199 Abnormal TSH levels and pediatric obesity

Abstract

<h3></h3> To determine the prevalence of elevated thyroid-stimulating hormone (TSH) levels in obese children and adolescents referred to pediatric endocrinology clinics and its association with positive Anti Thyroid Peroxidase Antibodies. ( Anti TPO) A retrospective review of medical records of 100 obese children referred for abnormal thyroid function test was performed. Children were younger than 18 years of age with BMI above 95th percentile. Data about age, sex, body mass index, TSH, thyroid functions, thyroid antibodies, were collected. All patients were referred for abnormal thyroid function tests and got repeated tests along with Anti TPO levels. Interpretation of TSH results showed normal level for age in 65% and slightly elevate TSH but below 10 uiu/ml in 32% Only three obese patients (3%) had Hashimoto disease (positive Anti TPO) and elevated TSH requiring therapy. Obese children are often screened and referred to pediatric endocrinology for abnormal thyroid function test. It is well known that TSH levels are mildly increased in obese children but there are no evidence –based data that treating this elevation can change the outcome of obesity. Mild elevation of TSH values in the absence of autoimmune thyroid disease is common in obese children and adolescents. This elevation is often a result of obesity rather than a cause. High Leptin level in obese children has been postulated as an etiology. Many primary care providers and even parents are looking for ‘an easy fix’ of obesity by making the diagnosis of hypothyroidism and treating it. Screening for thyroid dysfunction in obese children should be done based on symptoms and family history rather than dealing with obesity alone.