title: Subclinical hypothyroidism and myocardial function in obese children.
abstract: OBJECTIVE
  Pediatric obesity is an important health problem representing a major public health concern worldwide in the last decades. An isolated elevation of Thyroid Stimulating Hormone (TSH) with normal levels of thyroid hormones is frequently found in obese children. It has been named Isolated Hyperthyreotropinemia or Subclinical Hypothyroidism (SCH) and may be considered a consequence of obesity. Evidence exists that SCH is related to impairment of both systolic and diastolic myocardial function in the adult population. The aim of our study is to establish if obesity-related SCH influences myocardial function in children.
  
  
  RESULTS
  We examined 34 obese children and adolescents with SCH and 60 obese children with normal TSH levels who underwent Doppler echocardiographic to evaluate myocardial function. Global systolic function as assessed by Ejection Fraction (EF) was comparable between groups, however Right Ventricle pressure global systolic function and pressure were significantly reduced in SCH group. Mitral annulus peak systolic (MAPSE) excursion lateral and MAPSE septum resulted significantly reduced in SCH group. Tissue Doppler imaging peak systolic motion (TDI-S) was reduced in SCH group. Diastolic function also showed significant modifications in SCH group.
  
  
  CONCLUSIONS
  These results suggest possible involvement of cardiac function in obese children with SCH resulting in both abnormal diastolic function and reduced longitudinal systolic function. This new insight into cardiovascular consequences of obesity-related SCH in children could influence clinical approach to such patients by pediatric endocrinologists.
authors: Department of Pediatrics, Second University of Naples, Via De Crecchio 4, 80138 Naples, Italy. Electronic address: carmineus@gmail.com.
authors: C
authors: C
authors: Brienza
authors: A
authors: A
authors: Grandone
authors: G
authors: G
authors: Di Salvo
authors: A M
authors: AM
authors: Corona
authors: A
authors: A
authors: Di Sessa
authors: C
authors: C
authors: Pascotto
authors: R
authors: R
authors: Calabrò
authors: R
authors: R
authors: Toraldo
authors: L
authors: L
authors: Perrone
authors: E Miraglia
authors: EM
authors: del Giudice
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology; D063766:Pediatric Obesity / Q000150:complications / Q000503:physiopathology*; D013599:Systole / Q000502:physiology; D013963:Thyroid Hormones / Q000097:blood; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D013963:Thyroid Hormones; D014280:Triglycerides