No association between subclinical hypothyroidism and dyslipidemia in children and adolescents
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RESEARCH ARTICLE
Open Access
No association between subclinical hypothyroidism and dyslipidemia in children and adolescents Ashkan Habib1 and Asadollah Habib2*
Abstract Background: There are controversies about the correlation between higher levels of thyroid stimulating hormone (TSH) and dyslipidemia in children. This study was designed to assess the relation between lipid profile components and TSH levels in children. Method: This cross-sectional study was performed in a pediatric endocrinology growth assessment clinic in Shiraz, southern Iran. Children aged 2–18 years who referred to the clinic from January until April 2018 were included. TSH levels equal or above 5 mIU/L and lower than 10 mIU/L with normal free T4 (FT4) were considered as having subclinical hypothyroidism (SH). Results: Six hundred sixty-six children were euthyroid while 181 had SH. No significant difference was found between the mean serum total cholesterol (P = 0.713), LDL-C (P = 0.369), HDL-C (P = 0.211), non-HDL-C (P = 0.929), and triglyceride (P = 0.215) levels between euthyroid children and subjects with SH. There was also no significant difference in the prevalence of dyslipidemias in any lipid profile components between the two groups. The adjusted correlation was not significant between TSH levels and any lipid profile component. Conclusion: Based on the results of our study, we found no correlation between SH and dyslipidemia in children. The association between dyslipidemia and SH in children still seems to be inconsistent based on the results of this and previous studies. We recommend a meta-analysis or a significantly larger retrospective study on this subject. Keywords: Lipid, Children, Thyroid, Hypothyroidism
Introduction Subclinical hypothyroidism (SH) is defined as elevated thyroid stimulating hormone (TSH) levels, while T4 or free T4 (FT4) levels are normal [1]. It is a common disorder with a prevalence of 4–15% in the adult community [2, 3], while in the pediatric population, its prevalence is slightly lower than 2% [2, 4]. Although initially symptom free, 2–5% of SH patient progress to overt hypothyroidism each year [5]. In * Correspondence: [email protected] 2 Department of Endocrinology, School of Medicine, Kazerun Branch, Islamic Azad University, PO Box: 71384-37984, First Floor, Zafar Building, Zand St, Shiraz, Iran Full list of author information is available at the end of the article
addition, SH has been linked to several complications such as decreased cardiac output and higher chances of cardiac diseases [6–12], neuromuscular and neurobehavioral alterations, insulin resistance [8, 13–16] and specifically, obesity. Several studies have linked SH to higher BMI and BMI Z-scores [17–19], although weight reduction plans have resulted in normalization of TSH concentrations in some cases [20, 21]. Association of SH and dyslipidemia has been less clear cut. Studies have correlated SH in adults with higher levels of total cholesterol, low-density lipoprotein (LDL), non-high density lipoprotein (HDL), triglyceride (TG)
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