BACKGROUND Reduced central sensitivity to thyroid hormones (TH) has been observed in euthyroid adults with reduced renal function. This topic is unexplored in young people with overweight or obesity (OW/OB). OBJECTIVE To evaluate the association between sensitivity to TH and mild reduced estimated glomerular filtration rate (MReGFR) in euthyroid children and adolescents with OW/OB. METHODS Data of 788 euthyroid children and adolescents with OW/OB (aged 6-16 years), recruited from seven Italian centers for the care of OW/OB, were evaluated. Peripheral sensitivity to TH was estimated through the FT3/FT4 ratio, while central sensitivity was assessed by estimating TSH index (TSHI), Thyrotroph T4 Resistance Index (TT4RI), Thyroid Feedback Quantile-based Index (TFQI), Parametric Thyroid Feedback Quantile-based Index (PTFQI). MReGFR was defined by an eGFR value ≥60 and ≤90 mL/min/1.73 m2. RESULTS Subjects with MReGFR had significantly lower levels of FT3/FT4 ratio (0.43±0.09 vs 0.44±0.10; p=0.028) and higher levels of TSH (2.89±1.00 vs 2.68±0.99; p=0.019), TSH Index (2.95±0.45 vs 2.85±0.55; p=0.031), TFQI [1.00 (0.98-1.00) vs 1.00 (0.97-1.00); p=0.046] and PTFQI (0.66±0.17 vs 0.60±0.23; p=0.006) compared with individuals with normal eGFR. Odds ratio of MReGFR raised of 1.2-3.2-fold for each increase of 1 mIU/L in TSH, 1 unit in TSHI, and PTFQI, but not for FT3/FT4 ratio. CONCLUSION MReGFR is associated with reduced indices of central sensitivity to TH in euthyroid children and adolescents with OW/OB. This preliminary observation should be confirmed in prospective studies.

中文翻译：

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超重或肥胖儿童和青少年对甲状腺激素的敏感性和肾小球滤过减少。

背景 在肾功能下降的甲状腺功能正常的成年人中观察到对甲状腺激素（TH）的中枢敏感性降低。这个话题在超重或肥胖 (OW/OB) 的年轻人中尚未得到探索。目的 评估甲状腺功能正常的 OW/OB 儿童和青少年对 TH 敏感性与估计肾小球滤过率 (MReGFR) 轻度降低之间的关联。方法 对从七个意大利 OW/OB 护理中心招募的 788 名甲状腺功能正常的 OW/OB 儿童和青少年（年龄 6-16 岁）的数据进行了评估。通过 FT3/FT4 比值估计外周对 TH 的敏感性，而通过估计 TSH 指数 (TSHI)、促甲状腺素 T4 抵抗指数 (TT4RI)、基于甲状腺反馈分位数的指数 (TFQI)、基于参数甲状腺反馈分位数来评估中枢敏感性指数（PTFQI）。MReGFR 的定义是 eGFR 值≥60 且≤90 mL/min/1.73 m2。结果 MReGFR 受试者的 FT3/FT4 比值水平显着较低（0.43±0.09 vs 0.44±0.10；p=0.028），TSH 水平显着较高（2.89±1.00 vs 2.68±0.99；p=0.019），TSH 指数（2.95± 0.45 vs 2.85±0.55；p=0.031)，TFQI [1.00 (0.98-1.00) vs 1.00 (0.97-1.00)；与 eGFR 正常的个体相比，p=0.046] 和 PTFQI（0.66±0.17 vs 0.60±0.23；p=0.006）。TSH 每增加 1 mIU/L、TSHI 和 PTFQI 每增加 1 个单位，MReGFR 的优势比就会增加 1.2-3.2 倍，但 FT3/FT4 比值不会增加。结论 MReGFR 与甲状腺功能正常的儿童和青少年 OW/OB 的中枢敏感性指数降低相关。这一初步观察结果应在前瞻性研究中得到证实。