Abstract

Purpose In this study, we investigated the status of thyroid function and its association with metabolic risk factors in Korean adolescents. Methods Among 2679 subjects aged 10–19 years who participated in the Korea National Health and Nutrition Examination Survey VI (2013–2015), 1067 adolescents (M = 559, F = 508) with available data on free T4 (FT4) and thyroid-stimulating hormone (TSH) were included. Study participants were classified into normal weight [body mass index (BMI) below 85th percentile, 80.7%], overweight (85th ≤ BMI< 95th percentile, 8.7%), and obesity (BMI ≥ 95th percentile, 10.6%). Results With increasing levels of BMI category, the means of TSH increased (2.73 ± 0.06, 2.77 ± 0.02, and 3.24 ± 0.22 mIU/L, P = 0.031) and FT4 decreased (1.30 ± 0.01, 1.26 ± 0.02, and 1.25 ± 0.02 ng/mL, P = 0.001). Positive linear associations were observed between TSH and BMI z-score (P = 0.031), waist circumference (P = 0.013), waist-height ratio (P = 0.002), systolic blood pressure (P = 0.001), total cholesterol (P = 0.008), and triglyceride (P = 0.002) after adjusting for age and sex. With per-unit increase in TSH, the odds ratios of having abdominal obesity (OR = 1.18, 95% CI, 1.01–1.38) and triglyceride ≥ 150 mg/dL (OR = 1.18, 95% CI, 1.04–1.34) were significantly increased after adjusting for age, sex, and BMI. Conclusions In adolescents with obesity, TSH was higher and FT4 was lower than in adolescents with normal weight. Hyperthyrotropinemia was associated with abnormal metabolic risk factors including abdominal obesity and elevated triglyceride.

Highlights

  • The prevalence of childhood obesity has significantly increased worldwide and has become an important global public health issue [1]

  • Since alterations in levels of thyroid function test were often normalized with weight loss, they seem to be a reversible consequence of the weight status [10, 13]

  • Thyroid Function and Metabolic Risk Factors according to Increasing Levels of body mass index (BMI) Category in 10–19-Year-Old Korean Adolescents

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Summary

Introduction

The prevalence of childhood obesity has significantly increased worldwide and has become an important global public health issue [1]. It is well established that thyroid hormone (TH) status correlates with body weight and energy expenditure [3, 4]. The well-supported hypothesis explaining hyperthyrotropinemia in subjects with obesity is an adaptation process to increase energy expenditure for reducing the availability of energy for conversion into fat [12, 14]. Few reports are available regarding the relationship between obesity and thyroid function in Korean adolescents. There is still a lack of data regarding the relationship between thyroid function and other metabolic risk factors in children with obesity. We conducted a cross-sectional study based on data obtained in the 2013–2015 Korea National Health and Nutrition Examination Surveys (KNHANES) to investigate the status of thyroid function and its association with metabolic risk factors in Korean adolescents

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