title: Thyroid hormone levels in obese children and adolescents with non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  We aimed to determine the association of thyroid functions with the components of metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) in pediatric obese patients.
  
  
  METHODS
  The study included 109 obese children (aged 9-15 years) and a control group of 44 healthy age and gender-matched children of normal weight. NAFLD was diagnosed by conventional ultrasound examination. We assessed the anthropometric data and serum biochemical parameters including lipid profile, alanine aminotransferase (ALT), fasting glucose and insulin levels and thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) levels. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as a measure of IR.
  
  
  RESULTS
  The mean age and gender distributions in the groups were similar (p=0.23). The mean body mass index (BMI) z-scores of obese children with grade 2-3 NAFLD were significantly higher than those of the obese children without hepatic steatosis (p<0.001). Mean ALT, triglyceride (TG) and LDL cholesterol increased and HDL-cholesterol significantly decreased as the hepatic steatosis increased (p<0.05). HOMA-IR levels in obese subjects with grade 2-3 NAFLD were significantly higher than those in both obese children without NAFLD and grade 1 NADFL (p=0.05 and 0.001, respectively). In the obese subjects, TSH levels were increased significantly as the degree of steatosis increased (p=0.04) but fT3 and fT4 levels were not different. In correlation analysis, TSH was significantly correlated with ALT, BMI SDS and the degree of steatosis.
  
  
  CONCLUSIONS
  Obese children demonstrate an increase in TSH levels as the degree of steatosis increased.
authors.affiliation: Bezmialem Vakıf University Medical Faculty, Department of Pediatrics, İstanbul, Turkey. E-ma-il: dr.emeltorun@gmail.com.
authors.forename: Emel
authors.initials: E
authors.lastname: Torun
authors.forename: Ilker Tolga
authors.initials: IT
authors.lastname: Özgen
authors.forename: Selim
authors.initials: S
authors.lastname: Gökçe
authors.forename: Sinem
authors.initials: S
authors.lastname: Aydın
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Cesur
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D005234:Fatty Liver / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000032:analysis; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D015415:Biomarkers; D008055:Lipids; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine