PROGNOSTIC FACTORS AND OUTCOMES IN OBESE AND OVERWEIGHT CHILDREN WITH SUBCLINICAL HYPOTHYROIDISM

Hazar Monif* and Ahmad Chreitah

ABSTRACT

Objectives: Subclinical hypothyroidism (SH) is known as high concentrations of serum thyroid stimulating hormone (TSH) above the upper limits with normal concentrations of free Thyroxine (F T4). Its prevalence rates have increased in children, especially with obesity. This study was conducted to evaluate the most important prognostic factors associated with the clinical course of (SH) in obese and overweight children. Methods: A prospective Analytical prognostic study was carried out on 52 overweight and obese children, aged between (3-14) years, diagnosed with (SH) in the pediatric endocrinology clinic in Lattakia, starting in June 2021 and, lasted for 18 months. Demographic, clinical, anthropometric, and, thyroid function parameters were evaluated every 6 months for all participants, and they received healthy lifestyle modifications. Results: Of the 52 obese and overweight children, TSH values returned to normal in 35 children (67.3%). By the univariate analysis, the following prognostic factors were associated with the normalization of TSH values: A Decrease in body mass index (BMI) with (p-value= 0.03), and lower initial TSH valuewith (p-value= 0.001), and in females with (p-value =0.03). Multivariate regression analysis revealed reduction BMI as the independent predictor for healing of TSH values, with an odds ratio of 3.2(95% confidence interval [CI] 1.4-7.3) (p-value 0.001). Of the 29 children tested for thyroid antibodies, only 3 (10.3%) were positive. Conclusion: The majority of cases of subclinical hypothyroidism in obese children resolve spontaneously and reducing the body mass index is considered the most important factor in improving TSH values.

Keywords: body mass index; obesity; subclinical hypothyroidism; weight loss.