Key result
Subclinical hypothyroidism in obese children is not associated with impaired aortic strain or elasticity.
Why the study?
Subclinical hypothyroidism is more prevalent in obese children and may compound their early cardiovascular risk, prompting evaluation of its association with echocardiographic aortic elasticity.
Is mild subclinical hypothyroidism associated with reduced echocardiographic aortic elasticity in obese children and adolescents aged 5–18 years compared to euthyroid obese controls?
Cross-Sectional (n=82)
No
Is mild subclinical hypothyroidism associated with reduced echocardiographic aortic elasticity in obese children and adolescents aged 5–18 years compared to euthyroid obese controls?
In obese children and adolescents, mild subclinical hypothyroidism (TSH 4.5–10 mIU/mL) is not associated with impaired echocardiographic aortic elasticity, whereas systolic blood pressure is the primary independent determinant of aortic stiffness and distensibility.
Answers are grounded in this paper and cite their sources.
No difference in aortic elasticity; leaves open whether subclinical hypothyroidism compounds vascular risk in obese children.
Background Childhood obesity predisposes to early cardiovascular risk, and subclinical hypothyroidism — elevated thyroid-stimulating hormone with normal free thyroxine — is more prevalent in obese children and may compound vascular risk. We aimed to evaluate its association with echocardiographic aortic elasticity in obese children aged 5–18 years. We hypothesized that subclinical hypothyroidism would be associated with reduced aortic elasticity. Methods In this prospective cross-sectional study, 82 obese children (5–18 years) presenting to the Pediatric Endocrinology and Pediatric Cardiology clinics of Kütahya Health Sciences University City Hospital (March 2024–March 2025) were enrolled: 41 with mild subclinical hypothyroidism (thyroid-stimulating hormone 4.5–10 mIU/mL) and 41 euthyroid controls. Aortic strain, distensibility, stiffness index, and pressure–strain elastic modulus were calculated from M-mode echocardiography. Results Aortic elasticity parameters did not differ between the subclinical hypothyroidism and control groups (all p>0.05). Aortic diastolic diameter, glucose, and aspartate aminotransferase were significantly higher in children with thyroid-stimulating hormone of 7 mIU/mL or higher (p = 0.042, 0.036, and 0.026). In an exploratory, Bonferroni-corrected regression analysis, systolic blood pressure was the only independent predictor of aortic elasticity; thyroid-stimulating hormone showed no independent association with any parameter. Conclusions Subclinical hypothyroidism was not associated with measurable changes in aortic elasticity, refuting our hypothesis. A thyroid-stimulating hormone threshold of 7 mIU/mL or higher identified a subgroup with increased aortic diastolic diameter and metabolic perturbation, though this was not confirmed within the subclinical hypothyroidism group alone and did not survive Bonferroni correction. Systolic blood pressure, not thyroid-stimulating hormone, emerged as the independent correlate of aortic elasticity.
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Erturun et al. (2026) conducted a cross-sectional in Childhood obesity with or without mild subclinical hypothyroidism (n=82). Mild subclinical hypothyroidism (TSH 4.5–10 mIU/mL with normal fT4) vs. Euthyroid obese controls (normal TSH reference range) was evaluated on Aortic strain (%) (p=0.74). Subclinical hypothyroidism in obese children was not associated with significant differences in aortic strain or other aortic elasticity parameters compared to controls.
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