Obez Çocuk ve Ergenlerde Subklinik Hipotiroidi Sıklığı ve İlgili Parametrelerin İncelenmesi

Abstract

Amaç: Subklinik hipotiroidizm (SH), obez çocuk ve ergenlerde sık görülen bir tiroid hormon bozukluğudur. Bu çalışmada, obez çocuk ve ergenlerde subklinik hipotiroidi sıklığını belirlemek, TSH düzeyi ile antropometrik ve metabolik parametreler arasındaki ilişkinin araştırılması planlanmıştır. Araçlar ve Yöntem: Çalışmaya yaşları 10-18 yaş aralığından değişen 100 obez grup, 70 kontrol grubu olmak üzere toplam 170 olgu alındı. Tüm olguların dosya kayıtlarından; cinsiyet, antropometrik ölçümleri (vücut ağırlığı, boy, beden kitle indeksleri) ve standart deviasyon skorları (SDS), tiroid fonksiyon testleri (TSH, sT4, sT3), insülin, açlık kan şekeri, total kolesterol (TK), yüksek dansiteli lipoprotein, kolesterol (HDL-K), trigliserid ve düşük dansitelilipoprotein kolesterol (LDL-K), HOMA-IR düzeyleri elde edildi. Bulgular: Obez gruptaki 100 hastanın 7’sinde (% 7) SH saptandı. Obez grubun VA ve BKİ-SDS değerleri kontrol grubuna göre anlamlı derecede yüksek saptandı. (p=<0.01,<0.01, sırasıyla). Obez grupta sT4 düzeyi kontrol grubuna göre anlamlı düşük (p=0.04 ), HOMA-IR ve AST düzeyi de anlamlı olarak yüksek bulundu (p=<0.01, <0.01, sırasıyla). Serum TSH düzeyi ile HOMA-IR düzeyi arasında pozitif yönde düşük derecede korelasyon saptandı (r=0.15, p=0.049). Sonuç: Obez çocuk ve ergenlerde SH normal popülasyona göre daha sık görülür, ancak çoğu olguda TSH 10 UI/ml’nın altında ve tedaviye ihtiyaç duyulmamaktadır. Obez çocuklarda Hashimato tiroiditi olmaksızın tiroid otoantikor pozitifliği görülebilir. TSH düzeyi ile insülin direnci arasında düşük derecede de olsa pozitif bir ilişki olduğundan, obez çocuklarda SH saptanması insülin direnci olasılığı konusunda klinisyen için uyarıcı olmalıdır.

Keywords

• beden kitle indeksi
• insülin direnci
• obezite
• tiroid hormonları

An Examination of the Frequency of Subclinical Hypothyroidism and Relevant Parameters in Obese Children and Adolescents

Abstract

Purpose: Subclinical hypothyroidism (SH) is a thyroid hormone disorder commonly observed in obese children and adolescents. In this study, it was aimed to determine the frequency of subclinical hypothyroidism in obese children and adolescents and to investigate the relationship between TSH levels and anthropometric and metabolic parameters. Materials and Methods: A total of 170 patients aged 10-18 years were included in the study, 100 in the obese group and 70 in the control group. Gender, anthropometric measurements and laboratory data were obtained from the patients medical records. Results: SH was detected in 7 of the 100 patients (7%) in the obese group. The BW and BMI SDS values were found significantly higher in the obese group compared to the control group (p=<0.01,<0.01, respectively).In the obese group, fT4 levels were signif-icantly lower (p=0.04) than in the control group, and HOMA-IR and AST levels were significantly higher (p=<0.01, <0.01, re-spectively). A low positive correlation was found between serum TSH levels and HOMA IR levels (r=0.15, p=0.049). Conclusion: Subclinical hypothyroidism (SH) is more common in obese children and adolescents compared to the general popu-lation; however, in most cases, TSH levels remain below 10 IU/mL, and treatment is not required. In obese children, thyroid autoantibody positivity may be observed without Hashimoto's thyroiditis. Since there is a weak but positive correlation between TSH levels and insulin resistance, the detection of SH in obese children should alert clinicians to the possibility of insulin resistance.

Keywords

• body mass index
• ınsulin resistance
• obesity
• thyroid hormones

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