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CV risk parameters tied to TSH concentrations in overweight, obesity
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Thyroid-stimulating hormone concentrations are associated with several cardiovascular risk parameters in children with overweight or obesity and normal thyroid function, study data show.
Anita C.E. Vreugdenhil , MD, PhD, of the Centre for Overweight Adolescent and Children’s Healthcare (COACH), department of pediatrics, Maastricht University Medical Center in the Netherlands, and colleagues evaluated 330 children (median age, 12 years; 43% boys) with overweight (20%), obesity (45%) or severe obesity (35%) and normal thyroid status from the COACH program, a long-term, outpatient, tailored lifestyle intervention, to determine the associations between circulating TSH concentrations and CV risk parameters.
Participants with severe obesity were more likely to have several CV risk factors, including higher serum LDL-cholesterol and C-reactive protein concentrations, homeostasis model of assessment for insulin resistance (HOMA-IR) and diastolic blood pressure compared with participants with overweight or obesity. At baseline, the median serum TSH concentration was 2.6 mU/L and the medial serum free thyroxine (T4) concentration was 12.9 pmol/L.
Serum TSH concentrations were positively associated with serum total cholesterol concentrations (P = .006), LDL-cholesterol concentrations (P = .002), triacylglycerol concentrations (P = .003) and monocyte chemotactic protein-1 concentrations (P = .017) at baseline. Free T4 concentrations were not associated with lipid or lipoprotein concentrations or with markers reflecting proinflammatory status and endothelial dysfunction.
During the intervention, participants who had a decrease in BMI z score also saw improvement in several CV risk parameters. Changes in TSH concentrations were significantly associated with changes in total cholesterol, LDL-cholesterol and triacylglycerol concentrations in participants whose BMI improved.
“In euthyroid overweight and (morbidly) obese children serum TSH concentrations are positively associated with markers representing increased CVD risk, such as [total cholesterol], LDL-[cholesterol], [triacylglycerol] and [monocyte chemotactic protein-1] concentrations,” the researchers wrote. “The additional observation that changes in TSH are associated with changes in [total cholesterol], LDL-[cholesterol], and [triacylglycerol] concentrations in children with successful weight loss after 1 year participating in a lifestyle intervention strengthens the earlier assumptions that serum TSH is indeed an intermediary factor in modulating lipid and lipoprotein metabolism, although causality could not be demonstrated. It is worth exploring in more depth the potential association between TSH and whole body cholesterol metabolism, including endogenous cholesterol synthesis, intestinal cholesterol absorption, and receptor mediated cholesterol clearance.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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