Thyroid hormonal status among children with obesity

Background: It is presumed that free T4 and thyroid-stimulating hormone (TSH) levels are related to obesity, but the findings are inconsistent. In this study we evaluated T4 and TSH concentrations between normal children and those with obesity and possible correlations between body mass index (BMI) and these markers. Methods: In this prospective study, 190 children who were overweight and obese and 133 children without obesity of the same age and sex were evaluated. Thyroid function tests (TSH, total T4, free T4 and free T3) were measured in all subjects in both groups. Thyroid antibodies (thyroid peroxidase and thyroglobulin) were determined among those with elevated TSH levels. Results: Levels of TSH and total T4 were significantly higher in children with obesity compared with the control group. Subclinical hypothyroidism was significantly higher in children with obesity (14.7%) compared with normal subjects (6.8%, p = 0.02). Among children with obesity and increased TSH levels, 10.7% had positive thyroid peroxidase and thyroglobulin antibodies. There was significantly positive correlation between BMI z score and TSH level ( r = 0.198, p < 0.001) and T4 level ( r = 0.18, p = 0.001). Conclusion: TSH and total T4 levels are increased in children who are overweight or obese and are a common finding in these children, but the incidence of thyroid antibodies is low in these patients and so could not be accounted for by thyroid autoimmunity. Due to these findings it is possible that increased TSH and total T4 levels are a consequence of obesity and could be reduced by decreasing BMI

Comparing the Efficacy of High and Low Doses of Vitamin A in Prevention of Bronchopulmonary Dysplasia

Background Bronchopulmonary dysplasia (BPD) is one of the most common serious squeal of preterm infants. It involves approximately one quarter of infants with birth weight less than 1500 grams and 30% of less than 1000 grams. Vitamin A has been shown to reduce BPD rate. We compared efficacy of low and high doses of vitamin A for prevention of BPD in very low birth weight preterm infants. Materials and Methods In a randomized clinical trial, 120 preterm infants with gestation age 32 weeks or less and birth weight less than 1,500 grams were enrolled in the study. Group A (n=60) received 1,500 IU vitamin A intramuscularly three times per week and group B (n=60) received 5,000 IU vitamin A intramuscularly 3 times/week. Vitamin A was continued for 4 weeks in all patients. Oxygen dependency at age 28 days after birth and at 36 weeks’ postmenstrual age was determined in all studied infants. Results The mean gestation age and birth weight in group A was 29.2 ± 2.1 weeks and 1095 ± 211 gr and in group B 28.7 ± 2.1week and 1147 ± 218 grams (P>0.05). Moderate to severe bronchopulmonary dysplasia was detected in 6 (10%) neonates in group A and 13(21.6%) infants in group B, P= 0.09. Mortality rate was 4 (6.6%) infants in group A and 3 (5%) patients in group B (P>0.05). Conclusion In our study, high and low doses of vitamin A were similar with respect to the BPD, intra-ventricular hemorrhage, and retinopathy of prematurity and total number of days for hospital stay in very low birth weight preterm infants

One-Year Self-Reported Appetite Is Similar in Adolescents with Obesity Who Do or Do Not Undergo Sleeve Gastrectomy

Background: With the growing prevalence of severe obesity in adolescents, sleeve gastrectomy (SG), a type of metabolic bariatric surgery (MBS), is increasingly being performed at a younger age. Data regarding changes in homeostatic and hedonic appetite following SG are conflicting in adults, with some studies showing no change and others showing a decrease in appetite. Data evaluating the effect of SG on appetite during adolescence, when appetite is more plastic, are currently lacking. Objective: To evaluate appetite changes one year after SG in adolescents with obesity vs. in non-surgical controls (NS). Methods: Thirty-nine subjects 13&ndash;21 years old with severe obesity were followed for a year; 19 underwent SG, and 20 were followed without surgery. Subjects had fasting blood tests for appetite-regulating hormones and completed a visual analog scale for appetite assessment (VAS). Results: The SG group had a decrease in body mass index (BMI) at one-year (baseline: 48.2 &plusmn; 1.7 kg/m2; one-year follow-up: 42.6 &plusmn; 1.0 kg/m2 (p &le; 0.0001)). No within- or between-group differences were noted in the one-year change in appetite in the SG and NS groups. After SG, fasting ghrelin decreased (p &le; 0.0001); however, no changes were noted in peptide YY (PYY) levels. Changes in one homeostatic appetite measure following SG were inversely associated with changes in fasting PYY (r = &minus;0.583, p = 0.011). Appetite changes were not associated with weight loss or final BMI. Conclusions: There were no changes in appetite measures one-year after SG from pre-surgery levels in adolescents with obesity, and appetite changes were not associated with changes in BMI. It is important to evaluate the impact of long-term appetite changes, if any, on weight loss after SG