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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. Numerous studies have been conducted and the literature on the related issues has been abounding. Several thereof have strived at pinpointing a significant link between the function of the thyroid axis and the body mass. Yet, it still remains to be clarified whether these subtle changes in the level of thyroid hormones and TSH observed in childhood obesity are responsible for the increased body mass or rather they represent a secondary phenomenon. The mechanism most often put forward by the researchers that links obesity to thyroid function is the increased level of leptin, which affects neurones in the hypothalamus and the thyroid axis causing TRH and TSH secretion. The body mass is positively correlated with serum leptin and elevated level of leptin is connected with an increase in TSH level. However, there is still controversy whether these inconspicuous differences observed in thyroid axis merit the treatment with thyroxine since these changes seem to constitute a consequence rather than a cause of obesity. Therefore, as most authors postulate, primary importance should be placed on lifestyle changes and body weight reduction leaving substitutive treatment as a supplementary option. The purpose of this review is to present the most current issues on child obesity and the related malfunction of the thyroid axis through an overview of international publications from the years 1996-2011.

Introduction and aim of the study: Considering worldwide epidemic of childhood obesity, its individual progress and complications require early evaluation and prevention. The aim of this study was to assess whether the relatively short-lasting childhood obesity already affects ?-cell function beyond the adaptive hyperinsulinemia. Material and methods: The study comprised 138 overweight and obese patients and 20 healthy controls, aged 13.0?3.3 and 12.4?3.4 years respectively, and classified by their body mass index standard deviation score (BMI-SDS). Patients were also stratified by oral glucose tolerance test (OGTT) as individuals with normal (NGT) or impaired glucose tolerance (IFG/IGT) and as insulin resistant (+IR) or non-resistant (non-IR). Serum insulin levels and indices of insulin resistance/sensitivity were assessed. Children underwent intravenous glucose tolerance test (IVGTT) to evaluate their first phase insulin release (FPIR). Results: Overweight and obese patients demonstrated lower insulin sensitivity indices compared to controls. IVGTT revealed significantly higher FPIR results (mU/l; up to 3 min) in obese vs. control patients (272.9?143.8 vs. 125.4?70.1). The +IR subgroup displayed the highest FPIR values (297.6?156.3). In the observation prolonged up to 10 min, significant differences in insulin secretion between +IR (486.8?213.6), non-IR (393.6?190.6) patients and controls (196.8?82.4) were also found. Moreover, NGT obese patients demonstrated significantly higher insulin (292.1?151.2) levels in FPIR (3min) than control (125.4?70.1) and IFG/IGT (171.5?75.5) group as well. Additionally, the latter group was characterised by the highest insulin resistance and BMI-SDS values. Conclusions: IFG/IGT may present very early in obese children. It reflects failing ?-cell function, which should be recognized as prediabetes and needs urgent intervention to prevent type 2 diabetes.

Epidemia otyłości obejmuje w coraz większym stopniu dzieci i młodzież. Nadmierna masa ciała prowadzi do zaburzeń metabolicznych, cukrzycy typu 2, zaburzeń w układzie sercowo-naczyniowym, układzie oddechowym, układzie szkieletowo-mięśniowym i w sferze psychospołecznej. Otyłość prosta wtórnie wywołuje też zaburzenia hormonalne. W rozwoju powikłań otyłości podstawowe znaczenie ma nasilająca się z czasem trwania choroby insulinooporność i przewlekły stan prozapalny, indukowany przez cytokiny wytwarzane w tkance tłuszczowej. Wiele zaburzeń okazuje się być odwracalnych we wczesnych etapach, jeśli uda się uzyskać chociaż niewielki spadek masy ciała.