title: Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents.
abstract: OBJECTIVE
  To investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  27 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 <2.5mIU/mL exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values.
  
  
  CONCLUSIONS
  SCH 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.
authors.affiliation: Instituto Estadual de Diabetes e Endocrinologia (IEDE), Divisão de Metabologia, Rio de Janeiro, RJ, Brazil. Electronic address: lu-lopes@uol.com.br.
authors.forename: Luciana Lopes de
authors.initials: LL
authors.lastname: Souza
authors.affiliation: Instituto Estadual de Diabetes e Endocrinologia (IEDE), Divisão de Metabologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Erika Paniago
authors.initials: EP
authors.lastname: Guedes
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), Divisão de Endocrinologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Patrícia Fátima Dos Santos
authors.initials: PF
authors.lastname: Teixeira
authors.affiliation: Instituto Estadual de Diabetes e Endocrinologia (IEDE), Divisão de Metabologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Rodrigo Oliveira
authors.initials: RO
authors.lastname: Moreira
authors.affiliation: Instituto Estadual de Diabetes e Endocrinologia (IEDE), Divisão de Metabologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Amelio Fernando
authors.initials: AF
authors.lastname: Godoy-Matos
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), Divisão de Endocrinologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Mario
authors.initials: M
authors.lastname: Vaisman
mesh_terms: D000293:Adolescent; D001938:Brazil; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D050177:Overweight / Q000097:blood* / Q000150:complications; D063766:Pediatric Obesity / Q000097:blood* / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood*; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D013972:Thyrotropin
keywords: Adolescentes; Adolescents; Cardiovascular risk factors; Fatores de risco cardiovascular; Hipotireoidismo subclínico; Obesidade; Obesity; Overweight; Sobrepeso; Subclinical hypothyroidism