Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents / Níveis de TSH sérica associados a fatores de risco cardiovascular em adolescentes acima do peso e obesos
J. pediatr. (Rio J.)
; 92(5): 532-538, Sept.-Oct. 2016. tab
Article
in English
| LILACS
| ID: lil-796110
Responsible library:
BR1.1
ABSTRACT
Abstract Objective:
To investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents.Methods:
A retrospective, longitudinal analysis of 199 overweight and obese pubescent adolescents was performed. The TSH and free T4 (fT4) levels, anthropometric measurements, and laboratory test results of these patients were analyzed.Results:
27 individuals (13.56%) presented with TSH levels above the normal level (subclinical hypothyroidism [SCH]). Their waist circumference (WC) was significantly higher than those of euthyroid individuals. Serum TSH was positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Using TSH and BMI as independent variables, TSH levels were shown to be independently related to HOMA-IR (p = 0.001) and TG (p = 0.007). Among euthyroid subjects, individuals with TSH values <2.5 mIU/mL exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values.Conclusion:
SCH in overweight and obese adolescents appears to be associated with excess weight, especially visceral weight. In euthyroid adolescents, there appears to be a direct relationship between TSH and some CRF. In conclusion, in the present sample of overweight and obese adolescents, TSH levels appear to be associated with IR and CRF.RESUMO
Resumo Objetivo Investigar a relação entre tireotrofina sérica (TSH), resistência à insulina (RI) e fatores de risco cardiovascular (FRC) em uma amostra de adolescentes brasileiros acima do peso e obesos. Métodos Foi realizada uma análise longitudinal retrospectiva de 190 adolescentes púberes acima do peso e obesos. Foram analisados os níveis de TSH e T4 livre (T4l), as medidas antropométricas e os resultados de exames laboratoriais desses pacientes. Resultados 27 indivíduos (13,56%) apresentaram níveis de TSH acima do normal (hipotireoidismo subclínico (HSC)). Eles apresentaram circunferência da cintura (CC) significativamente maior que os indivíduos eutireoideos. A TSH sérica foi positivamente correlacionada ao índice do modelo de avaliação da homeostase de resistência à insulina (HOMA-IR), triglicerídeos (TG) e lipoproteína de alta densidade-colesterol (HDL-C). Usando TSH e IMC como variáveis independentes, os níveis de TSH estavam relacionados ao HOMA-IR (p = 0.001) e a TG (p = 0.007) de forma independente. Entre os pacientes eutireoideos, indivíduos com valores de TSH < 2.5 mIU/mL apresentaram reduções estatisticamente significativas na razão cintura/quadril, nos níveis de HDL-C e nos escores de HOMA-IR e tendência a menores valores de CC. Conclusão O HSC em adolescentes acima do peso e obesos parece estar associado ao excesso de peso, principalmente de peso visceral. Em adolescentes eutireoideos, parece haver uma relação direta entre TSH e alguns FRC. Concluindo, em nossa amostra de adolescentes acima do peso e obesos, os níveis de TSH parecem estar associados a RI e FRC.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Thyrotropin
/
Cardiovascular Diseases
/
Overweight
/
Pediatric Obesity
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
J. pediatr. (Rio J.)
Journal subject:
Pediatrics
Year:
2016
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Estadual de Diabetes e Endocrinologia/BR