Filiz Mine ÇİZMECİOĞLU, Elif ÖZSU, Şükrü HATUN, Yeşiltepe R. Gül MUTLU

Şişman çocuklarda hafif TSH yüksekli¤i: Nasıl bir sorun?

Amaç: fiiflmanl›¤›n çocuklarda tiroid hormonlar› üzerine etkilerinin araflt›r›lmas›. Gereç ve Yöntem: Çocuk endokrinoloji ve diyabet poliklini¤inde Mart 2006- May›s 2009 tarihleri aras›nda fliflmanl›k tan›s› ile izlenen 132 olgunun dosyalar› geriye dönük olarak incelendi. Antropometrik ölçümleri, kan lipit düzeyleri, tiroid hormon düzeyleri, açl›k kan flekeri ve insulin düzeyleri de¤erlendirildi. HOMA-IR (homeostasis model assessment of insulin resistance) 3,16 olan olgular›n TSH (tiroid uyar›c› hormon) düzeyleri karfl›laflt›r›ld›. Tiroid uyar›c› düzeyi ile beden kitle indeksi (BK‹) ve HOMA-IR düzeyleri aras›ndaki iliflki incelendi. Veriler SPSS 13.0 istatistik program› ile analiz edildi. Ba¤›ms›z gruplar aras›ndaki karfl›laflt›rmalar ki-kare testi ile, korelasyon analizi ‘Pearson yöntemi’ ile yap›ld›. Anlaml›l›k s›n›r› p97,5 persantil olan hiçbir olgunun serbest/total T4 düzeyi normalin alt›nda de¤ildi. HOMA-IR3,16 olan olgular TSH düzeyleri aç›s›ndan karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› fark bulunmad›. TSH ile BK‹ ve HOMA-IR de¤eri aras›nda pozitif yönde, zay›f derecede, istatistiksel olarak anlaml› olmayan bir iliflki saptand›. Ç›kar›mlar: fiiflman çocuklarda TSH düzeyi, tiroid ifllevleri etkilenmeksizin yükselmifl olabilir, bu durum hipotiroidi lehine de¤erlendirilmemeli ve ilk de¤erlendirmede L-tiroksin tedavisi bafllanmamal›d›r.

Elevated TSH levels in obese children: What kind of problem is it?

Aim: To determine the effects of obesity on thyroid functions in children Material and Method: The records of 132 patients who were followed up in our Pediatric Endocrinology and Diabetes Division with the diagnosis of obesity from March 2006 to May 2009, were investigated retrospectively. Anthropometric measurements, serum lipid profiles, thyroid hormone levels, fasting blood glucose and insulin levels were evaluated. TSH levels of patients whose HOMA-IR 3.16 were compared. Correlation between TSH levels and HOMA-IR, BM‹ (body mass index) was investigated. Statistical evaluation was done using SPSS 13.0 statistical program. For comparasion of independent groups chi-square and for correlation analysis “Pearson method” were used. p

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