Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents

J Pediatr (Rio J). 2016 Sep-Oct;92(5):532-8. doi: 10.1016/j.jped.2016.01.011. Epub 2016 Jun 22.

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 <2.5mIU/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.

Keywords: Adolescentes; Adolescents; Cardiovascular risk factors; Fatores de risco cardiovascular; Hipotireoidismo subclínico; Obesidade; Obesity; Overweight; Sobrepeso; Subclinical hypothyroidism.

MeSH terms

  • Adolescent
  • Brazil
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / complications
  • Child
  • Cholesterol, HDL / blood
  • Female
  • Humans
  • Hypothyroidism / complications
  • Insulin Resistance
  • Longitudinal Studies
  • Male
  • Overweight / blood*
  • Overweight / complications
  • Pediatric Obesity / blood*
  • Pediatric Obesity / complications
  • Retrospective Studies
  • Risk Factors
  • Thyrotropin / blood*
  • Triglycerides / blood
  • Waist Circumference

Substances

  • Cholesterol, HDL
  • Triglycerides
  • Thyrotropin