IMPE Abstracts

Background and Aims: Whether as a cause or consequence, thyroid dysfunction is associated with overweight and obesity. There is limited data on radiological assessment of thyroid glands in obese patients. The present study was conducted to measure the radiological changes in thyroid glands in overweight/obese children.

Methods: This case-control study enrolled forty overweight/obese children (5-18 years) and compared with sex and age-matched healthy controls. Patients with known thyroid disorders excluded. Demographic, clinical data, physical examination and body mass index (BMI) recorded. Thyroid functions and anti-thyroid peroxidase antibody measured. High frequency linear-array transducer (7-15 Hz) measured the size, thyroid volume, focal lesions, nodularity, echogenicity, and echotexture in cases and controls. Thyroid volumes were analyzed based on WHO and ICCIDD recommended cut-off values for age and gender in iodine replete children (6-15 years). Curvilinear array transducer in the range of 5-12 MHz used for high resolution of the deeper structures within the liver and adequate penetration of enlarged or fatty liver.

Results: The mean±SD age of the cases was 9.3±4 years and controls was 9.6±4 years. The mean±SD BMI of cases and controls was 21.1±2.2Kg/m² and 15.7±1.6Kg/m² respectively. Among cases, 22 (55%) were hypertensive, 9 (22.5%) hypertriglyceridemic, one (2.5%) metabolic syndrome, 12 (30%) hypothyroidism (subclinical/overt) and only two (5%) had elevated anti-TPO levels. Thyroid functions were normal in all controls. The mean thyroid volume in hypothyroid (n=12) and euthyroid (n=28) patients was 4.3±4ml and 4.0±2.3ml respectively. Only one child had increased thyroid volume for age and both with raised antibody had altered echogenicity. Four (10%) cases with obesity had hypo-anechoic lesions in thyroid gland (two of these with hypothyroidism). Liver ultrasound showed fatty liver in 14 (51.8%) obese and one overweight child.

Conclusion: The thyroid morphology was similar on ultrasonographic evaluation in children with overweight/ obesity to those with normal BMI. Coexistent autoimmunity was associated with altered thyroid echogenicity. Fatty liver was seen in almost one-third cases reiterating the need for healthy lifestyle.