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Rijks J, Penders B, Dorenbos E, Straetemans S, Gerver WJ, Vreugdenhil A. Pituitary response to thyrotropin releasing hormone in children with overweight and obesity. Sci Rep 2016; 6:31032. [PMID: 27485208 PMCID: PMC4971570 DOI: 10.1038/srep31032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/12/2016] [Indexed: 12/27/2022] Open
Abstract
Thyroid stimulating hormone (TSH) concentrations in the high normal range are common in children with overweight and obesity, and associated with increased cardiovascular disease risk. Prior studies aiming at unravelling the mechanisms underlying these high TSH concentrations mainly focused on factors promoting thyrotropin releasing hormone (TRH) production as a cause for high TSH concentrations. However, it is unknown whether TSH release of the pituitary in response to TRH is affected in children with overweight and obesity. Here we describe TSH release of the pituitary in response to exogenous TRH in 73 euthyroid children (39% males) with overweight or (morbid) obesity. Baseline TSH concentrations (0.9–5.5 mU/L) were not associated with BMI z score, whereas these concentrations were positively associated with TSH concentrations 20 minutes after TRH administration (r2 = 0.484, p < 0.001) and the TSH incremental area under the curve during the TRH stimulation test (r2 = 0.307, p < 0.001). These results suggest that pituitary TSH release in response to TRH stimulation might be an important factor contributing to high normal serum TSH concentrations, which is a regular finding in children with overweight and obesity. The clinical significance and the intermediate factors contributing to pituitary TSH release need to be elucidated in future studies.
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Affiliation(s)
- Jesse Rijks
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,School of Nutrition &Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands
| | - Bas Penders
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Elke Dorenbos
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,School of Nutrition &Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands
| | - Saartje Straetemans
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,School of Nutrition &Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands
| | - Willem-Jan Gerver
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,School of Nutrition &Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands
| | - Anita Vreugdenhil
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,School of Nutrition &Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands
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Lobotková D, Staníková D, Staník J, Cervenová O, Bzdúch V, Tichá L. Lack of association between peripheral activity of thyroid hormones and elevated TSH levels in childhood obesity. J Clin Res Pediatr Endocrinol 2014; 6:100-4. [PMID: 24932603 PMCID: PMC4141570 DOI: 10.4274/jcrpe.1251] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE An elevated thyroid stimulating hormone (TSH) level is a frequent finding in obese children, but its association with peripheral hormone metabolism is not fully understood. We hypothesized that in obesity, the changes in thyroid hormone metabolism in peripheral tissues might lead to dysregulation in the thyroid axis. The purpose of this study was to investigate the association of TSH with thyroid hormones in a group of obese children as compared to normal-weight controls. METHODS Serum TSH, free thyroxine (fT4) and free triiodothyronine (fT3) levels were measured in 101 obese children and in 40 controls. Serum reverse T3 (rT3) levels were also measured in a subgroup of 51 obese children and in 15 controls. RESULTS Serum TSH level was significantly higher in obese children compared to controls (2.78 vs. 1.99 mIU/L, p<0.001), while no difference was found in fT4, fT3, rT3 levels and in fT3/rT3 ratio. In the obese group, fT3 level positively correlated with fT4 (r=0.217, p=0.033) and inversely with rT3 (r=-0.288, p=0.045). However, thyroid hormone levels and TSH levels were not correlated. CONCLUSION In obese children, normal fT4, fT3 and rT3 levels suggest an undisturbed peripheral hormone metabolism. These levels show no correlation with elevated TSH levels.
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Affiliation(s)
- Denisa Lobotková
- Comenius University Faculty of Medicine and Children's University Hospital, Department of Pediatrics, Bratislava, Slovakia. E-ma-il:
| | - Daniela Staníková
- Comenius University Faculty of Medicine and Children’s University Hospital, Department of Pediatrics, Bratislava, Slovakia
| | - Juraj Staník
- Comenius University Faculty of Medicine and Children’s University Hospital, Department of Pediatrics, Bratislava, Slovakia
| | - Ol’ga Cervenová
- Comenius University Faculty of Medicine and Children’s University Hospital, Department of Pediatrics, Bratislava, Slovakia
| | - Vladimír Bzdúch
- Comenius University Faculty of Medicine and Children’s University Hospital, Department of Pediatrics, Bratislava, Slovakia
| | - L’ubica Tichá
- Comenius University Faculty of Medicine and Children’s University Hospital, Department of Pediatrics, Bratislava, Slovakia
,* Address for Correspondence: Comenius University Faculty of Medicine and Children’s University Hospital, Department of Pediatrics, Bratislava, Slovakia Phone: +421 259 371 871 E-mail:
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Abstract
The increasing prevalence of obesity and its comorbidities reflects the interaction of genes that favor the storage of excess energy as fat with an environment that provides ad libitum availability of energy-dense foods and encourages an increasingly sedentary lifestyle. Although weight reduction is difficult in and of itself, anyone who has ever lost weight will confirm that it is much harder to keep the weight off once it has been lost. The over 80% recidivism rate to preweight loss levels of body fatness after otherwise successful weight loss is due to the coordinate actions of metabolic, behavioral, neuroendocrine and autonomic responses designed to maintain body energy stores (fat) at a central nervous system-defined 'ideal'. This 'adaptive thermogenesis' creates the ideal situation for weight regain and is operant in both lean and obese individuals attempting to sustain reduced body weights. Much of this opposition to sustained weight loss is mediated by the adipocyte-derived hormone 'leptin'. The multiple systems regulating energy stores and opposing the maintenance of a reduced body weight illustrate that body energy stores in general and obesity in particular are actively 'defended' by interlocking bioenergetic and neurobiological physiologies. Important inferences can be drawn for therapeutic strategies by recognizing obesity as a disease in which the human body actively opposes the 'cure' over long periods of time beyond the initial resolution of symptomatology.
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Affiliation(s)
- M Rosenbaum
- Division of Molecular Genetics, Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY, USA.
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