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Thyroid Function and Structure Are Affected in Childhood Obesity

Departments of Pediatrics (G.R., W.K., L.P.) and Internal Medicine (C.C.), Regional Hospital of Bolzano, 39100 Bolzano, Italy; Department of Pediatrics (F.B.), University of Brescia, 15-25121 Brescia, Italy; and Department of Pediatrics (N.d.I., M.M.), IRCCS G. Gaslini Institute, University of Genova, 16147 Genova, Italy

Address all correspondence and requests for reprints to: Dr. Giorgio Radetti, Department of Pediatrics, Regional Hospital, via L. Boehler 5, 39100 Bolzano, Italy. E-mail: giorgio.radetti{at}asbz.it.

Objective: Alterations in thyroid function are reported in obesity, although no relevant data exist on the thyroid structure of these patients and the frequency of autoimmunity. The aim of our study was to evaluate the involvement of the thyroid gland in a large group of obese children.

Design: This was a cross-sectional study.

Methods: The study was conducted between March 2004 and December 2007 in 186 overweight and obese children. In all subjects, serum free T₃, free T₄, TSH, antithyroid antibodies, and a thyroid ultrasound were assessed. A total ot 40 healthy children matched for age and of normal weight for height served as controls.

Results: A total of 23 children (12.4%) showed antithyroid antibodies and an ultrasound pattern suggestive of Hashimoto’s thyroiditis (group A). Of them, 20 (10.8%) showed antithyroid antibodies and normal ultrasound (group B). A total of 70 subjects (37.6%) showed absent antithyroid antibodies and an ultrasound pattern suggestive of Hashimoto’s thyroiditis (group C), and 73 children (39.2%) showed no thyroid antibodies with normal ultrasound (group D). TSH was higher in groups A and C compared with groups B and C, and controls (P < 0.05). Mean free T₄ was lower in group B (P < 0.05) than in controls, whereas free T₃ was higher in group C than in controls (P < 0.05). TSH and body mass index SD scores were significantly correlated in group C (P < 0.001), and TSH was also significantly associated with the degree of thyroid structure alterations (P < 0.05).

Conclusion: Obese children frequently show alterations of thyroid structure and function that are not completely explained by the presence of an autoimmune involvement.

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