title: Thyroid function derangement and childhood obesity: an Italian experience.
abstract: BACKGROUND
  In recent years, there has been an increasing attention to thyroid function in paediatric obese patients. In the present study we aimed 1) to determine the prevalence of abnormally elevated thyroid-stimulating hormone (TSH) levels in Italian obese children and adolescents 2) to investigate whether hyperthyrotropinemia in obese children cardiovascular and metabolic risk factors 3) to verify if TSH elevation is reversible after weight loss.
  
  
  METHODS
  We examined 938 obese children and adolescents (450 females). Anthropometric, metabolic and hormonal variables were determined at baseline and, in a subgroup of children with hyperthyrotropinemia, after a six month weight loss program.
  
  
  RESULTS
  Hyperthyrotropinemia (TSH >/=4.2 muUI/ml) was diagnosed in 120 patients (12,8%). Body mass index (BMI) z-score (p = 0.02) and free T3 (fT3) levels (p = 0.03) were higher in patients with elevated TSH compared to the group with normal TSH. There were not significant differences in other metabolic parameters between the two groups.A positive correlation between baseline TSH and BMI z-score (p = 0.0045) and between Ft3 and BMI z-score (p = 0.0034) was observed, while there was no correlation between TSH and lipids. Twenty-three patients among those with hyperthyrotropinemia who participated to weight reduction intervention (64 patients), presented substantial weight loss and concomitantly a significant decrease in TSH and in fT3.
  
  
  CONCLUSIONS
  These results suggest that: (1) a moderate elevation of TSH concentrations, is frequently found in obese children; (2) in obese children increase of TSH is not associated to metabolic risk factors, (3) hyperthyrotropinemia is reversible after weight loss and these data suggest that it should not be treated.
authors.affiliation: Department of Pediatrics "F, Fede", Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 2, 80138, Napoli, Italy. agrandone@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Grandone
authors.forename: Nicola
authors.initials: N
authors.lastname: Santoro
authors.forename: Filomena
authors.initials: F
authors.lastname: Coppola
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.forename: Laura
authors.initials: L
authors.lastname: Perrone
authors.forename: Emanuele Miraglia
authors.initials: EM
authors.lastname: Del Giudice