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Treatment of pediatric Graves' disease is associated with excessive weight gain
Nicole R van Veenendaal1, Scott A Rivkees
1Pediatric Endocrinology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Insights
Children treated for Graves' disease (GD) experience significant weight gain within six months of treatment, which can be persistent. This study examined body weight changes in pediatric GD patients.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Thyroid Disease
Background:
- Limited data exists on body weight and BMI changes in children undergoing Graves' disease (GD) treatment.
- Understanding these changes is crucial for managing pediatric GD patients.
Purpose of the Study:
- To investigate body weight and BMI z-score fluctuations in children before, during, and after Graves' disease treatment.
- To correlate weight changes with clinical features in pediatric GD.
Main Methods:
- Retrospective analysis of medical records for 43 pediatric patients with GD.
- Inclusion criteria required 1 year of data pre- and post-diagnosis.
- Assessed weight, height, BMI z-scores, and thyroid hormone levels.
Main Results:
- Patients showed no significant difference in average BMI z-score compared to the normal population or premorbid values.
- Overweight/obese children experienced a significant BMI decrease during hyperthyroidism.
- A significant increase in BMI z-scores was observed within 6 months of GD treatment, persisting in ~25% of patients.
Conclusions:
- Children treated for Graves' disease exhibit notable weight gain within six months of therapy initiation.
- This treatment-induced weight gain can be a lasting issue in pediatric patients.
Context:
Little information is available about changes in body weight and body mass index in children before, during, and after treatment for Graves' disease (GD).
Objective:
Our objective was to examine changes in body weight after treatment for GD in children as related to clinical features.
Design:
The medical records of 43 pediatric patients with GD [35 girls and eight boys, aged 4.0-18.5 (mean 10.9) yr] were examined. Patients were included if clinical data were available for 1 yr before and after the diagnosis of GD.
Main Outcome Measures:
Weight, height, body mass index (BMI) z-scores, and thyroid hormone levels were assessed.
Results:
Overall, patients presented with an average BMI z-score of -0.02 ± 1.05 that was not different from the normal population (P = 0.921) or their premorbid values (P = 0.07). However, in the subset of patients who were initially overweight or obese in the premorbid state, the BMI decreased significantly during the development of hyperthyroidism (P < 0.05). After initiation of treatment, patients gained significant amounts of weight over the first 6 months leading to elevated BMI z-scores (P < 0.0001), and elevations in BMI persisted in about 25% of the patients.
Conclusion:
Excessive weight gain within 6 months of treatment is seen in children treated for GD, and the gain in weight can persist.
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