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

Year 2021, Volume: 5 Issue: 3, 236 - 242, 22.12.2021

Abdulvahit Aşık Semih Bolu

https://doi.org/10.46332/aemj.832093

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

References

  • 1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. 2012;307(5):483-490.
  • 2. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32(9):1431-1437.
  • 3. Margolis-Gil M, Yackobovitz-Gavan M, Phillip M, Shalitin S. Which predictors differentiate between obese children and adolescents with cardiometabolic complications and those with metabolically healthy obesity?. Pediatr Diabetes. 2018;19(7):1147-1155.
  • 4. Yılmazbaş P, Gökçay G. Childhood obesity and its prevention. J Child. 2018;18(3):103-112.
  • 5. Shashaj B, Bedogni G, Graziani MP, et al. Origin of cardiovascular risk in overweight preschool children: A cohort study of cardiometabolic risk factors at the onset of obesity. JAMA Pediatr. 2014;168(10):917-924.
  • 6. Grandone A, Santoro N, Coppola F, Calabrò P, Perrone L, Del Giudice EM. Thyroid function derangement and childhood obesity: an Italian experience. BMC Endocr Disord. 2010;10(8):1-7.
  • 7. Denzer C, Karges B, Nake A, et al. Subclinical hypothyroidism and dyslipidemia in children and adolescents with type 1 diabetes mellitus. Eur J Endocrinol. 2013;168(4):601-608.
  • 8. Brufani C, Manco M, Nobili V, Fintini D, Barbetti F, Cappa M. Thyroid function tests in obese prepubertal children: correlations with insulin sensitivity and body fat distribution. Horm Res Paediatr. 2012;78(2):100-105.
  • 9. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol. 2010;316(2):165-171.
  • 10. Pearce E. Hypothyroidism and dyslipidemia: modern concepts and approaches. Curr Cardiol Rep. 2004;6(6):451-456.
  • 11. Liu Y, Wang W, Yu X, Qi X. Thyroid function and risk of non-alcoholic fatty liver disease in euthyroid subjects. Ann Hepatol. 2018;17(5):779-788.
  • 12. Borges-Canha M, Neves JS, Mendonça F, et al. Thyroid Function and the Risk of Non-Alcoholic Fatty Liver Disease in Morbid Obesity. Front Endocrinol. 2020;11:572128.
  • 13. Jaruvongvanich V, Sanguankeo A, Upala S. Nonalcoholic fatty liver disease ıs not associated with thyroid hormone levels and hypothyroidism: a systematic review and metaanalysis. Eur Thyroid J. 2017;6(4):208-215.
  • 14. Patton HM, Sirlin C, Behling C, Middleton M, Schwimmer JB, Lavine JE. Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research. J Pediatr Gastroenterol Nutr. 2006;43(4):413-427.
  • 15. Bozic MA, Subbarao G, Molleston JP. Pediatric nonalcoholic fatty liver disease. Nutr Clin Pract. 2013;28(4):448-458.
  • 16. Jin HY. Prevalence of subclinical hypothyroidism in obese children or adolescents and association between thyroid hormone and the components of metabolic syndrome. J Paediatr Child Health. 2018;54(9):975-980.
  • 17. Manji N, Boelaert K, Sheppard MC, Holder RL, Gough SC, Franklyn JA. Lack of association between serum TSH or free T4 and body mass index in euthyroid subjects. Clin Endocrinol (Oxf). 2006;64(2):125-128.
  • 18. Reinehr T. Thyroid function in the nutritionally obese child and adolescent. Curr Opin Pediatr. 2011;23(4):415-420.
  • 19. Sorisky A, Bell A, Gagnon A. TSH receptor in adipose cells. Horm Metab Res. 2000;32(11-12):468-474.
  • 20. Soriguer F, Valdes S, Morcillo S, et al. Thyroid hormone levels predict the change in body weight: a prospective study. Eur J Clin Invest. 2011;41(11):1202-1209.
  • 21. Díez JJ, Iglesias P. Relationship between thyrotropin and body mass index in euthyroid subjects. Exp Clin Endocrinol Diabetes. 2011;119(3):144-150.
  • 22. Michalaki MA, Vagenakis AG, Leonardou AS, et al. Thyroid function in humans with morbid obesity. Thyroid. 2006;16(1):73-78. 23. Aeberli I, Jung A, Murer SB, et al. During rapid weight loss in obese children, reductions in TSH predict improvements in insulin sensitivity independent of changes in body weight or fat. J Clin Endocrinol Metab. 2010;95(12):5412-5418.
  • 24. De Pergola G, Ciampolillo A, Alo D, Sciaraffia M, Guida P. Free triiodothyronine is associated with smoking habit, independently of obesity, body fat distribution, insulin, and metabolic parameters. J Endocrinol Invest. 2010;33(11):815-818.
  • 25. Taylor PN, Richmond R, Davies N, et al. Paradoxical relationship between body mass ındex and thyroid hormone levels: a study using mendelian randomization. J Clin Endocrinol Metab. 2016;101(2):730-738.
  • 26. Bilgin H, Pirgon O. Thyroid function in obese children with non-alcoholic fatty liver disease. J Clin Res Pediatr Endocrinol. 2014;6(3):152-157.
  • 27. Kaltenbach TE, Graeter T, Oeztuerk S, et al. Thyroid dysfunction and hepatic steatosis in overweight children and adolescents. Pediatr Obes. 2017;12(1):67-74.
  • 28. Marras V, Casini MR, Pilia S, et al. Thyroid function in obese children and adolescents. Horm Res Paediatr. 2010;73(3):193-197.
  • 29. Reinehr T, de Sousa G, Andler W. Hyperthyrotropinemia in obese children is reversible asTer weight loss and is not related to lipids. J Clin Endocrinol Metab. 2006;91(8):3088-3091.

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

Year 2021, Volume: 5 Issue: 3, 236 - 242, 22.12.2021

Abdulvahit Aşık Semih Bolu

https://doi.org/10.46332/aemj.832093

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

References

  • 1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. 2012;307(5):483-490.
  • 2. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32(9):1431-1437.
  • 3. Margolis-Gil M, Yackobovitz-Gavan M, Phillip M, Shalitin S. Which predictors differentiate between obese children and adolescents with cardiometabolic complications and those with metabolically healthy obesity?. Pediatr Diabetes. 2018;19(7):1147-1155.
  • 4. Yılmazbaş P, Gökçay G. Childhood obesity and its prevention. J Child. 2018;18(3):103-112.
  • 5. Shashaj B, Bedogni G, Graziani MP, et al. Origin of cardiovascular risk in overweight preschool children: A cohort study of cardiometabolic risk factors at the onset of obesity. JAMA Pediatr. 2014;168(10):917-924.
  • 6. Grandone A, Santoro N, Coppola F, Calabrò P, Perrone L, Del Giudice EM. Thyroid function derangement and childhood obesity: an Italian experience. BMC Endocr Disord. 2010;10(8):1-7.
  • 7. Denzer C, Karges B, Nake A, et al. Subclinical hypothyroidism and dyslipidemia in children and adolescents with type 1 diabetes mellitus. Eur J Endocrinol. 2013;168(4):601-608.
  • 8. Brufani C, Manco M, Nobili V, Fintini D, Barbetti F, Cappa M. Thyroid function tests in obese prepubertal children: correlations with insulin sensitivity and body fat distribution. Horm Res Paediatr. 2012;78(2):100-105.
  • 9. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol. 2010;316(2):165-171.
  • 10. Pearce E. Hypothyroidism and dyslipidemia: modern concepts and approaches. Curr Cardiol Rep. 2004;6(6):451-456.
  • 11. Liu Y, Wang W, Yu X, Qi X. Thyroid function and risk of non-alcoholic fatty liver disease in euthyroid subjects. Ann Hepatol. 2018;17(5):779-788.
  • 12. Borges-Canha M, Neves JS, Mendonça F, et al. Thyroid Function and the Risk of Non-Alcoholic Fatty Liver Disease in Morbid Obesity. Front Endocrinol. 2020;11:572128.
  • 13. Jaruvongvanich V, Sanguankeo A, Upala S. Nonalcoholic fatty liver disease ıs not associated with thyroid hormone levels and hypothyroidism: a systematic review and metaanalysis. Eur Thyroid J. 2017;6(4):208-215.
  • 14. Patton HM, Sirlin C, Behling C, Middleton M, Schwimmer JB, Lavine JE. Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research. J Pediatr Gastroenterol Nutr. 2006;43(4):413-427.
  • 15. Bozic MA, Subbarao G, Molleston JP. Pediatric nonalcoholic fatty liver disease. Nutr Clin Pract. 2013;28(4):448-458.
  • 16. Jin HY. Prevalence of subclinical hypothyroidism in obese children or adolescents and association between thyroid hormone and the components of metabolic syndrome. J Paediatr Child Health. 2018;54(9):975-980.
  • 17. Manji N, Boelaert K, Sheppard MC, Holder RL, Gough SC, Franklyn JA. Lack of association between serum TSH or free T4 and body mass index in euthyroid subjects. Clin Endocrinol (Oxf). 2006;64(2):125-128.
  • 18. Reinehr T. Thyroid function in the nutritionally obese child and adolescent. Curr Opin Pediatr. 2011;23(4):415-420.
  • 19. Sorisky A, Bell A, Gagnon A. TSH receptor in adipose cells. Horm Metab Res. 2000;32(11-12):468-474.
  • 20. Soriguer F, Valdes S, Morcillo S, et al. Thyroid hormone levels predict the change in body weight: a prospective study. Eur J Clin Invest. 2011;41(11):1202-1209.
  • 21. Díez JJ, Iglesias P. Relationship between thyrotropin and body mass index in euthyroid subjects. Exp Clin Endocrinol Diabetes. 2011;119(3):144-150.
  • 22. Michalaki MA, Vagenakis AG, Leonardou AS, et al. Thyroid function in humans with morbid obesity. Thyroid. 2006;16(1):73-78. 23. Aeberli I, Jung A, Murer SB, et al. During rapid weight loss in obese children, reductions in TSH predict improvements in insulin sensitivity independent of changes in body weight or fat. J Clin Endocrinol Metab. 2010;95(12):5412-5418.
  • 24. De Pergola G, Ciampolillo A, Alo D, Sciaraffia M, Guida P. Free triiodothyronine is associated with smoking habit, independently of obesity, body fat distribution, insulin, and metabolic parameters. J Endocrinol Invest. 2010;33(11):815-818.
  • 25. Taylor PN, Richmond R, Davies N, et al. Paradoxical relationship between body mass ındex and thyroid hormone levels: a study using mendelian randomization. J Clin Endocrinol Metab. 2016;101(2):730-738.
  • 26. Bilgin H, Pirgon O. Thyroid function in obese children with non-alcoholic fatty liver disease. J Clin Res Pediatr Endocrinol. 2014;6(3):152-157.
  • 27. Kaltenbach TE, Graeter T, Oeztuerk S, et al. Thyroid dysfunction and hepatic steatosis in overweight children and adolescents. Pediatr Obes. 2017;12(1):67-74.
  • 28. Marras V, Casini MR, Pilia S, et al. Thyroid function in obese children and adolescents. Horm Res Paediatr. 2010;73(3):193-197.
  • 29. Reinehr T, de Sousa G, Andler W. Hyperthyrotropinemia in obese children is reversible asTer weight loss and is not related to lipids. J Clin Endocrinol Metab. 2006;91(8):3088-3091.
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Abdulvahit Aşık 0000-0002-5508-1181

Semih Bolu 0000-0002-8183-2188

Publication Date December 22, 2021
Published in Issue Year 2021 Volume: 5 Issue: 3

Cite

APA Aşık, A., & Bolu, S. (2021). Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi. Ahi Evran Medical Journal, 5(3), 236-242. https://doi.org/10.46332/aemj.832093
AMA Aşık A, Bolu S. Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi. Ahi Evran Med J. December 2021;5(3):236-242. doi:10.46332/aemj.832093
Chicago Aşık, Abdulvahit, and Semih Bolu. “Obezitesi Ve Karaciğer Yağlanması Olan Çocuk Ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi”. Ahi Evran Medical Journal 5, no. 3 (December 2021): 236-42. https://doi.org/10.46332/aemj.832093.
EndNote Aşık A, Bolu S (December 1, 2021) Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi. Ahi Evran Medical Journal 5 3 236–242.
IEEE A. Aşık and S. Bolu, “Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi”, Ahi Evran Med J, vol. 5, no. 3, pp. 236–242, 2021, doi: 10.46332/aemj.832093.
ISNAD Aşık, Abdulvahit - Bolu, Semih. “Obezitesi Ve Karaciğer Yağlanması Olan Çocuk Ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi”. Ahi Evran Medical Journal 5/3 (December 2021), 236-242. https://doi.org/10.46332/aemj.832093.
JAMA Aşık A, Bolu S. Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi. Ahi Evran Med J. 2021;5:236–242.
MLA Aşık, Abdulvahit and Semih Bolu. “Obezitesi Ve Karaciğer Yağlanması Olan Çocuk Ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi”. Ahi Evran Medical Journal, vol. 5, no. 3, 2021, pp. 236-42, doi:10.46332/aemj.832093.
Vancouver Aşık A, Bolu S. Obezitesi ve Karaciğer Yağlanması Olan Çocuk ve Ergenlerde Tiroid Fonksiyon Testlerinin Değerlendirilmesi. Ahi Evran Med J. 2021;5(3):236-42.
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