[Atherogenic lipid profile in children with subclinical hypothyroidism]. / Perfil lipídico aterogénico en niños con hipotiroidismo subclínico.

OBJECTIVE: To evaluate lipid profile in children with subclinical hypothyroidism. PATIENTS AND METHODS: Forty-six children of both sexes aged between 2 and 9 years old, 17 with subclinical hypothyroidism (study group) and 23 healthy children (control group), were studied. Subclinical hypothyroidism was diagnosed when levels of thyroid-stimulating hormone (TSH) were greater than 4.65 .U/mL and those of free thyroxin (fT4) were normal. Children with subclinical hypothyroidism were observed for 4 months with no interventions and TSH and fT4 were again determined to confirm the diagnosis. A complete medical history was taken and a blood sample was extracted for lipid determinations including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Anti-thyroglobulin antibodies (ATGA) and antithyroid peroxidase (anti-TPO) antibodies were also determined. RESULTS: Of the 17 children who initially presented elevated serum TSH levels, seven (41.2 %) had normal levels at 4 months and were consequently excluded. No significant differences were found in age, weight, height or body mass index between the study and the control groups. No differences were found between the two groups in levels of anti-TPO antibodies and ATGA. The mean plasma HDL-C level was significantly lower in children with subclinical hypothyroidism than in controls (p < 0.05) and a statistically significant association (p < 0.013) was found between the presence of subclinical hypothyroidism and a greater frequency of low HDL-C levels. CONCLUSION: Subclinical hypothyroidism may be transitory in a considerable percentage of children. Children with subclinical hypothyroidism had significantly lower HDL-C levels, suggesting an atherogenic lipid profile in this entity.

Perfil lipídico aterogénico en niños con hipotiroidismo subclínico / Atherogenic lipid profile in children with subclinical hypothyroidism

Objetivo: Evaluar el perfil lipídico en niños con hipotiroidismo subclínico. Pacientes y métodos: Se estudiaron 46 niños de ambos sexos, en edades comprendidas entre 2 y 9 años, 17 con hipotiroidismo subclínico (grupo de estudio) y 23 niños sanos (grupo control). El hipotiroidismo subclínico se diagnosticó cuando los niveles de tirotropina (TSH) fueron mayores de 4,65 mU/ml y los de tiroxina libre (T4L) fueron normales. Los niños con hipotiroidismo subclínico se observaron por 4 meses sin intervención alguna y se les tomó nueva muestra para TSH y T4L con el objeto de corroborar el diagnóstico. Se les realizó una historia clínica completa y se les tomó muestra de sangre para lipidograma, que incluyó triglicéridos, colesterol total (CT), colesterol unido a las lipoproteínas de alta densidad (c-HDL) y el cálculo del colesterol unido a las lipoproteínas de baja densidad (c-LDL); además se determinaron los anticuerpos antitiroglobulina (anti-TG) y antiperoxidasa (anti-TPO). Resultados: De los 17 niños que presentaron niveles séricos elevados de TSH al inicio, 7 (41,2 %) los normalizaron a los 4 meses, por lo que fueron excluidos. No se apreciaron diferencias significativas en cuanto a la edad, peso, talla e índice de masa corporal entre el grupo de estudio y el control. Los niveles de anticuerpos anti-TPO y anti-TG no fueron diferentes entre los grupos. El nivel plasmático promedio de c-HDL fue significativamente más bajo en los niños con hipotiroidismo subclínico que en los controles (p < 0,05) y se observó una asociación estadística significativa (p < 0,013) entre la presencia de este proceso y la mayor frecuencia de niveles bajos de c-HDL. Conclusión: El hipotiroidismo subclínico puede ser una condición transitoria en un porcentaje importante de niños. Los niños con hipotiroidismo subclínico presentan una disminución significativa en los niveles de c-HDL, lo cual sugiere un patrón lipídico aterogénico en esta entidad

Objective: To evaluate lipid profile in children with subclinical hypothyroidism. Patients and methods: Forty-six children of both sexes aged between 2 and 9 years old, 17 with subclinical hypothyroidism (study group) and 23 healthy children (control group), were studied. Subclinical hypothyroidism was diagnosed when levels of thyroid-stimulating hormone (TSH) were greater than 4.65 mU/mL and those of free thyroxin (fT4) were normal. Children with subclinical hypothyroidism were observed for 4 months with no interventions and TSH and fT4 were again determined to confirm the diagnosis. A complete medical history was taken and a blood sample was extracted for lipid determinations including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Anti-thyroglobulin antibodies (ATGA) and antithyroid peroxidase (anti-TPO) antibodies were also determined. Results: Of the 17 children who initially presented elevated serum TSH levels, seven (41.2 %) had normal levels at 4 months and were consequently excluded. No significant differences were found in age, weight, height or body mass index between the study and the control groups. No differences were found between the two groups in levels of anti-TPO antibodies and ATGA. The mean plasma HDL-C level was significantly lower in children with subclinical hypothyroidism than in controls (p < 0.05) and a statistically significant association (p < 0.013) was found between the presence of subclinical hypothyroidism and a greater frequency of low HDL-C levels. Conclusion: Subclinical hypothyroidism may be transitory in a considerable percentage of children. Children with subclinical hypothyroidism had significantly lower HDL-C levels, suggesting an atherogenic lipid profile in this entity

Frecuencia de obesidad y sobrepeso en escolares de la zona urbana de Mérida-Venezuela

Objetivos. Determinar la frecuencia de alteraciones en el peso en escolares de 3 planteles públicos, ubicados en la zona urbana de la ciudad de Mérida-Venezuela. Métodos. Estudio observacional, transversal, en el cual se incluyeron 349 escolares, con edades entre 6 y 13 años, 189 de sexo femenino y 160 de sexo masculino, provenientes de 3 planteles públicos, ubicados en la Urb. J.J. Osuna Rodríguez y la Parroquia, de la Ciudad de Mérida; 127 niños del plantel A (Los Curos), 111 del B (Bicentenario) y 111 del C (10 de Diciembre). A los niños se les determinó el peso y la talla y se calculó el índice de masa corporal (IMC) y el indicador talla edad (T/E). Según el IMC, se ubicó cada niño en el percentil correspondiente para sexo y edad; se clasificaron en: obesos: IMC > percentil 97th, sobrepeso: IMC <97th y > 90th, normopeso: IMC< 90th y >10th y bajo peso: IMC < 10th. El diagnostico nutricional antropométrico se hizo por combinación de los indicadores IMC y T/E. Resultados. El 35% del total de niños presentó alteraciones del IMC para su edad; el sobrepeso representó el 11%, la obesidad el 14% y el bajo peso el 10% del total. En cada plantel no se observó la misma distribución. La frecuencia de alteraciones en el IMC fue significativamente menor (p<0,01) en las niñas (26%) que en los varones (42%). Esta diferencia se correspondió con un aumento significativo en la frecuencia de obesidad y sobrepeso en los varones. En el 26,4% hubo alteraciones en la talla-edad, siendo mas frecuentes en los varones que en las niñas. Los niños con obesidad y sobrepeso presentaron una mayor frecuencia de talla alta (p<0,05) que los normales. En base al diagnostico nutricional antropométrico el 8,8% de los niños presentaron peso y talla bajos. Conclusiones. Las cifras obtenidas documentan un importante aumento en la frecuencia de obesidad y sobrepeso en nuestros escolares. Las potenciales consecuencias en términos de morbilidad y mortalidad nos obligan a mejorar las estrategias en prevención primaria y secundaria, no solo promoviendo el ejercicio y optimizando la alimentación de nuestros niños, sino además, identificando a los grupos de riesgo.

Objective. To assess the frequency of weight problems in school-children from educational centers of Mérida-Venezuela. Methods. An observational and transversal study was performed. Three hundred forty nine school-children, 6 to 12 years old, 160 boys and 189 girls, were studied. They belong to three educational centers from Mérida; 127 children from the school A (Los Curos), 111 from the school B (Bicentenario), and 111 from the school C (10 de Diciembre). The weight and stature were measured in all children. Body mass index-for age (BMI/A) and stature-for age (S/A) were established: obese (BMI ³ 97thpercentile), overweight (BMI <97th and > 90th), normal weight (BMI £ 90th and ³10th), and low weight (BMI< 10th). The nutritional evaluation was done by the combination of 2 indexes: BMI-for age (BMI/A) and stature-for age (S/A). Results. BMI-for age abnormal values were obtained in 35% of the 349 school-children; overweight was diagnosed in 11% of them, 14% were obese and low weight was found in 10% of the sample. There was a significative difference in the BMI/A related to the sex: alterations were observed in the 26% of girls and 42% of boys (p<0,01). The difference was attributed to a higher frequency of obesity and overweight in boys. The overall frequency of alterations in the S/A index was 26.4%, and it was more frequent in boys than in girls. The school-children with obesity and overweight showed a higher frequency of high stature compared to normal weight subjects (p<0,05). According to the nutrition evaluation, 8.8% of these school-children showed low weight and height. Conclusion. Our results reveal a substantial increase in frequency of obesity and overweight in children from educational centers in Mérida city-Venezuela. The potential consequences in terms of morbidity and mortality, should be taking in consideration in order to develop secure and preventive strategies. Individuals at risk should be identified. Promoting regular physical activities in childhood and improving the quality of nutrition, are priorities to overcome these problems.