Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents

AbstractObjectiveTo investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents.MethodsA retrospective, longitudinal analysis of 199 overweight and obese pubescent adolescents was performed. The TSH and free T4 (fT4) levels, anthropometric measurements, and laboratory test results of these patients were analyzed.Results27 individuals (13.56%) presented with TSH levels above the normal level (subclinical hypothyroidism [SCH]). Their waist circumference (WC) was significantly higher than those of euthyroid individuals. Serum TSH was positively correlated with the homeostasis model assessment of insulin resistance (HOMA‐IR) index, triglycerides (TG) and high‐density lipoprotein cholesterol (HDL‐C). Using TSH and BMI as independent variables, TSH levels were shown to be independently related to HOMA‐IR (p=0.001) and TG (p=0.007). Among euthyroid subjects, individuals with TSH values<2.5 mIU/mL exhibited statistically significant decreases in waist‐to‐hip ratio, HDL‐C levels, and HOMA‐IR scores and a tendency towards lower WC values.ConclusionSCH in overweight and obese adolescents appears to be associated with excess weight, especially visceral weight. In euthyroid adolescents, there appears to be a direct relationship between TSH and some CRF. In conclusion, in the present sample of overweight and obese adolescents, TSH levels appear to be associated with IR and CRF.ResumoObjetivoInvestigar a relação entre tireotrofina sérica (TSH), resistência à insulina (RI) e fatores de risco cardiovascular (FRC) em uma amostra de adolescentes brasileiros acima do peso e obesos.MétodosFoi realizada uma análise longitudinal retrospectiva de 190 adolescentes púberes acima do peso e obesos. Foram analisados os níveis de TSH e T4 livre (T4l), as medidas antropométricas e os resultados de exames laboratoriais desses pacientes.Resultados27 indivíduos (13,56%) apresentaram níveis de TSH acima do normal (hipotireoidismo subclínico (HSC)). Eles apresentaram circunferência da cintura (CC) significativamente maior que os indivíduos eutireoideos. A TSH sérica foi positivamente correlacionada ao índice do modelo de avaliação da homeostase de resistência à insulina (HOMA‐IR), triglicerídeos (TG) e lipoproteína de alta densidade‐colesterol (HDL‐C). Usando TSH e IMC como variáveis independentes, os níveis de TSH estavam relacionados ao HOMA‐IR (p=0.001) e a TG (p=0.007) de forma independente. Entre os pacientes eutireoideos, indivíduos com valores de TSH