Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Obez Çocuk ve Ergenlerde Metabolik Sendrom Sıklığı ve Subklinik Hipotiroidinin Araştırılması: Retrospektif Tek Merkezli Gözlemsel Bir Çalışma
Investigation of Metabolic Syndrome Frequency and Subclinical Hypothyroidism in Obese Children and Adolescents: A Retrospective Single Center Observational Study
Perihan BEYSELa, Nurullah ÇELİKb
aSivas Cumhuriyet Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları ABD, Sivas TÜRKİYE
bSivas Cumhuriyet Üniversitesi Tıp Fakültesi, Çocuk Endokrinoloji BD, Sivas TÜRKİYE
Turkiye Klinikleri J Pediatr. 2022;31(1):9-18
doi: 10.5336/pediatr.2021-83667
Article Language: TR
Full Text
ÖZET
 Amaç: Önemli bir halk sağlığı sorunu olan obezite sıklığı, tüm dünyada olduğu gibi ülkemizde de giderek artmaktadır. Türkiye'de, çocukluk çağı ve adölesan obezitesi ile ilişkili olan metabolik sendrom (MS) sıklığı ve risk faktörleri üzerine kısıtlı sayıda çalışma vardır. Bu çalışmanın amacı, 6-18 yaş grubu obez çocuk ve adölesanlarda MS sıklığı ve risk faktörlerini belirlemek, MS olan ve olmayan olgularda tiroid fonksiyon test sonuçlarını karşılaştırmak ve subklinik hipotiroidi sıklığını hesaplamaktır. Gereç ve Yöntemler: Bu retrospektif tek merkezli gözlemsel araştırma, 6-18 yaş grubu 957 obez çocuk ve adölesan üzerinde yapıldı. Olgular, 6-12 yaş (Grup 1) ve 12-18 yaş (Grup 2) olmak üzere 2 gruba ayrıldı. Uluslararası Diyabet Federasyonu [International Diabetes Federation (IDF)], Cook ve ark. ile de Ferranti ve ark. kriterlerine göre MS sıklığı hesaplandı. Tiroid fonksiyon testleri (tiroid uyarıcı hormon ve serbest T4) MS olan ve olmayan olgularda karşılaştırıldı. Bulgular: MS sıklığı, Grup 1 ve Grup 2'de IDF kriterlerine göre sırasıyla %7,7 ve %12,5; Cook kriterlerine göre %12,9 ve 26,4; de Ferranti kriterlerine göre %25 ve %37,4 olarak bulundu. Grup 2'de obez kızlar, erkeklere göre daha düşük serbest T4 düzeyine sahip idi (p=0,04). MS olan ve olmayan grupta subklinik hipotiroidi sıklığı benzerdi (p>0,05). Sonuç: Bu çalışmada, ülkemizde daha önce yapılan çalışmalara benzer şekilde farklı tanı kriterlerine göre MS sıklığı değişkenlik göstermiştir. Bu nedenle çocukluk yaş grubunda uluslararası kabul gören bir MS tanı ölçütünün geliştirilmesi gerekmektedir.

Anahtar Kelimeler: Pediatrik obezite; metabolik sendrom; prevalans; tiroid hormonları
ABSTRACT
 Objective: The prevalence of obesity, as an important public health problem, has been raised in our country as well as all over the world. There is insufficient data in terms of metabolic syndrome (MS) prevalence and its risk factors in Turkey. The aim of this study is to determine the frequency and risk factors of MS in 6-18 years old obese children and adolescents, to compare thyroid function test results, and to calculate the frequency of sub clinical hypothyroidism in patients with and without MS. Material and Methods: This retrospective single-center observational study was conducted on 957 obese children and adolescents aged 6-18 years. The cases were divided into 2 groups as 6-12 years old (Group 1) and 12-18 years old (Group 2). Than, the frequencies of MS were calculated according to the criteria of the International Diabetes Federation (IDF), Cook et al. and de Ferranti et al. Thyroid function test (thyroid-stimulating hormone and free T4) results were compared in patients with and without MS. Results: The prevalence of MS in Group 1 and Group 2 were found as 7.7% and 12.5%, respectively for IDF criteria, 12.9% and 26.4% for Cook criteria, and 25 and 37.4% for de Ferranti criteria. In Group 2, obese girls had lower free T4 levels than boys (p=0.04). The frequency of subclinical hypothyroidism was similar in the groups with and without MS (p>0.05). Conclusion: In this study, the frequency of MS according to different diagnostic criteria varied, similar to previous studies in our country. So it is necessary to develop an internationally acceptable MS diagnostic criterion in childhood age group.

Keywords: Pediatric obesity; metabolic syndrome; prevalence; thyroid hormones
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