Abstract
Objectives: Although the association between thyroid stimulating hormone (TSH) and obesity in children has been investigated in several cross-sectional studies, no study evaluated this association among girls during puberty, which were in a key period closely related to the fluctuations of thyroid hormones and development of obesity. Therefore, we conducted a cohort study to investigate the association of general and abdominal obesity with TSH in girls during puberty.Setting and participants: A cohort study of 481 school-aged girls during puberty was conducted in four regions in east China, with a baseline survey in 2017 and a follow-up survey in 2019.Outcome measures: Anthropometric indexes including height, weight and waist circumference (WC) were measured, and body mass index (BMI) was then calculated. Blood samples were collected to determine TSH and free thyroxine (FT4).Results: Of the 474 girls at baseline survey, the prevalences of BMI-based general obesity and WC-based abdominal obesity were 19.8% (94/474) and 21.7% (103/474), respectively. Compared with normal weight girls, the median serum TSH level was significantly higher in general obese girls (P = 0.037), but not in central obese girls (P = 0.173). Multiple logistic regression models indicated that those in the highest tertile of serum TSH level had a significantly higher risk of BMI-based overweight/obesity (OR = 1.83, 95% CI 1.01 to 3.32) compared with the lowest tertile. Analyses from 435 girls prospectively followed-up for 2 years revealed that those with general or central obesity also had higher follow-up TSH level (P = 0.004 and P = 0.008, respectively). The TSH level for girls with general obesity at baseline but normal weight at follow-up was 0.45 mU/L (95% CI 0.11 to 0.79) higher than those with normal weight at baseline and follow-up.Conclusions: TSH was positively associated with both general and abdominal obesity among girls during puberty.
Highlights
Overweight and obesity are defined as abnormal and excess fat accumulation due to an imbalance between calorie intake and expenditure
The prevalence was 19.83% for general overweight/obesity based on body mass index (BMI), and was 21.73% for central overweight/obesity based on waist circumference (WC) (Table 1)
Overweight/obese girls had a higher serum thyroid stimulating hormone (TSH) concentration than under/normal weight girls, but serum free thyroxine (FT4) levels show no significant difference between the two groups (P = 0.280)
Summary
Overweight and obesity are defined as abnormal and excess fat accumulation due to an imbalance between calorie intake and expenditure. The prevalence of overweight and obesity among children and adolescents aged 5–19 years has increased dramatically from 4% in 1975 to over 18% in 2016 globally [1]. Childhood obesity has been linked to increased risks of asthma [2], metabolic syndrome [3], cardiovascular diseases (CVD) [4] and premature death in adulthood [5]. Overweight compared with normal weight children are more likely to be obese in adulthood [6]. Obesity is related to multiple endocrine alterations including various hormones [7, 8]. Identifying hormonal targets may help obesity prevention and control
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