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Inverse correlation between thyroid function and hemostatic markers for coronary heart disease in obese children and
S Gallistl1, K M Sudi, B Leschnik
1Ludwig Boltzmann Research Institute for Pediatric Hemostasis and Thrombosis, Department of Pediatrics, University of Graz, Austria. Siegfried.gallistl@kfunigraz.ac.at
Insights
Thyroid dysfunction in obese children is linked to poorer blood clotting factors, increasing coronary heart disease (CHD) risk. This suggests thyroid health is crucial for pediatric cardiovascular health.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Hematology
Background:
- Childhood obesity is a growing concern, potentially linked to thyroid dysfunction.
- Both obesity and hypothyroidism are recognized risk factors for coronary heart disease (CHD) in adults.
- These risks in adults are mediated by elevated serum lipids and hemostatic abnormalities.
Purpose of the Study:
- To investigate the potential relationship between thyroid function and hemostatic markers associated with CHD risk.
- To explore this connection specifically in obese children and adolescents.
Main Methods:
- Studied 39 obese children and adolescents after an overnight fast.
- Measured thyroid hormones (free thyroxine - fT4, free triiodothyronine - fT3, thyroid-stimulating hormone - TSH).
- Assessed hemostatic markers: Factor VII coagulant activity (VIIc), Factor VIII coagulant activity (VIIIc), fibrinogen, von Willebrand factor antigen (vWF-Ag), tissue plasminogen activator antigen (tPA-Ag), and plasminogen activator inhibitor-1 antigen (PAI-1-Ag).
Main Results:
- A significant inverse correlation was found between fT4 and factor VIIc and fibrinogen, even after adjusting for body fat mass.
- fT4 showed a tendency towards negative correlation with Factor VIIIc and vWF-Ag.
- fT3 was inversely related to factor VIIc and showed a weaker negative correlation with fibrinogen, though not independent of body fat mass.
Conclusions:
- Thyroid function is closely associated with hemostatic markers for CHD in obese pediatric populations.
- Thyroid dysfunction may contribute to an unfavorable hemostatic profile in children and adolescents.
- These findings highlight the importance of assessing thyroid function in obese children regarding cardiovascular risk.
Background:
Childhood obesity may be associated with thyroid dysfunction. Both obesity and hypothyroidism are related to increased risk of coronary heart disease (CHD) in adults through high levels of serum lipids and/or hemostatic abnormalities.
Objective:
To investigate a possible relationship between thyroid function and hemostatic markers for CHD in obese children and adolescents.
Study Design:
Thirty-nine obese children and adolescents were investigated for thyroid function and markers for CHD after overnight fast. Thyroid hormones were measured by radioimmunoassay. Factor VII coagulant activity (VIIc) and factor VIII coagulant activity (VIIIc) were determined using one stage clotting assays; fibrinogen was measured according to the method of Clauss; von Willebrand factor antigen (vWF-Ag), tissue type plasminogen activator antigen (tPA-Ag), and plasminogen activator inhibitor-1 antigen (PAI-1-Ag) were determined by ELISA.
Results:
We found a significant inverse correlation between fT4 and factor VIIc (r = -0.33, p = 0.03) and fibrinogen (r = -0.35, p = 0.02), which remained significant after adjustment for body fat mass. Factor VIIIc (r = -0.26, p = 0.066) and vWF-Ag (r = -0.28, p = 0.053) tended to be correlated negatively to fT4. fT4 did not correlate with tPA-Ag and PAI-1-Ag. fT3 was inversely related to factor VIIc (r = -0.3, p = 0.039), which was not independent of body fat mass, and showed a less impressive negative correlation with fibrinogen (r = -0.27, p = 0.058). fT3 did not correlate with vWF-Ag, tPA-Ag, or PAI-1-Ag. There was no relationship between TSH and the determined hemostatic markers.
Conclusion:
Our study demonstrates a close relationship between thyroid function and hemostatic markers for CHD in obese children and adolescents and suggests that thyroid dysfunction is associated with an unfavorable hemostatic state even in pediatric patients.