Obesity-related thyroiditis in childhood: relationship with insulin resistance
-
Fatma Dursun
,
Tülay Atasoy Öztürk
Abstract
Background
Thyroid dysfunction is the most common hormonal abnormality in obesity. It should actually be considered as an adaptation response to fat excess. However, little has been reported on the morphology of the thyroid gland, and no data regarding the relationship between thyroid gland changes and metabolic parameters are available in obese adolescents.
Objective
The study aimed to evaluate the frequency of non-autoimmune thyroiditis in obese adolescents and compare the metabolic status of patients with or without thyroiditis.
Methods
A total of 218 obese children and 49 age-matched control healthy children were included. Thyroid ultrasonography (USG) was performed in all participants, as well as thyroid hormone levels, thyroid antibodies (Abs), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR) and high-sensitivity C-reactive protein (HsCRP) were determined. Obese children were divided into three groups according to the presence of thyroid autoantibodies and USG findings of thyroiditis (Group-1: Abs [−], normal thyroid morphology/Group-2: Abs [+], abnormal thyroid morphology/Group-3: Abs [−], abnormal thyroid morphology). The relationship between body mass index, metabolic parameters and thyroid gland status was analyzed.
Results
Seventy-two of 218 obese patients (33%) had non-autoimmune thyroiditis (Group-3). The rate of insulin resistance was significantly higher in Group-3 than in Group-1 (p = 0.024). Similarly, the frequency of metabolic syndrome (MS) was higher in Group-3 (44.3%) than in Group-1 (27.1%) (p = 0.014).
Conclusions
Obese adolescents with non-autoimmune thyroiditis had a higher incidence of insulin resistance. This finding supported the hypothesis that insulin resistance may have an effect on thyroid morphology. Further randomized trials investigating this relationship are required.
Author contributions: Concept: FD, TAÖ, HK, GSK; Design: FD, HK, GSK, TAÖ; Data collection or processing: FD, TAÖ, GSK, HK; Analysis or interpretation: FD, GSK, HK, TAÖ; Literature search: FD, TAÖ, GSK, HK; Writing: FD, HK, TAÖ. The first author is FD. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Witkowska-Sedek E, Kucharska A, Ruminska M, Pyrzak B. Thyroid dysfunction in obese and overweight children. Endokrynol Pol. DOI:10.5603/EP.0007.Search in Google Scholar PubMed
2. 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;91:3088–91.10.1210/jc.2006-0095Search in Google Scholar PubMed
3. Tagliaferri M, Berselli ME, Calo G, Minocci A, Savia G, et al. Subclinical hypothyroidism in obese patients: relation to resting energy expenditure, serum leptin, body composition, and lipid profile. Obes Res 2001;9:196–201.10.1038/oby.2001.21Search in Google Scholar PubMed
4. Naslund E, Andersson I, Degerblad M, Kogner P, Kral JG, et al. Associations of leptin, insulin resistance and thyroid function with long-term weight loss in dieting obese men. J Intern Med 2000;248:299–308.10.1046/j.1365-2796.2000.00737.xSearch in Google Scholar PubMed
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;62:487–91.10.1111/j.1365-2265.2005.02247.xSearch in Google Scholar PubMed
6. Özer S, Bütün İ, Sönmezgöz E, Yılmaz R, Demir O. Relationships among thyroid hormones and obesity severity, metabolic syndrome and its components in Turkish children with obesity. Nutr Hosp 2015;32:645–51.10.5222/j.child.2015.010Search in Google Scholar PubMed
7. Radetti G, Kleon W, Buzi F, Crivellaro C, Pappalardo L, et al. Thyroid function and structure are affected in childhood obesity. J Clin Endocrinol Metab 2008;9:4749–54.10.1210/jc.2008-0823Search in Google Scholar PubMed
8. Longhi S, Radetti G. Thyroid function and obesity. J Clin Res Pediat Endocrinol 2013;5:40–4.Search in Google Scholar
9. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1–452.Search in Google Scholar PubMed
10. Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, et al. Reference values for weight, height, head circumference and body mass index in Turkish children. J Clin Res Pediat Endocrinol 2015;7:280–93.10.4274/jcrpe.2183Search in Google Scholar PubMed PubMed Central
11. Tanner JM, Whitehouse RH, Takaishi M. Standarts from birth to maturity for height, weight, height velocity and weight velocity: British children. Arch Dis Child 1966;41:613–35.10.1136/adc.41.220.613Search in Google Scholar PubMed PubMed Central
12. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF. Homeostasis model assessment: insulin resistance and β cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Search in Google Scholar PubMed
13. Kurtoğlu S, Hatipoğlu N, Mazıcıoğlu M, Kendirci M, Keskin M, et al. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J Clin Res Pediat Endocrinol 2010;2:100–6.10.4274/jcrpe.v2i3.100Search in Google Scholar
14. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, et al. IDF Consensus Group. The metabolic syndrome in children and adolescents – an IDF consensus report. Pediat Diabet 2007;8:299–306.10.1111/j.1399-5448.2007.00271.xSearch in Google Scholar
15. Scatarige JC, Scott WW, Donovan PJ, Siegelman SS, Sanders RC. Fatty infiltration of the liver: ultrasonographic and computed tomographic correlation. J Ultrasound Med 1984;3:9–14.10.7863/jum.1984.3.1.9Search in Google Scholar PubMed
16. de Vries L, Bulvik S, Phillip M. Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child 2009;94:33–7.10.1136/adc.2007.134841Search in Google Scholar PubMed
17. Rallison ML, Dobyns BM, Keating FR, Rall JE, Tyler FH. Occurrence and natural history of chronic lymphocytic thyroiditis in childhood. J Pediat 1975;86:675–82.10.1016/S0022-3476(75)80350-7Search in Google Scholar
18. Radetti G. Clinical aspects of Hashimoto’s thyroiditis. Endocr Dev 2014;26:158–70.10.1159/000363162Search in Google Scholar PubMed
19. Szczyrski J, Kosiak W, Korpal-Szczyrska M, Mysliwiec M. Ultrasound image of the thyroid gland in obese children. J Ultrasonogr 2015;15:423–8.10.15557/JoU.2015.0039Search in Google Scholar PubMed PubMed Central
20. Chrousos GP. The hypothalamic-pituitary-adrenal axis and immunomediated inflammation. N Engl J Med 1995;332:1351–62.10.1056/NEJM199505183322008Search in Google Scholar PubMed
21. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004;89:2548–56.10.1210/jc.2004-0395Search in Google Scholar PubMed
22. Fruhbeck G, Gomez-Ambrosi J, Muruzabal FJ, Burrel MA. The adipocyte: a model for integration of endocrine and metabolic signaling in energy metabolism regulation. Am J Physiol Endocrinol Metab 2001;280:827–47.10.1152/ajpendo.2001.280.6.E827Search in Google Scholar PubMed
23. Al-Tahami BA, Bee YT, Ismail AA, Rasool AH. Impaired microvascular endothelial function in relatively young obese humans is associated with altered metabolic and inflammatory markers. Clin Hemorheol Microcirc 2011;47: 87–97.10.3233/CH-2010-1370Search in Google Scholar PubMed
24. Sanip Z, Ariffin FD, Al-Tahami BA, Sulaiman WA, Rasool AH. Obesity indices and metabolic markers are related to hs-CRP and adiponectin levels in overweight and obese females. Obes Res Clin Pract 2013;7:315–20.10.1016/j.orcp.2012.05.002Search in Google Scholar PubMed
25. Chen H, Zhang H, Tang W, Xi Q, Liu X, et al. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population. J Pediat Endocr Met 2013;26:489–96.10.1515/jpem-2012-0299Search in Google Scholar PubMed
©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Reviews
- Using height-corrected definition of metabolic syndrome in children and adolescents
- Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis
- Original Articles
- Carbonated beverage consumption is associated with lower C-peptide in adolescents
- Low levels of cardiorespiratory fitness and abdominal resistance are associated with metabolic risk in schoolchildren
- Effect of metformin on clinical and biochemical hyperandrogenism in adolescent girls with type 1 diabetes
- Obesity-related thyroiditis in childhood: relationship with insulin resistance
- An isolated Xp deletion is linked to autoimmune diseases in Turner syndrome
- Non-invasive assessment of aortic stiffness and blood pressure in young Turner syndrome patients
- High frequency of non-classical congenital adrenal hyperplasia form among children with persistently elevated levels of 17-hydroxyprogesterone after newborn screening
- The “combined team” transition clinic model in endocrinology results in high adherence rates and patient satisfaction
- Utilizing health information technology to improve the recognition and management of life-threatening adrenal crisis in the pediatric emergency department: medical alert identification in the 21st century
- Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia: 6 years of follow-up
- Letter to the Editor
- Growth failure in infancy and early adiposity rebound
- Short Communication
- Clinical utility of stimulation tests in infants with suspected adrenal insufficiency (AI)
- Case Reports
- Two siblings with Gaucher type 3c: different clinical presentations
- Acquired partial lipodystrophy with metabolic disease in children following hematopoietic stem cell transplantation: a report of two cases and a review of the literature
- Therapeutic challenges in a patient with the simple virilizing (SV) form of congenital adrenal hyperplasia (CAH) due to the P30L/I172N genotype
Articles in the same Issue
- Frontmatter
- Reviews
- Using height-corrected definition of metabolic syndrome in children and adolescents
- Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis
- Original Articles
- Carbonated beverage consumption is associated with lower C-peptide in adolescents
- Low levels of cardiorespiratory fitness and abdominal resistance are associated with metabolic risk in schoolchildren
- Effect of metformin on clinical and biochemical hyperandrogenism in adolescent girls with type 1 diabetes
- Obesity-related thyroiditis in childhood: relationship with insulin resistance
- An isolated Xp deletion is linked to autoimmune diseases in Turner syndrome
- Non-invasive assessment of aortic stiffness and blood pressure in young Turner syndrome patients
- High frequency of non-classical congenital adrenal hyperplasia form among children with persistently elevated levels of 17-hydroxyprogesterone after newborn screening
- The “combined team” transition clinic model in endocrinology results in high adherence rates and patient satisfaction
- Utilizing health information technology to improve the recognition and management of life-threatening adrenal crisis in the pediatric emergency department: medical alert identification in the 21st century
- Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia: 6 years of follow-up
- Letter to the Editor
- Growth failure in infancy and early adiposity rebound
- Short Communication
- Clinical utility of stimulation tests in infants with suspected adrenal insufficiency (AI)
- Case Reports
- Two siblings with Gaucher type 3c: different clinical presentations
- Acquired partial lipodystrophy with metabolic disease in children following hematopoietic stem cell transplantation: a report of two cases and a review of the literature
- Therapeutic challenges in a patient with the simple virilizing (SV) form of congenital adrenal hyperplasia (CAH) due to the P30L/I172N genotype
