Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 32
Issue: 5
Pages: 471-478
Volume: 32
Issue: 5
Pages: 471-478
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Obesity-related thyroiditis in childhood: relationship with insulin resistance
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Background
Thyroid dysfunction is the most common hormonal abnormality in obesity. It should actually be considered as an adaptation response to fat excess. However, little has been reported on the morphology of the thyroid gland, and no data regarding the relationship between thyroid gland changes and metabolic parameters are available in obese adolescents.
Objective
The study aimed to evaluate the frequency of non-autoimmune thyroiditis in obese adolescents and compare the metabolic status of patients with or without thyroiditis.
Methods
A total of 218 obese children and 49 age-matched control healthy children were included. Thyroid ultrasonography (USG) was performed in all participants, as well as thyroid hormone levels, thyroid antibodies (Abs), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR) and high-sensitivity C-reactive protein (HsCRP) were determined. Obese children were divided into three groups according to the presence of thyroid autoantibodies and USG findings of thyroiditis (Group-1: Abs [−], normal thyroid morphology/Group-2: Abs [+], abnormal thyroid morphology/Group-3: Abs [−], abnormal thyroid morphology). The relationship between body mass index, metabolic parameters and thyroid gland status was analyzed.
Results
Seventy-two of 218 obese patients (33%) had non-autoimmune thyroiditis (Group-3). The rate of insulin resistance was significantly higher in Group-3 than in Group-1 (p = 0.024). Similarly, the frequency of metabolic syndrome (MS) was higher in Group-3 (44.3%) than in Group-1 (27.1%) (p = 0.014).
Conclusions
Obese adolescents with non-autoimmune thyroiditis had a higher incidence of insulin resistance. This finding supported the hypothesis that insulin resistance may have an effect on thyroid morphology. Further randomized trials investigating this relationship are required.
Keywords: adolescents; children; insulin resistance; non-autoimmune thyroiditis; obesity
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About the article
Received: 2018-11-26
Accepted: 2019-03-14
Published Online: 2019-05-01
Published in Print: 2019-05-27
Author contributions: Concept: FD, TAÖ, HK, GSK; Design: FD, HK, GSK, TAÖ; Data collection or processing: FD, TAÖ, GSK, HK; Analysis or interpretation: FD, GSK, HK, TAÖ; Literature search: FD, TAÖ, GSK, HK; Writing: FD, HK, TAÖ. The first author is FD. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 32, Issue 5, Pages 471–478, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2018-0516.
©2019 Walter de Gruyter GmbH, Berlin/Boston.
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