. Aeberli I, Jung A, Murer SB, Wildhaber J, Wildhaber-Brooks J, 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;95:5412–8.Suche in Google Scholar
10. Tanner T. Growth at adolescence: with a general consideration of the effects of hereditary and envi- ronmental factors upon growth and maturation from birth to maturity, 2nd edition. Oxford: Blackwell Scientific, 1962.Suche in Google Scholar
11. Fredriks A, Van Buuren S, Wit J, Verloove-Vanhorick S. Body index measurements in 1996–7, compared with 1980. Arch Dis Child 2000;82:107–12.Suche in Google Scholar
12. Fredriks AM, van Buuren S, Fekkes M, Verloove-Vanhorick SP, Wit JM. Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? Eur J Pediatr 2005;164:216–22.Suche in Google Scholar
13. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–74.Suche in Google Scholar
14. Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, et al. Homeostasis model assessment: insulin resistance and B-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.Suche in Google Scholar
15. Center NC. NHLBI Growth and Health Study (NGHS) data monitoring report. Baltimore: Maryland Medical Research, 1998.Suche in Google Scholar
16. De Man SA, Andre JL, Bachmann H, Grobbee DE, Ibsen KK, et al. Blood pressure in childhood: pooled findings of six European studies. J Hypertens 1991;9:109–14.Suche in Google Scholar
17. Strauss RS, Barlow SE, Dietz WH. Prevelance of abnormal serum aminotransferase values in overweight and obese adolescents. J Pediatr 2000;136:727–33.Suche in Google Scholar
18. Sartorio A, Del Col A, Agosti F, Mazzilli G, Bellentani S, et al. Predictors of non-alcoholic fatty liver disease in obese children. Eur J Clin Nutr 2006;61:877–83.Suche in Google Scholar
19. Bastemir M, Akin F, Alkis E, Kaptanoglu B. Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss Med Wkly 2007;137: 431–4.Suche in Google Scholar
20. Mitrou P, Boutati E, Lambadiari V, Tsegka A, Raptis AE, et al. Insulin resistance in hyperthyroidism: the role of IL6 and TNF alpha. Eur J Endocrinol 2010;162:121–6.Suche in Google Scholar
21. Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 2009;160: 785–90.Suche in Google Scholar
22. Kosovskii M, Katkova S, Mirakhmedov M, Rakhimdzhanov R. Insulin resistance in experimental hypo-and hyperthyroidism. Probl Endokrinol 1989;35:50–4.Suche in Google Scholar
23. Cettour-Rose P, Theander-Carrillo C, Asensio C, Klein M, Visser T, et al. Hypothyroidism in rats decreases peripheral glucose utilisation, a defect partially corrected by central leptin infusion. Diabetologia 2005;48:624–33.Suche in Google Scholar
24. Tuzcu A, Bahceci M, Gokalp D, Tuzun Y, Gunes K. Subclinical hypothyroidism may be associated with elevated high-sensitive c-reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocr J 2005;52:89–94.Suche in Google Scholar
25. Targher G, Montagnana M, Salvagno G, Moghetti P, Zoppini G, et al. Association between serum TSH, free T4 and serum liver enzyme activities in a large cohort of unselected outpatients. Clin Endocrinol 2008;68:481–4.Suche in Google Scholar
26. Shalitin S, Yackobovitch-Gavan M, Phillip M. Prevalence of thyroid dysfunction in obese children and adolescents before and after weight reduction and its relation to other metabolic parameters. Horm Res 2009;71:155–61.Suche in Google Scholar
27. Elgadi A, Zemack H, Marcus C, Norgren S. Tissue-specific knockout of TSHr in white adipose tissue increases adipocyte size and decreases TSH-induced lipolysis. Biochem Biophys Res Commun 2010;393:526–30.Suche in Google Scholar
28. Haraguchi K, Shimura H, Ikeda M, Endo T, Onaya T. Effects of cytokines on expression of thyrotropin receptor mRNA in rat preadipocytes. Thyroid 1998;8:687–92.Suche in Google Scholar
29. Bell A, Gagnon A, Grunder L, Parikh SJ, Smith TJ, et al. Functional TSH receptor in human abdominal preadipocytes and orbital fibroblasts. Am J Physiol-Cell Physiol 2000;279:C335–C40.Suche in Google Scholar
30. Lu S, Guan Q, Liu Y, Wang H, Xu W, et al. Role of extrathyroidal TSHR expression in adipocyte differentiation and its association with obesity. Lipids Health Dis 2012;11:17.Suche in Google Scholar
31. Santi A, Duarte MM, de Menezes CC, Loro VL. Association of lipids with oxidative stress biomarkers in subclinical hypothyroidism. Int J Endocrinol 2012;2012.Suche in Google Scholar
32. Leonibus C, Giannini C, Corazzini V, Chiarelli F, Mohn A. Thyroid dysfunction in obese pre-pubertal children: Oxidative stress as a potential pathogenetic mechanism. Free Rad Res 2012;46:303–9.Suche in Google Scholar
33. Reilly J, Kelly J, Wilson D. Accuracy of simple clinical and epidemiological definitions of childhood obesity: systematic review and evidence appraisal. Obes Rev 2010;11: 645–55.Suche in Google Scholar
34. Pacifico L, Nobili V, Anania C, Verdecchia P, Chiesa C. Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk. World J Gastroenterol 2011;17: 3082.Suche in Google Scholar
35. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, et al. Prevalence of fatty liver in children and adolescents. Pediatrics 2006;118:1388–93.Suche in Google Scholar
36. Liangpunsakul S, Chalasani N. Is hypothyroidism a risk factor for non-alcoholic steatohepatitis? J Clin Gastroenterol 2003;37:340.Suche in Google Scholar
37. Andersen S, Pederson KM, Bruun NH, Lauberg P. Narrow individual variations in serum T4 and T3 in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab 2002;87:1068–72.Suche in Google Scholar
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- Meetings
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Artikel in diesem Heft
- Masthead
- Masthead
- Editorial
- Success has many fathers, failure is orphan
- Review Article
- Normosmic idiopathic hypogonadotropic hypogonadism: update on the genetic background and future challenges
- Original Articles
- Temporary brittle bone disease: association with intracranial bleeding
- Asymmetric dimethylarginine (ADMA) and L-arginine levels in children with glycogen storage disease type I
- Application of liquid chromatography-tandem mass spectrometry in the diagnosis and follow-up of maple syrup urine disease in a Chinese population
- The role of uncoupling protein 2 and 3 genes polymorphism and energy expenditure in obese Indonesian children
- Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome1)
- Frequency of the E23K polymorphism of the KCNJ11 gene in children born small for gestational age and its influence on auxological and metabolic parameters in the prepubertal period
- Reference intervals for serum thyroid hormones in preterm hospitalized infants1)
- The clinical and biochemical presentation of vitamin D deficiency and insufficiency in children and adolescents
- A risk score for identifying overweight adolescents with dysglycemia in primary care settings1)
- Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population
- Propionic acidaemia: demographic characteristics and complicationsa
- Negative correlation between serum IL-6 level and cardiorespiratory fitness in 10- to 11-year-old boys with increased BMI
- Penile length and genital anomalies in Egyptian male newborns: epidemiology and influence of endocrine disruptors
- Efficacy of vitamin D loading doses on serum 25-hydroxy vitamin D levels in school going adolescents: an open label non-randomized prospective trial
- Characteristics of infants admitted with hypoglycemia to a neonatal unit
- Increasing thyroid-stimulating hormone is associated with impaired glucose metabolism in euthyroid obese children and adolescents
- The role of FTO genotype on eating behavior in obese Sardinian children and adolescents
- Prevalence of multiple forms of autoimmunity in Egyptian patients with Turner syndrome: relation to karyotype
- A novel DAX-1 mutation presented with precocious puberty and hypogonadotropic hypogonadism in different members of a large pedigree
- Patient Reports
- Pseudohypoparathyroidism type Ia: a novel GNAS mutation in a Brazilian boy presenting with an early primary hypothyroidism
- Diabetic ketoacidosis with cerebral hemorrhage and alpha coma in an adolescent female
- A novel mutation in thyrotropin (thyroid-stimulating hormone) gene in congenital hypothyroidism
- Citric acid as the last therapeutic approach in an acute life-threatening metabolic decompensation of propionic acidaemia
- A case of autosomal dominant osteopetrosis type II with a novel TCIRG1 gene mutation
- The interpretation of color – an endocrine cause of skin discoloration mimicking cyanosis
- Novel heterozygous thyrotropin receptor mutation presenting with neonatal hyperthyrotropinaemia, mild thyroid hypoplasia and absent uptake on radioisotope scan
- Turner Syndrome and apparent absent uterus: a case report and review of the literature
- 10.1515/jpem-2012-0133
- Vaginal bleeding in a 4-month-old preterm girl: extreme minipuberty mimicking central precocious puberty
- A rare case of isolated Cushing syndrome in a 3-month-old boy
- Letters to the Editors
- Gynecomastia in puberty is usually asymptomatic and regresses spontaneously
- Is endometriosis ultimately the end result of the interplay between interferon-γ (IFN-γ) and the HOXA10 gene network?
- Does treatment with L-selenomethionine reduce thyroid volume in euthyroid children with autoimmune thyroiditis?
- Meetings
- Meetings Calendar
