Endocrine Abstracts (2013) 32 P798 | DOI: 10.1530/endoabs.32.P798

Subclinical hypothyroidism in obese children: the influence of L-thyroxin treatment on metabolic comorbidities and a success of dietary therapy

Pawel Matusik, Aleksandra Januszek-Trzciakowska & Ewa Malecka-Tendera

Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland.

Introduction: Subclinical hypothyroidism (sHT) is defined as elevated level of TSH with normal levels of thyroid hormone. In obese children there is a high frequency of this disturbance. However, the influence of sHT on therapy success and an appearance of metabolic complications in childhood obesity is unclear. Furthermore, the supplementation L-thyroxin (L-T4) in this case seems to be very controversial.

Aim: The aim of this study was to evaluate of sHT appearance and L-T4 treatment influence on metabolic complication and therapy success in obese children.

Materials and methods: Medical records of 55 obese children with sHT diagnosed underwent retrospective analysis. 29 children (group 1) L-T4 treated with mean age 9.8 years and mean BMI – 27.1 kg/m2. Not treated group: 26 children with mean age – 10.1 years.and BMI – 27.2 kg/m2 (group 2). Both groups received dietetic and behavioural counselling. Anthropometrical parameters, metabolic complications and efficiency of dietary therapy were analysed in both groups.

Results: In 1 and 2 g respectively 86.2 and 80.8% of children showed up on a check-up visit. There was no significant difference in frequency of metabolic complications between both groups. Proportion of children that obtained the body mass loss was similar (48% in 1 g and 43% in 2 g). The efficiency of therapy presented by delta of BMI Z-score (S.D.) was also comparable (Δ Z-score BMI was respectively −0.55 and −0.63 S.D.). Normalisation of TSH was gained at 62% of children in group not treated with L-T4.

Conclusions: sHT doesn’t decrease the efficiency of dietary therapy in children. The L-T4 treatment of sHT in children has no influence on frequency of metabolic complications and efficiency of therapy. The body mass reduction in obese children with sHT enables the normalization of TSH without the necessity of pharmacotherapy.

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