Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi

Abstract

Amaç: Çalışmamızda obezitesi ve obeziteye bağlı karaciğer yağlanması olan çocuk ve ergenlerin tiroid fonksiyon testlerinin değerlendirilmesi amaçlandı.

Araçlar ve Yöntem: Ekim 2016 ile Mart 2020 tarihleri arasında çocuk endokrin polikliniğinde obezite tanısı ile takip edilen, yaşları 7 ile 18 arasında değişen toplam 163 hasta ile 47 sağlıklı olgunun verileri geriye dönük incelendi. Olgular karaciğerde yağlanması olan obez hastalar (Grup 1), karaciğerde yağlanması olmayan obez hastalar (Grup 2) ve sağlıklı kontrol grubu (Grup 3) olarak gruplara ayrıldı. Hasta ve kontrol grubundaki olguların açlık kan şekerleri, ALT (alanin aminotransferaz), AST (aspartat aminotransferaz), sT4 (serbest tiroksin), sT3 (serbest triiyodotironin), tiroid uyarıcı hormon (TSH), insülin ve kan lipit değerleri incelendi. İnsülin direnci, homeostaz model değerlendirmesi-insülin direnci (HOMA-IR) ile değerlendirildi. Serbest T3/T4 oranı, deiyodinaz aktivitesinin dolaylı göstergesi olarak kabul edildi.

Bulgular: Sağlıklı kontrol grubuna göre obez hasta gruplarının (karaciğer yağlanması olan ve olmayan) vücut kitle indeksi-standart sapma skoru (VKİ-SDS) değerleri, sistolik kan basınçları (SKB), açlık kan şekerleri, plazma lipid düzeyleri, açlık insülin, HOMA-IR, AST, ALT ve sT3 değerleri anlamlı olarak daha yüksek saptandı (p<0.05). Karaciğer yağlanması olan ve olmayan obez olgular
arasında HOMO-IR bakımından anlamlı fark yoktu (p=0.365). Obez hasta gruplarının sT3 değerleri ve karaciğer yağlanması olmayan obez hasta grubunun sT3/sT4 oranı sağlıklı kontrol grubundan anlamlı derecede yüksek bulundu (p<0.001). 

Sonuç: Çalışmamızda obez çocuk ve ergenlerin sağlıklı kontrollere göre yüksek sT3 ve karaciğer yağlanması olmayan obez olguların yüksek sT3/sT4 oranına sahip oldukları saptanmıştır.

Keywords

• Çocuk ve ergen
• Karaciğer yağlanması
• Obezite
• Tiroid fonksiyon testleri

An Evaluation of Thyroid Functions Tests in Children and Adolescents with Obesity and Hepatic Steatosis

Abstract

Purpose: The purpose of our study was to evaluate the thyroid function tests of children and adolescents with obesity and obesityrelated hepatic steatosis.

Materials and Methods: Data for 163 patients aged between 7 and 18 years under follow-up with diagnoses of obesity at the pediatric endocrinology clinic between October 2016 and March 2020, and of 47 healthy cases were examined retrospectively. Cases were divided into obese patients with hepatic steatosis (Group 1), obese patients without hepatic steatosis (Group 2), and a healthy control
group (Group 3). Fasting blood sugars, alanine aminotransferase (ALT), aspartate aminotransferase (AST), free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone, insulin, and blood lipid values of the cases in the patient and control groups were examined. The fT3/fT4 ratio was regarded as an indirect marker of deiodinase activity. 

Results: Body mass index-standard deviation score values, systolic blood pressure, fasting blood sugars, insulin and lipid levels, HOMA-IR (Homeostatic Model Assessment of Insulin Resistance), AST, ALT and fT3 values were significantly higher in the patient groups (with and without hepatic steatosis) than in the healthy control group (p<0.05). There was no significant difference in HOMAIR between the obese cases with and without hepatic steatosis (p=0.365). FT3 values in the obese patient groups and the fT3/fT4 ratio in the obese patient group without hepatic steatosis were significantly higher than in the healthy control group (p<0.001). 

Conclusions: Our study showed that obese children and adolescents had higher fT3 than the healthy controls, and that obese cases without hepatic steatosis had higher fT3/fT4 ratios.

Keywords

• : Child and adolescent
• Hepatic steatosis
• Obesity
• Thyroid function tests

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