Niveles de hormonas tiroideas en niños obesos / Thyroid function in obese children
Rev. chil. pediatr
; 85(3): 288-297, jun. 2014. graf, tab
Article
in Es
| LILACS
| ID: lil-719135
Responsible library:
CL1.1
RESUMEN
Introducción:
El rendimiento del estudio de función tiroidea en niños obesos es desconocido. Nuestro objetivo fue describir en esta población los niveles de hormona tiro-estimulante (TSH) y tiroxina plasmática libre (T4L), los factores asociados y la frecuencia de hipotiroidismo. Pacientes yMétodo:
Estudio retrospectivo de 260 fichas clínicas de niños obesos que consultaron a una nutrióloga infantil por primera vez entre enero de 2007 y junio de 2012. Se consignó la edad, sexo, pubertad, peso, talla y perímetro de cintura (PC). Calculamos el índice de masa corporal (IMC, z-score), peso/talla (IPT) y talla/edad (NCHS 2000). Se determinaron los niveles de TSH y T4L.Resultados:
Se incluyeron 210 pacientes entre 2 y 18 años, 59 por ciento mujeres, 51,4 por ciento pre-púberes. 23,9 por ciento sobrepeso y 76,1 por ciento obesidad. 70,8 por ciento presentó obesidad central. TSH y T4L fueron 2,31 uUI/mL (0,69 a 8,07) y 1,289 +/- 0,17 ng/dL, respectivamente. Se encontró hipotiroidismo en 21 pacientes (10 por ciento), subclínico en 20 de éstos. Hubo una correlación inversa de LogTSH con edad y directa de LogTSH con zIMC. Con regresión múltiple solamente zIMC fue significativo (p < 0,001, R2 ajustado 8,2 por ciento, beta 0,19). No hubo diferencias en edad, sexo, pubertad ni estado nutricional entre eutiroideos e hipotiroideos.Conclusión:
Encontramos 9,5 por ciento de hipotiroidismo subclínico, lo cual justifica el tamizaje con TSH en niños obesos.ABSTRACT
Introduction:
Study results regarding thyroid function in obese children are unknown. The objective of this study was to describe the levels of thyroid stimulating hormone (TSH), free plasma thyroxine (FT4), associated factors and frequency of hypothyroidism in these children. Patients andMethod:
A retrospective study of medical records of 260 obese children who consulted a physician for the first time between January 2007 and June 2012. Age, gender, puberty, weight, height and waist circumference (WC) were considered; body mass index (BMI z -score), weight/height (IPT) and height/age (NCHS 2000) were calculated, and TSH and FT4 were measured.Results:
210 patients aged 2 to 18 years were included, 59 percent female, 51.4 percent prepubescent children, 23.9 percent were overweight and 76.1 percent obese. 70.8 percent of the children surveyed had central obesity. TSH and FT4 values were 2.31 uUI/mL (0.69 to 8.07) and 1.289 +/- 0.17 ng/dL, respectively. Hypothyroidism was found in 21 patients (10 percent), 20 of these presented it as subclinical condition. An inverse correlation was present between age and log TSH and a direct correlation was described between log TSH and zBMI. Qnly zBMI was significant (p < 0.001, adjusted R2 8.2 percent beta 0.19) after using multiple regression. No differences in age, gender, nutritional status and puberty between euthyroid and hypothyroid patients were found.Conclusion:
9.5 percent of patients presented subclinical hypothyroidism, which supports TSH screening in obese children.Key words
Full text:
1
Index:
LILACS
Main subject:
Thyroxine
/
Thyrotropin
/
Hypothyroidism
/
Obesity
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
Es
Journal:
Rev. chil. pediatr
Journal subject:
PEDIATRIA
Year:
2014
Type:
Article