Subclinical hypothyroidism and myocardial function in obese children
C Brienza1, A Grandone, G Di Salvo
1Department of Pediatrics, Second University of Naples, Via De Crecchio 4, 80138 Naples, Italy.
Insights
Pediatric obesity-related Subclinical Hypothyroidism (SCH) is linked to impaired cardiac function in children. Obese children with SCH showed reduced systolic and diastolic function, suggesting potential cardiovascular risks.
Area of Science:
- Pediatric Endocrinology
- Cardiology
- Metabolic Disorders
Background:
- Pediatric obesity is a growing global health concern.
- Isolated Hyperthyreotropinemia, or Subclinical Hypothyroidism (SCH), is common in obese children.
- SCH in adults is associated with impaired myocardial function.
Purpose of the Study:
- To investigate the impact of obesity-related SCH on myocardial function in children.
- To determine if SCH influences cardiac performance in pediatric obesity.
Main Methods:
- Doppler echocardiography was used to assess myocardial function.
- 34 obese children with SCH and 60 obese children without SCH were studied.
- Evaluated global systolic function (Ejection Fraction) and diastolic function.
Main Results:
- Global systolic function (EF) was similar between groups.
- Reduced Right Ventricle systolic function and pressure in the SCH group.
- Significant reductions in Mitral Annulus Peak Systolic excursion and Tissue Doppler Imaging peak systolic motion (TDI-S) in the SCH group.
- Abnormalities in diastolic function were observed in the SCH group.
Conclusions:
- Obesity-related SCH in children may involve impaired cardiac function.
- Findings suggest abnormal diastolic function and reduced longitudinal systolic function in pediatric SCH.
- These results may alter clinical management of obese children with SCH.
Background And Aims:
Pediatric obesity is an important health problem representing a major public health concern worldwide in the last decades. An isolated elevation of Thyroid Stimulating Hormone (TSH) with normal levels of thyroid hormones is frequently found in obese children. It has been named Isolated Hyperthyreotropinemia or Subclinical Hypothyroidism (SCH) and may be considered a consequence of obesity. Evidence exists that SCH is related to impairment of both systolic and diastolic myocardial function in the adult population. The aim of our study is to establish if obesity-related SCH influences myocardial function in children.
Methods And Results:
We examined 34 obese children and adolescents with SCH and 60 obese children with normal TSH levels who underwent Doppler echocardiographic to evaluate myocardial function. Global systolic function as assessed by Ejection Fraction (EF) was comparable between groups, however Right Ventricle pressure global systolic function and pressure were significantly reduced in SCH group. Mitral annulus peak systolic (MAPSE) excursion lateral and MAPSE septum resulted significantly reduced in SCH group. Tissue Doppler imaging peak systolic motion (TDI-S) was reduced in SCH group. Diastolic function also showed significant modifications in SCH group.
Conclusion:
These results suggest possible involvement of cardiac function in obese children with SCH resulting in both abnormal diastolic function and reduced longitudinal systolic function. This new insight into cardiovascular consequences of obesity-related SCH in children could influence clinical approach to such patients by pediatric endocrinologists.
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