ECEESPE2025 Rapid Communications Rapid Communications 3: Metabolism and Aging (6 abstracts)
Sensitivity to thyroid hormones and glomerular hyperfiltration in children and adolescents with overweight or obesity
Domenico Corica 1 , Procolo Di Bonito 2 , Pierluigi Marzuillo 3 , Maria Rosaria Licenziati 4 , Anna Di Sessa 5 , Emanuele Miraglia Del Giudice 5 , Maria Felicia Faienza 6 , Valeria Calcaterra 7 , Francesca Franco 8 , Giulio Maltoni 9 , Giuliana Valerio 10 & Malgorzata Wasniewska 11
1University of Messina, Department of Economics, Messina, Italy; 2“S. Maria delle Grazie” Hospital, Department of Internal Medicine, Pozzuoli, Italy; 3University of Campania “Luigi Vanvitelli, Department of Woman, Child and of General and Specialized Surgery, Napoli, Italy; 4Santobono-Pausilipon Children’s Hospital, Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Napoli, Italy; 5University of Campania “Luigi Vanvitelli”, Department of Woman, Child and of General and Specialized Surgery, Napoli, Italy; 6University of Bari “Aldo Moro", Department of Precision and Regenerative Medicine and Ionian Area, Bari, Italy; 7University of Pavia, Buzzi Children’s Hospital, Pediatric Department, Milan, Department of Internal Medicine, Pavia, Italy; 8Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, Pediatric Department, Udine, Italy; 9IRCCS Azienda Ospedaliero-Universitaria di Bologna, Pediatric Unit, Bologna, Italy; 10University of Napoli “Parthenope,”, Department of Medical, Movement Sciences and Wellbeing, Napoli, Italy; 11University of Messina, University Hospital "G. Martino" of Messina, Department of Human Pathology of Adulthood and Childhood "G. Barresi", Messina, Italy
JOINT2396
Background: Glomerular hyperfiltration (GHF) is an early manifestation of obesity-related glomerulopathy, with an estimated prevalence of 7 to 31% in childhood. GHF in obesity has been hypothesized to be a physiological adaptation mechanism to the changes the organism undergoes, including increased absolute mass of adipose tissue and body mass, increased cardiac output, increased glomerular pressure. A reduction in GFR has been correlated with a modification in sensitivity to thyroid hormones (THs), particularly a reduction in central sensitivity to THs, both in adults and youths with obesity. However, no data are available regarding the possible correlation between GHF and sensitivity to THs.
Objective: The aim of this study is to evaluate the association between sensitivity to TH and GHF in euthyroid non-diabetic youths with overweight (OW) and obesity (OB).
Material and methods: This cross-sectional study included 654 Caucasian youths with OW or OB (aged 6-18 years) recruited at seven Italian centers for the care of OW/OB. Inclusion criteria were: THs within the normal range in each center, anti-thyroid antibody negativity. Exclusion criteria were: diabetes mellitus, thyroid diseases, renal disease, subclinical hypothyroidism, genetic or endocrine obesity, chronic diseases, pharmacological treatment. Estimated glomerular filtration rate (eGFR) was calculated using Pottel’s formula. Youths with reduced eGFR (<90 ml/min/1.73 m2) were excluded. GHF was defined by eGFR>120 ml/min/1.73 m2. Pulse pressure (PP) was calculated as: systolic blood pressure (BP) minus diastolic BP. The fT3/fT4 ratio was evaluated to assess peripheral sensitivity, while TSH index (TSHI), Thyrotroph T4 Resistance Index (TT4RI), Thyroid Feedback Quantile-based Index (TFQI) and Parametric TFQI (PTFQI) were calculated to assess central sensitivity.
Results : Youth with GHF (n=203) had significantly higher values of peripheral sensitivity to THs (FT3/FT4 ratio 0.46±0.11 vs 0.44±0.09 vs; P=0.004), fasting glucose (89.2±9.0 mg/dl vs 85.5±9.6 vs; P0.0001) and PP (47.5±11.8 vs 45.4±12.8 vs mmHg; P=0.047) compared to youths with normal eGFR. No significant differences were observed for indices of THs central sensitivity. Odds ratio of hyperfiltration rose of 1.04– and 13.16–fold for each increase of 1 mg/dl of fasting glucose (P<0.0001) and 1 mIU/l in FT3/FT4 ratio (P=0.004), respectively, independently of centers, PTFQI and PP.
Conclusions: GHF was associated with an increased peripheral sensitivity to THs in youths with OW/OB. GHF could be an allostatic adaptation mechanism in obesity and may represent early expression of obesity-related glomerulopathy. Further studies are needed to confirm these results.
Volume 110
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