Abstract
The interest in the relationship between thyroid dysfunction and obesity is on the increase. This study compares the triiodothyronine-to-thyroxine (T3/T4) ratio in obese and lean children and adolescents, and correlates thyroid hormones with body mass index (BMI) in obese Nigerian children. It is a retrospective study of records of 76 obese children and adolescents with a BMI of 31.7 ± 0.1 kg/m2 (26 males aged 10.9 ± 0.35 years, and 50 females aged 10.8 ± 0.4 years) that were referred to the laboratory for thyroid hormone evaluation because of their obese status. The controls were 20 age-matched non-obese apparently healthy subjects, with a mean age of 11.0 ± 0.47 years and a BMI of 20.2 ± 0.2 kg/m2. Serum T3, T4, and thyroid stimulating hormone (TSH) were determined using ELECSYS 1010 auto-analyzer (Roche Diagnostics, Penzberg, Germany). The BMI (p < 0.001), T3 (p < 0.01), TSH (p < 0.001) and T3/T4 ratio (p < 0.001) were significantly higher in obese than non-obese children and adolescents. Triiodothyronine (r = 0.230; p < 0.05), TSH (r = 0.272; p < 0.02), and T3/T4 ratio (r = 0.232; p < 0.05) correlated positively with BMI in obese children and adolescents. The T3/T4 ratio (p < 0.005) was significantly higher in obese boys than obese girls. Serum T3, TSH, and T3/T4 ratio correlated positive with BMI in obese Nigerian children and adolescents. Since thyroid dysfunction represents a continuum from asymptomatic to clinical symptomatic disease, it is suggested that obese children be counseled on the need to maintain ideal BMI in order to avoid the risks associated with obesity.
Highlights
Childhood obesity has emerged as a public health challenge in both developed and developing countries of the world
We previously reported sub-clinical hypothyroidism in Nigerian obese children and adolescents characterized by elevated thyroid stimulating hormone (TSH) [15]
This study observed a positive association between T3, TSH, T3/T4 ratio, and body mass index (BMI) in obese children and adolescents
Summary
Childhood obesity has emerged as a public health challenge in both developed and developing countries of the world. The thyroid hormones are involved in the control of energy homeostasis and impact on body weight, thermogenesis, and lipid metabolism [1,2]. It was reported that thyroid stimulating hormone (TSH) induces differentiation of pre-adipocytes into adipocytes via its receptors in fat tissues (adipocytes) [3,4]. Previous studies have reported high serum levels of TSH with normal levels of triiodothyronine (T3) and thyroxine (T4) (sub-clinical hypothyroidism) in obese subjects [7,8,9,10]. Thyroid abnormalities were previously regarded as a cause of obesity, but recent studies have observed that they are considered an adaptation process aimed at increasing resting energy expenditure and total energy expenditure.
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