甲状腺轴在儿童肥胖中的调节作用

近年来,越来越多的研究人员开始对甲状腺的功能与肥胖儿童的体重之间的关系感兴趣。观察到的甲状腺激素和促甲状腺激素水平的变化是否导致了肥胖儿童体重的增加,仍有待澄清。血清瘦素同TSH水平相关,甲状腺功能与肥胖相关的机制是下丘脑神经元的TRH和TSH分泌异常,从而瘦素水平升高。而体重与瘦素水平升高呈正相关。但TRH和TSH的这些分泌上的变化是否导致肥胖,依据甲状腺轴的变化是否应该对肥胖进行甲状腺素治疗,仍存在争议。因此,大多数学者认为,重要的是应该把生活方式的改变和减轻体重作为肥胖症的治疗方法而不是进行甲状腺素替代治疗。本文的目的是就当前对儿童肥胖与甲状腺轴相关关系做一探讨。

The alterations of thyroid axis in childhood obesity

In recent years researchers have become increasingly interested in the particular relation between the function of the thyroid gland and the body mass in the population of obese children. It still remains to be clarified whether the observed changes in the level of thyroid hormones and TSH led the increase of body mass in obesity child. The serum leptin level was associated with TSH, the related mechanisms between thyroid function and obesity was the abnormal secretion of the TRH and TSH of hypothalamic neurons, thus the lift of leptin levels. The body mass is positively correlated with serum leptin. However, there is still controversy whether the changes of TRH and TSH secretion caused obesity, if it should be treated according to the changes in the thyroid axis on obesity. Therefore, as most authors believe, primary importance should be placed on lifestyle changes and body weight reduction leaving substitutive treatment as a upplementary option. The purpose of this paper is to study the correlation between childhood obesity and thyroid axis.