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Thyroid function, sensitivity to thyroid hormones, and metabolic syndrome in euthyroid children and adolescents with Down syndrome

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Abstract

Purpose

Patients with Down Syndrome (DS) showed multiple comorbidities, including thyroid disorders, obesity, and metabolic derangement. Different thyroid hormone (THs) patterns and sensitivity to thyroid hormone indices (STHI) seem to be associated with metabolic disorders. The study’s aim was to evaluate the prevalence of metabolic syndrome (MS) in pediatric patients affected by DS, taking into consideration the relationship between the metabolic parameters, THs and STHI.

Methods

We enlisted 50 euthyroid patients with DS (9.03 ± 4.46). Clinical parameters, TSH, FT3, FT4 and the presence of MS were recorded. Indexes of peripheral sensitivity (FT3/FT4 ratio) and central sensitivity (TSH index, TSHI; TSH T4 resistance index, TT4RI; TSH T3 resistance index, TT3RI) were also detected. Thirty healthy subjects were included as a control group.

Results

MS was detected in 12% of the subjects with DS. FT3, FT4, and TSH levels were higher in DS than in the control group (p < 0.01); higher levels of FT3/FT4 ratio, TSHI and TT3RI and lower TT4RI values (p < 0.01) were also detected. A significant correlation was detected between FT3 and fasting blood glucose (FBG) (R = 0.46), triglyceride (TG) (r = 0.37), total (r = 0.55) and high density lipoprotein-cholesterol (HDL-C) (r = − 0.38), diastolic blood pressure (DBP) (r = − 0.4); FT3/FT4 ratio and waist circumference (WC) (r = 0.36); TSHI and total (r = 0.30) and HDL cholesterol (r = − 0.31); TT4RI and HDL cholesterol (r = − 0.31); TT3RI and total (r = 0.39) and HDL cholesterol (r = − 032).

Conclusion

We confirmed a higher MS prevalence in children with DS compared to the control group. A significant association between THs, STHI, and the glucose and lipid metabolism parameters was detected supporting their role in metabolic alterations related to the DS.

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Acknowledgements

We thank Vivi Down Onlus Association (Milano, Italy) for the research support and Dr. Cinzia Barlera for the support nurses in conducting the study.

Funding

This research received no external funding.

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Author notes

  1. A. Gazzarri and A. De Silvestri have equally contributed to this work.

Authors and Affiliations

  1. Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100, Pavia, Italy

    V. Calcaterra

  2. Pediatric Department, “V. Buzzi” Children’s Hospital, 20154, Milan, Italy

    V. Calcaterra, P. Baldassarre, V. Rossi & V. Garella

  3. Associazione Vivi Down Onlus, 20158, Milan, Italy

    A. Gazzarri & C. Madia

  4. Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy

    A. De Silvestri

  5. Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157, Milan, Italy

    G. Zuccotti

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  1. V. Calcaterra
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Correspondence to V. Calcaterra.

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Ethics approval

The study was performed according to the recommendations and approval of our Institute’s ethics committee (Protocol number n. 2021/ST/207. Protocol register n. 0016834, 04/04/2022, CE Area 1 Milan, Italy) and according to the Declaration of Helsinki as revised in 2013.

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Calcaterra, V., Gazzarri, A., De Silvestri, A. et al. Thyroid function, sensitivity to thyroid hormones, and metabolic syndrome in euthyroid children and adolescents with Down syndrome. J Endocrinol Invest 46, 2319–2325 (2023). https://doi.org/10.1007/s40618-023-02086-4

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