Pituitary response to thyrotropin releasing hormone in children with overweight and obesity

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Cardiovascular Risk Factors

Background:

• High normal thyroid stimulating hormone (TSH) concentrations are prevalent in children with overweight and obesity.
• These elevated TSH levels are linked to increased cardiovascular disease risk.
• Previous research focused on thyrotropin-releasing hormone (TRH) production, neglecting pituitary TSH release.

Purpose of the Study:

• To investigate pituitary TSH release in response to TRH stimulation in euthyroid children with overweight or obesity.
• To determine if altered pituitary responsiveness contributes to high normal TSH levels in this population.

Main Methods:

• A TRH stimulation test was administered to 73 euthyroid children (39% males) with overweight or obesity.
• Baseline and post-TRH TSH concentrations were measured.
• Correlation analysis was performed between TSH levels, BMI z-score, and TRH test response.

Main Results:

• Baseline TSH concentrations did not correlate with BMI z-score.
• Baseline TSH positively correlated with TSH levels 20 minutes after TRH administration (r²=0.484, p<0.001).
• Baseline TSH also correlated with the TSH incremental area under the curve during the TRH test (r²=0.307, p<0.001).

Conclusions:

• Pituitary TSH release in response to TRH stimulation may be a significant factor contributing to high normal TSH concentrations in children with overweight and obesity.
• These findings suggest a potential alteration in pituitary function in pediatric obesity.
• Further research is needed to explore the clinical significance and underlying factors of this pituitary TSH release.