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Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):59-65

DOI: 10.23736/S2283-8376.17.00013-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: Italian

Role of thyroid ultrasound in diagnostic evaluation of childhood obesity

Carmela BORREGGINE 1, Daniela GRASSO 2 , Luca P. STOPPINO 3, Irene RUTIGLIANO 4, Angelo CAMPANOZZI 4, Roberta VINCI 3, Luca MACARINI 3

1 Unità Operativa Radiodiagnostica, Ospedale G. Tatarella, Cerignola, Foggia, Italia; 2 Unità Operativa Radiodiagnostica, Azienda Ospedaliera Pia Fondazione di Culto e Religione Cardinale G. Panico, Tricase, Lecce, Italia; 3 Dipartimento di Diagnostica per Immagini, Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Foggia, Azienda Ospedaliera Ospedali Riuntiti, Foggia, Italia; 4 Centro di Studio per la Fisiopatologia del Sistema Endocrino-Metabolico e della Nutrizione, Scuola di Specializzazione in Pediatria, Università degli Studi di Foggia, Azienda Ospedaliera Ospedali Riuntiti, Foggia, Italia


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BACKGROUND: The aim of this study was to define the thyroid function and structure alterations in a cohort of obese children.
METHODS: A total of 698 overweight or obese pediatric patients were evaluated retrospectively. All patients underwent auxological evaluation, blood tests of thyroid function (3-iodothyronamine [FT3], thyroxine [FT4], thyroid-stimulating hormone [TSH], anti-thyroglobulin [ATG], thyroid peroxidase [TPO]) and a thyroid ultrasound examination. One hundred and ninety-six healthy children have been recruited as controls and compared by weight, age and Body Mass Index (BMI). The patients were divided into four groups in relation to autoantibodies alterations or ultrasound pattern. Two blinded observers evaluated ultrasound findings obtaining a specific score (from 0 to 4).
RESULTS: Nineteen children showed anti-thyroid antibodies and an ultrasound pattern suggestive of thyroiditis (group A). Fifty-four of them showed anti-thyroid antibodies and normal ultrasound (group B). One hundred and eighteen showed an ultrasound pattern suggestive of thyroiditis and absent anti-thyroid antibodies (group C), and 501 children showed no thyroid antibodies with normal ultrasound (group D). TSH was higher in groups A comlapared to group D and controls (P<0.05). TSH and BMI were not significantly correlated in group C and group D.
CONCLUSIONS: Ultrasound is an effective tool to evaluate thyroid structure in obese children and compared with laboratory data could allow etiologic hypotheses. Correlation between thyroid ultrasound and functional alterations appears to be related to obesity and metabolic abnormalities rather than autoimmune hypothesis.


KEY WORDS: Thyroid microsomal antibodies - Thyroiditis - Thyroid-stimulating hormone - Obesity

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