Thyroid hormone levels in obese children and adolescents with non-alcoholic fatty liver disease.
Thyroid hormone levels in obese children and adolescents with non-alcoholic fatty liver disease.
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DOI：
10.4274/jcrpe.1155
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发表时间：
2014
影响因子：
1.9
通讯作者：
Cesur Y
中科院分区：
文献类型：
--
作者：
Torun E;Özgen IT;Gökçe S;Aydın S;Cesur Y
目的：探讨儿童肥胖患者甲状腺功能与代谢综合征(MS)和非酒精性脂肪性肝病(NAFLD)的相关性。方法：本研究包括109名9-15岁肥胖儿童和44名年龄和性别匹配的正常体重儿童作为对照组。NAFLD通过常规超声检查确诊。测定血脂、丙氨酸氨基转移酶(ALT)、空腹血糖和胰岛素水平以及促甲状腺激素(TSH)、游离甲状腺素(FT4)和游离三碘甲腺原氨酸(FT3)水平。计算胰岛素抵抗的稳态模型评估(HOMA-IR)作为胰岛素抵抗的衡量标准。结果：两组的平均年龄和性别分布相似(p=0.23)。2~3级非酒精性脂肪肝肥胖儿童的平均体重指数z-分值显著高于无肝脂肪变性的肥胖儿童(p<；0.001)。随着肝脏脂肪变性程度的加重，平均ALT、甘油三酯(TG)和低密度脂蛋白(LDL)显著升高，而高密度脂蛋白(HDL)显著降低(p<；0.05)。2~3级非酒精性脂肪肝肥胖组的HOMA-IR水平显著高于非酒精性脂肪肝肥胖组和非酒精性脂肪肝肥胖组(p=0.001)。在肥胖者中，TSH水平随着脂肪变性程度的增加而显著升高(P=0.04)，而FT3和FT4水平无显著差异。相关分析显示，TSH与ALT、BMI、SDS、脂肪变性程度呈显著正相关。结论：肥胖儿童的TSH水平随着脂肪变性程度的增加而升高。
Objective: We aimed to determine the association of thyroid functions with the components of metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) in pediatric obese patients. Methods: The study included 109 obese children (aged 9-15 years) and a control group of 44 healthy age and gender-matched children of normal weight. NAFLD was diagnosed by conventional ultrasound examination. We assessed the anthropometric data and serum biochemical parameters including lipid profile, alanine aminotransferase (ALT), fasting glucose and insulin levels and thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) levels. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as a measure of IR. Results: The mean age and gender distributions in the groups were similar (p=0.23). The mean body mass index (BMI) z-scores of obese children with grade 2-3 NAFLD were significantly higher than those of the obese children without hepatic steatosis (p<0.001). Mean ALT, triglyceride (TG) and LDL cholesterol increased and HDL-cholesterol significantly decreased as the hepatic steatosis increased (p<0.05). HOMA-IR levels in obese subjects with grade 2-3 NAFLD were significantly higher than those in both obese children without NAFLD and grade 1 NADFL (p=0.05 and 0.001, respectively). In the obese subjects, TSH levels were increased significantly as the degree of steatosis increased (p=0.04) but fT3 and fT4 levels were not different. In correlation analysis, TSH was significantly correlated with ALT, BMI SDS and the degree of steatosis. Conclusions: Obese children demonstrate an increase in TSH levels as the degree of steatosis increased.