Vol 70, No 2 (2019)
Original paper
Published online: 2018-11-27

open access

Page views 2677
Article views/downloads 1402
Get Citation

Connect on Social Media

Connect on Social Media

The association of thyroid-stimulating hormone (TSH) and free thyroxine (fT4) concentration levels with carbohydrate and lipid metabolism in obese and overweight teenagers.

Katarzyna A. Korzeniowska1, Michał Brzeziński23, Kamila Szarejko2, Marcin Radziwiłł2, Tomasz Anyszek24, Leszek Czupryniak25, Piotr Soszyński26, Per-Olof Berggren7, Malgorzata Mysliwiec12
Pubmed: 30480748
Endokrynol Pol 2019;70(2):172-178.


Introduction: Obesity has increased rapidly among children and adolescents during the last 30 years. Paediatric patients with a BMI above the 85th centile are more often diagnosed with increased TSH levels than are children with proper body weight.

Material and methods: The data of 961 overweight and obese children, aged 13 years, recruited in four cities in Poland as part of PoZdro!, a two-year prophylactic program, were analysed to observe the relationship between serum TSH and fT4 concentration and carbohydrate and lipid metabolism parameters, as well as anthropometric parameters.
Results: TSH concentration in the study group was positively correlated, whereas fT4 concentration was negatively correlated with WHR and WHtR values, fasting serum glucose concentrations and one-hour glucose concentration, fasting serum insulin concentrations, one-hour and two-hour insulin concentration, ALT serum activity, as well as total cholesterol, LDL cholesterol, and triglyceride serum concentrations. An increased risk of metabolic syndrome was diagnosed previously in patients with TSH concentrations > 2.5 mUI/L.

Conclusions: TSH concentration in the upper half of the current reference range (> 2.50 mIU/L) is associated with an increased risk of lipid and carbohydrate metabolism disorders and therefore increased chances of developing metabolic syndrome. It seems advisable to regularly monitor thyroid function in overweight and obese paediatric patients.

Article available in PDF format

View PDF Download PDF file


  1. Güngör NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol. 2014; 6(3): 129–143.
  2. Kowal M, Woronkowicz A, Kryst Ł, et al. Sex differences in prevalence of overweight and obesity, and in extent of overweight index, in children and adolescents (3-18 years) from Kraków, Poland in 1983, 2000 and 2010. Public Health Nutr. 2016; 19(6): 1035–1046.
  3. Kułaga Z, Gurzkowska B, Grajda A, et al. The prevalence of overweight and obesity among Polish pre-school-aged children. Dev Period Med. 2016; 20(2): 143–149.
  4. Wolnicka K, Jarosz M, Jaczewska-Schuetz J, et al. Differences in the prevalence of overweight, obesity and underweight among children from primary schools in rural and urban areas. Ann Agric Environ Med. 2016; 23(2): 341–344.
  5. Rumińska M, Witkowska-Sędek E, Majcher A, et al. Thyroid Function in Obese Children and Adolescents and Its Association with Anthropometric and Metabolic Parameters. Adv Exp Med Biol. 2016; 912: 33–41.
  6. Steinberger J, Daniels S, Eckel R, et al. Progress and Challenges in Metabolic Syndrome in Children and Adolescents. Circulation. 2009; 119(4): 628–647.
  7. Firek-Pędras M, Małecka-Tendera E, Klimek K. Wpływ rozmieszczenia tkanki tłuszczowej na zaburzenia metaboliczne u dzieci i młodzieży z otyłością prostą. [The influence of fat tissue collocation on metabolic disorders in children and teenagers with simple obesity]. Endok. Diabet Chor. Przem. Materii Wieku Rozwoj. 2006; 12: 19–24.
  8. Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian J Endocrinol Metab. 2016; 20(4): 554–557.
  9. Sorof JM, Lai D, Turner J, et al. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004; 113(3 Pt 1): 475–482.
  10. Titmuss AT, Srinivasan S. Metabolic syndrome in children and adolescents: Old concepts in a young population. J Paediatr Child Health. 2016; 52(10): 928–934.
  11. Januszek-Trzciakowska A, Malecka-Tendera E. Subkliniczna niedoczynność tarczycy u otyłych dzieci [Subclinical hypothyroidism in obese children]. Postepy Hig Med Dosw (Online). 2013; 67: 770–774.
  12. Kulaga Z, Litwin M, Tkaczyk M, et al. The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references. BMC Public Health. 2010; 10: 109.
  13. Kułaga Z, Litwin M, Tkaczyk M, et al. Polish 2010 growth references for school-aged children and adolescents. Eur J Pediatr. 2011; 170(5): 599–609.
  14. Zimmet P, Alberti KG, Kaufman F, et al. IDF Consensus Group. The metabolic syndrome in children and adolescents — an IDF consensus report. Pediatr Diabetes. 2007; 8(5): 299–306.
  15. Knudsen N, Laurberg P, Rasmussen LB, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005; 90(7): 4019–4024.
  16. Ruhla S, Weickert MO, Arafat AM, et al. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf). 2010; 72(5): 696–701.
  17. Tiller D, Ittermann T, Greiser KH, et al. Association of Serum Thyrotropin with Anthropometric Markers of Obesity in the General Population. Thyroid. 2016; 26(9): 1205–1214.
  18. Sert A, Pirgon O, Aypar E, et al. Subclinical Hypothyroidism as a Risk Factor for the Development of Cardiovascular Disease in Obese Adolescents With Nonalcoholic Fatty Liver Disease. Pediatric Cardiology. 2013; 34(5): 1166–1174.
  19. Asvold BO, Vatten LJ, Nilsen TIL, et al. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study. Eur J Endocrinol. 2007; 156(2): 181–186.
  20. Radetti G, Grugni G, Lupi F, et al. The relationship between hyperthyrotropinemia and metabolic and cardiovascular risk factors in a large group of overweight and obese children and adolescents. J Endocrinol Invest. 2017; 40(12): 1311–1319.
  21. Reinehr T. Thyroid function in the nutritionally obese child and adolescent. Curr Opin Pediatr. 2011; 23(4): 415–420.
  22. Souza L, Guedes E, Teixeira P, et al. Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents. Jornal de Pediatria. 2016; 92(5): 532–538.
  23. García-García E, Vázquez-López MA, García-Fuentes E, et al. Thyroid Function and Thyroid Autoimmunity in Relation to Weight Status and Cardiovascular Risk Factors in Children and Adolescents: A Population-Based Study. J Clin Res Pediatr Endocrinol. 2016; 8(2): 157–162.
  24. Brufani C, Manco M, Nobili V, et al. Thyroid function tests in obese prepubertal children: correlations with insulin sensitivity and body fat distribution. Horm Res Paediatr. 2012; 78(2): 100–105.
  25. Wolters B, Lass N, Reinehr T. TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children. Eur J Endocrinol. 2013; 168(3): 323–329.
  26. Reinehr T, de Sousa G, Andler W. Hyperthyrotropinemia in obese children is reversible after weight loss and is not related to lipids. J Clin Endocrinol Metab. 2006; 91(8): 3088–3091.
  27. Pearce SHS, Brabant G, Duntas LH, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J. 2013; 2(4): 215–228.
  28. Witkowska-Sędek E, Kucharska A, Rumińska M, et al. Thyroid dysfunction in obese and overweight children. Endokrynol Pol. 2017; 68(1): 54–60.
  29. Oliveira RG, Guedes DP. Performance of anthropometric indicators as predictors of metabolic syndrome in Brazilian adolescents. BMC Pediatr. 2018; 18(1): 33.