Thyroid homeostasis in obesity children
Keywords:children, overweight, obesity, thyroid hormones
Background. Due to the rapid increase in the prevalence of childhood obesity in Europe in recent years, various initiatives and actions have been launched in response to this alarming tendency. Over the last decade, the question of the interaction between obesity and thyroid pathology has been the most controversial. The study was aimed to assess the state of thyroid supply in overweight children. Materials and methods. Out of 936 people, 160 people aged 7 to 18 years with overweight (OW) and obesity were selected for a detailed study. The levels of thyroid-stimulating hormone (TSH), free triiodothyronine, and thyroxine (fT3, fT4) in serum were determined by enzyme-linked immunosorbent assay. Results. More than half of the children who were selected for the study had both diffuse nontoxic goiter (DNG) both in boys and girls (51.4 %) with a predominance of thyroid volume corresponding to the first degree of goiter. Only in a small number of children with OW and obesity (14 out of 105 people, 13.3 %), TSH levels were shifted toward its increase (4.31–4.98 μIU/ml), and when using TSH/fT4, 20 (11.5 %) children showed signs of laboratory hypothyroidism with a slight predominance of hyperthyrotropinemia in boys (18.5 %) compared to girls (15.6 %). The frequency of TSH levels > 3.0 μIU/ml elevated with increasing age of patients from 12.9 % among children aged 7–9 years to 16.6 % in the group of patients aged 10–13 years and 15.1 % in children aged 14–18 years without significant differences by gender. Children with OW and obesity were more likely to have higher TSH values than children with DNG and normal body weight. Conclusions. Diffuse nontoxic goiter is more common in children with OW and obesity (51.2 %) than in children with normal body weight (21.7 %). The assessment of the age of the functional state of the thyroid gland in these children did not reveal significant changes in peripheral thyroid hormones, but in 11.5 % of people, TSH/fT4 ranged from 0.19 to 0.29 and 13.3 % of people had signs of subclinical hypothyroidism. This indicates the need to monitor the functional state of the thyroid gland in overweight and obese children.
Lissner L, Wijnhoven TM, Mehlig K, et al. Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008). Int J Obes (Lond). 2016 May;40(5):796-802. doi: 10.1038/ijo.2016.12.
Rito AI, Buoncristiano M, Spinelli A, et al. Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative - COSI 2015/2017. Obes Facts. 2019;12(2):226-243. doi: 10.1159/000500425.
Williams J, Buoncristiano M, Nardone P, et al. A Snapshot of European Children's Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI). Nutrients. 2020 Aug 17;12(8):2481. doi: 10.3390/nu12082481.
Wijnhoven TM, van Raaij JM, Spinelli A, et al. WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health. 2014 Aug 7;14:806. doi: 10.1186/1471-2458-14-806.
Venturelli F, Ferrari F, Broccoli S, et al. The effect of Public Health/Pediatric Obesity interventions on socioeconomic inequalities in childhood obesity: A scoping review. Obes Rev. 2019 Dec;20(12):1720-1739. doi: 10.1111/obr.12931.
Valerio G, Maffeis C, Saggese G, et al. Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Ital J Pediatr. 2018 Jul 31;44(1):88. doi: 10.1186/s13052-018-0525-6.
Lindberg L, Danielsson P, Persson M, Marcus C, Hagman E. Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Med. 2020;17(3):e1003078. doi:10.1371/journal.pmed.1003078.
Farrag NS, Cheskin LJ, Farag MK. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis. Adv Pediatr Res. 2017;4:8. doi:10.12715/apr.2017.4.8.
Miyawaki A, Evans CEL, Lucas PJ, Kobayashi Y. Relationships between social spending and childhood obesity in OECD countries: an ecological study. BMJ Open. 2021;11(2):e044205. doi:10.1136/bmjopen-2020-044205.
Bel-Serrat S, Ojeda-Rodríguez A, Heinen MM, et al. Clustering of Multiple Energy Balance-Related Behaviors in School Children and its Association with Overweight and Obesity-WHO European Childhood Obesity Surveillance Initiative (COSI 2015⁻2017). Nutrients. 2019 Feb 27;11(3):511. doi: 10.3390/nu11030511.
van Trotsenburg P, Stoupa A, Léger J, et al. Congenital Hypothyroidism: A 2020-2021 Consensus Guidelines Update-An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology. Thyroid. 2021 Mar;31(3):387-419. doi: 10.1089/thy.2020.0333.
Stinson SE, Jonsson AE, Lund MAV, et al. Fasting Plasma GLP-1 Is Associated With Overweight/Obesity and Cardiometabolic Risk Factors in Children and Adolescents. J Clin Endocrinol Metab. 2021;106(6):1718-1727. doi:10.1210/clinem/dgab098.
Koutny F, Weghuber D, Bollow E, et al. Prevalence of prediabetes and type 2 diabetes in children with obesity and increased transaminases in European German-speaking countries. Analysis of the APV initiative. Pediatr Obes. 2020 Apr;15(4):e12601. doi: 10.1111/ijpo.12601.
Ek A, Delisle Nyström C, Chirita-Emandi A, et al. A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study – an intervention within the STOP project. BMC Public Health. 2019 Jul 15;19(1):945. doi: 10.1186/s12889-019-7161-y.
De Spiegeleer M, De Paepe E, Van Meulebroek L, Gies I, De Schepper J, Vanhaecke L. Paediatric obesity: a systematic review and pathway mapping of metabolic alterations underlying early disease processes. Mol Med. 2021;27(1):145. doi:10.1186/s10020-021-00394-0.
Kalra S, Aggarwal S, Khandelwal D. Thyroid Dysfunction and Dysmetabolic Syndrome: The Need for Enhanced Thyrovigilance Strategies. Int J Endocrinol. 2021 Mar 29;2021:9641846. doi: 10.1155/2021/9641846.
Falalyeyeva T, Mamula Y, Scarpellini E, Leshchenko I, Humeniuk A, Pankiv I, Kobyliak N. Probiotics and obesity associated disease: an extended view beyond traditional strains. Minerva Gastroenterol (Torino). 2021 Dec;67(4):348-356. doi: 10.23736/S2724-5985.21.02909-0.
Pankiv VI, Yuzvenko TY, Pankiv IV. Type 2 diabetes mellitus and subclinical hypothyroidism: focusing on the role of cholecalciferol. Problems of Endocrine Pathology. 2021;68(2):46-51. doi: 10.21856/j-PEP.2019.2.07.
How to Cite
This work is licensed under a Creative Commons Attribution 4.0 International License.