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Authors
Abstract(s)
Introdução: O hipotiroidismo subclínico é encontrado com frequência em crianças e
adolescentes obesos e tem sido apontado como fator de risco para doenças
cardiovasculares e distúrbios metabólicos. Paralelamente, a acumulação de gordura
central nesses indivíduos está associada às mesmas consequências. Contudo, os
mecanismos responsáveis por estas alterações continuam por ser clarificados, não
havendo concordância em relação à necessidade de tratamento com levotiroxina na
abordagem destes pacientes.
Objetivos: Esta dissertação visou analisar a relação do hipotiroidismo subclínico com a
obesidade nas crianças e adolescentes, particularmente, a possibilidade de complicações
ao longo do seu crescimento decorrentes dessa associação. Pretendia também esclarecer
o papel da intervenção no estilo de vida e da terapia com levotiroxina no
acompanhamento destas condições clínicas.
Métodos: Para a realização desta dissertação, procedeu-se a uma pesquisa bibliográfica
de artigos científicos na plataforma PubMed. Utilizaram-se as seguintes palavras-chave:
subclinical hypothyroidism AND children obesity.
Resultados: Foram analisados 22 artigos que abordaram a relação do hipotiroidismo
subclínico e a obesidade infantil, as suas consequências e o seu seguimento. Vários
estudos reportados verificaram que a prevalência do hipotiroidismo subclínico é superior
em crianças e adolescentes com excesso de peso ou obesidade. Porém, não existe ainda
um consenso nas bases dos mecanismos responsáveis por tal associação. Para além
disso, os pacientes apresentaram diversas consequências a nível de resposta
inflamatória, perfil lipídico, patologia hepática e alterações cardiovasculares.
Relativamente à suplementação com levotiroxina, os resultados dos estudos foram
heterogéneos e não alcançaram considerações gerais fidedignas.
Conclusão: Estes efeitos metabólicos podem acompanhar o indivíduo para o resto da
sua vida, sendo imperativo reorganizar os procedimentos clínicos nestes casos. Deste
modo, algumas orientações devem ser introduzidas na gestão dos pacientes, como a
monitorização de parâmetros cardiovasculares ou o controlo das medidas
antropométricas. Por último, é fundamental a execução de mais estudos com um maior
acompanhamento longitudinal e maiores amostras para serem obtidos os resultados em
falta.
Introduction: Subclinical hypothyroidism is frequently found in obese children and adolescents and has been pointed out as a risk factor for cardiovascular diseases and metabolic disorders. In parallel, an accumulation of central fat mass in these individuals is associated with the same consequences. However, the mechanisms responsible for these changes must be clarified because there´s no agreement with the treatment of levothyroxine in the approach of these patients. The aim of this study was to analyze the relationship of the subclinical hypothyroidism with obesity in children and adolescents, particularly, the possibility of complications throughout their growth arising from that association. It also intended to clarify the role of the intervention in the lifestyle and therapy with levothyroxine in the follow-up of these clinical conditions. Methods: This dissertation was based on the research of scientific articles on the PubMed platform with the following keywords: subclinical hypothyroidism AND children obesity. Results: This work analyzed 22 articles that addressed the relationship of subclinical hypothyroidism and children obesity, their consequences and follow-up. Several reported studies have found that SH prevalence is higher in children and adolescents with overweight or obesity. However, there is still no consensus on the basis of the mechanisms responsible for such association. In addition, patients presented various consequences at inflammatory response, lipid profile, hepatic and cardiovascular changes. About supplementation with levothyroxine, the results of the studies were heterogeneous and no reliable general considerations were reached. Conclusion: These metabolic effects can follow the individuals for the rest of their lives, being imperative to reorganize clinical procedures in these cases. In this way, some guidelines must be introduced in patient management, such as monitoring cardiovascular parameters or controlling anthropometric measurements. Finally, the execution of further studies is fundamental with increased samples and longitudinal attendance to obtain the missing results.
Introduction: Subclinical hypothyroidism is frequently found in obese children and adolescents and has been pointed out as a risk factor for cardiovascular diseases and metabolic disorders. In parallel, an accumulation of central fat mass in these individuals is associated with the same consequences. However, the mechanisms responsible for these changes must be clarified because there´s no agreement with the treatment of levothyroxine in the approach of these patients. The aim of this study was to analyze the relationship of the subclinical hypothyroidism with obesity in children and adolescents, particularly, the possibility of complications throughout their growth arising from that association. It also intended to clarify the role of the intervention in the lifestyle and therapy with levothyroxine in the follow-up of these clinical conditions. Methods: This dissertation was based on the research of scientific articles on the PubMed platform with the following keywords: subclinical hypothyroidism AND children obesity. Results: This work analyzed 22 articles that addressed the relationship of subclinical hypothyroidism and children obesity, their consequences and follow-up. Several reported studies have found that SH prevalence is higher in children and adolescents with overweight or obesity. However, there is still no consensus on the basis of the mechanisms responsible for such association. In addition, patients presented various consequences at inflammatory response, lipid profile, hepatic and cardiovascular changes. About supplementation with levothyroxine, the results of the studies were heterogeneous and no reliable general considerations were reached. Conclusion: These metabolic effects can follow the individuals for the rest of their lives, being imperative to reorganize clinical procedures in these cases. In this way, some guidelines must be introduced in patient management, such as monitoring cardiovascular parameters or controlling anthropometric measurements. Finally, the execution of further studies is fundamental with increased samples and longitudinal attendance to obtain the missing results.
Description
Keywords
Hipotiroidismo Subclínico Obesidade Infantil