Elevated TSH levels in obese children: What kind of problem is it?

Abstract

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Keywords

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Şişman çocuklarda hafif TSH yüksekliği: Nasıl bir sorun?

Öz

Amaç: fiiflmanl›¤›n çocuklarda tiroid hormonlar› üzerine etkilerinin araflt›r›lmas›.

Gereç ve Yöntem: Çocuk endokrinoloji ve diyabet poliklini¤inde Mart 2006- May›s 2009 tarihleri aras›nda fliflmanl›k tan›s› ile izlenen 132 olgunun dosyalar› geriye dönük olarak incelendi. Antropometrik ölçümleri, kan lipit düzeyleri, tiroid hormon düzeyleri, açl›k kan flekeri ve insulin düzeyleri de¤erlendirildi. HOMA-IR (homeostasis model assessment of insulin resistance) <3,16 olan ile >3,16 olan olgular›n TSH (tiroid uyar›c› hormon) düzeyleri karfl›laflt›r›ld›. Tiroid uyar›c› düzeyi ile beden kitle indeksi (BK‹) ve HOMA-IR düzeyleri aras›ndaki iliflki incelendi. Veriler SPSS 13.0 istatistik program› ile analiz edildi. Ba¤›ms›z gruplar aras›ndaki karfl›laflt›rmalar ki-kare testi ile, korelasyon analizi ‘Pearson yöntemi’ ile yap›ld›. Anlaml›l›k s›n›r› p<0,05 olarak kabul edildi.

Bulgular: On yedi olgunun TSH de¤eri (%12,9) 97,5 persantilin üzerinde, 51 olgunun (%38,7) TSH de¤eri ise 90. persantilin üzerinde saptand›. TSH de¤eri >97,5 persantil olan hiçbir olgunun serbest/total T4 düzeyi normalin alt›nda de¤ildi. HOMA-IR<3,16 olan olgular ile HOMA-IR >3,16 olan olgular TSH düzeyleri aç›s›ndan karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› fark bulunmad›. TSH ile BK‹ ve HOMA-IR de¤eri aras›nda pozitif yönde, zay›f derecede, istatistiksel olarak anlaml› olmayan bir iliflki saptand›.

Çıkarımlar: fiiflman çocuklarda TSH düzeyi, tiroid ifllevleri etkilenmeksizin yükselmifl olabilir, bu durum hipotiroidi lehine de¤erlendirilmemeli ve ilk de¤erlendirmede L-tiroksin tedavisi bafllanmamal›d›r. 

Anahtar Kelimeler

• Beden kitle indeksi
• HOMA-IR
• şişmanlık
• TSH

Kaynakça

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