Obez çocuk ve adölesanlarda tiroid fonksiyonlarının değerlendirilmesi
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Tarih
2019
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
Attribution-NonCommercial 3.0 United States
info:eu-repo/semantics/closedAccess
info:eu-repo/semantics/closedAccess
Özet
Amaç: Bu çalışmada, obez çocuk ve adölesanlarda tiroid fonksiyonları ile metabolik ve antropometrik parametreler arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntemler: Çalışmaya pediatrik endokrinoloji polikliniğinde eksojen obezite tanısı konulan 147 hasta ile benzer yaş ve cinsiyette
46 sağlıklı birey alındı. Obez hastalar Grup 1 (karaciğerde yağlanma olmayan) ve Grup 2 (karaciğerde yağlanma olan) olarak iki gruba ayrıldı. Hasta ve kontrol grubundaki (Grup 3) tüm vakalardan açlık glukoz, insülin, total kolesterol, trigliserid, aspartat aminotransferaz, alanin aminotransferaz, tiroid uyarıcı hormon (TSH), serbest triiyodotironin (fT3) ve serbest tiroksin (fT4) için örnek alındı. İnsülin direnci HOMA-IR (Homeostatic Model Assesment for Insulin Resistance) ile değerlendirildi. Bulgular: Grup 2’de bel çevresi (BÇ), beden kitle indeksi - standart deviasyon skorları (SDS), kalça çevresi (KÇ), BÇ/KÇ oranı ile
trigliserid, açlık insülin ve HOMA-IR değerleri Grup 1 ve Grup 3’e göre anlamlı derecede yüksek iken yüksek dansiteli lipoprotein kolesterol düzeyi daha düşük idi. Obezitesi olan gruplarda (karaciğerde yağlanma olan ve olmayan) fT4 düzeyi kontrol grubuna göre anlamlı düzeyde düşük iken
fT3/fT4 oranı daha yüksek idi. Ortalama TSH düzeyi Grup 2’de Grup 3’e göre daha yüksek saptandı. fT3/fT4 oranı; BÇ, BÇ/KÇ oranı, açlık insülin ve HOMA-IR ile pozitif korelasyon göstermekteydi.
Sonuç: Obez çocuklarda fT4 düzeyinin düşük olduğu, fT3/fT4 oranının ise daha yüksek olduğu tespit edilmiştir. Obez çocuklarda yüksek fT3/fT4 oranının saptanması durumunda bu oranın BÇ ve insülin direnci ile pozitif korelasyon gösterdiği düşünülerek visseral yağ dokusuyla ilişkili komplikasyonlar konusunda klinisyen için uyarıcı olmalıdır.
Background: The aim of this study was to evaluate the relationship between thyroid functions and metabolic and anthropometric parameters in obese children and adolescents. Methods: The study included 147 patients diagnosed with exogenous obesity in the pediatric endocrinology outpatient clinic and 46 healthy subjects with similar age and sex. Obese patients were divided into two groups as Group 1 (non-fatty liver) and Group 2 (with fatty liver). Fasting glucose, insulin, total cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase, thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) samples were performed from all cases in patient groups and control group (Group 3). Insulin resistance was assessed by HOMA-IR (Homeostatic Model Assessment of Insulin Resistance). Results: In Group 2, waist circumference (WC), body mass index-standard deviation scores (SDS), hip circumference (HC), WC/ HC ratio and triglyceride, fasting insulin and HOMA-IR values were significantly higher than Group 1 and Group 3 while high density lipoprotein cholesterol level was lower. In Group 1 and Group 2, fT4 level was significantly lower than Group 3, whereas fT3 / fT4 ratio was higher. The mean TSH level was higher in Group 2 than Group 3. fT3 / fT4 ratio; WC, WC / HC ratio was positively correlated with fasting insulin and HOMA-IR. Conclusion: We found that fT4 level was low and fT3 / fT4 ratio was higher in obese children. Considering the high fT3 / fT4 ratio in obese children, this ratio should be stimulating for the clinician regarding the complications associated with visceral adipose tissue as it is positively correlated with WC and insulin resistance.
Background: The aim of this study was to evaluate the relationship between thyroid functions and metabolic and anthropometric parameters in obese children and adolescents. Methods: The study included 147 patients diagnosed with exogenous obesity in the pediatric endocrinology outpatient clinic and 46 healthy subjects with similar age and sex. Obese patients were divided into two groups as Group 1 (non-fatty liver) and Group 2 (with fatty liver). Fasting glucose, insulin, total cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase, thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) samples were performed from all cases in patient groups and control group (Group 3). Insulin resistance was assessed by HOMA-IR (Homeostatic Model Assessment of Insulin Resistance). Results: In Group 2, waist circumference (WC), body mass index-standard deviation scores (SDS), hip circumference (HC), WC/ HC ratio and triglyceride, fasting insulin and HOMA-IR values were significantly higher than Group 1 and Group 3 while high density lipoprotein cholesterol level was lower. In Group 1 and Group 2, fT4 level was significantly lower than Group 3, whereas fT3 / fT4 ratio was higher. The mean TSH level was higher in Group 2 than Group 3. fT3 / fT4 ratio; WC, WC / HC ratio was positively correlated with fasting insulin and HOMA-IR. Conclusion: We found that fT4 level was low and fT3 / fT4 ratio was higher in obese children. Considering the high fT3 / fT4 ratio in obese children, this ratio should be stimulating for the clinician regarding the complications associated with visceral adipose tissue as it is positively correlated with WC and insulin resistance.
Açıklama
Anahtar Kelimeler
İnsülin direnci, Karaciğer yağlanması, Obezite, Tiroid fonksiyonları, Insulin resistance, Fatty liver, Obesity, Thyroid functions
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
46
Sayı
2
Künye
Ünal, E., Taş, F.F., Kaya, M.M., Yıldırım, R., Aktar, F., Haspolat, Y.K. (2019). Obez çocuk ve adölesanlarda tiroid fonksiyonlarının değerlendirilmesi. Dicle Tıp Dergisi. 46(2), 335-343
