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Hosseini SM, Panahi-Azar A, Sheybani-Arani M, Morovatshoar R, Mirzadeh M, Salimi Asl A, Naghdipour Mirsadeghi M, Khajavi-Mayvan F. Vitamins, minerals and their maternal levels' role in brain development: An updated literature-review. Clin Nutr ESPEN 2024; 63:31-45. [PMID: 38907995 DOI: 10.1016/j.clnesp.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/26/2024] [Accepted: 05/16/2024] [Indexed: 06/24/2024]
Abstract
One's neurobehavioural and mental health are built during the exact and complex process of brain development. It is thought that fetal development is where neuropsychiatric disorders first emerged. Behavioural patterns can change as a result of neuropsychiatric illnesses. The incidence is rising quickly; nevertheless, providing exceptional care remains a significant challenge for families and healthcare systems. It has been demonstrated that one of the main factors causing the transmission of these diseases is maternal exposure. Through physiologic pathways, maternal health and intrauterine exposures can affect brain development. Our attention has been focused on epigenetic factors, particularly in the gestational environment, which may be responsible for human neurodegenerative diseases since our main mental development occurs during the nine months of intrauterine life. After thoroughly searching numerous databases, this study examined the effect of fat-soluble vitamins, water-soluble vitamins, and minerals and their maternal-level effect on brain development.
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Affiliation(s)
| | - Ava Panahi-Azar
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | | | - Reza Morovatshoar
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Mahdieh Mirzadeh
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Ali Salimi Asl
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Misa Naghdipour Mirsadeghi
- Department of Gynecology, School of Medicine, Reproductive Health Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.
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Han Y, Yang J, Zhong R, Guo X, Cai M, Lin W. Side effects of long-term oral anti-seizure drugs on thyroid hormones in patients with epilepsy: a systematic review and network meta-analysis. Neurol Sci 2022; 43:5217-5227. [DOI: 10.1007/s10072-022-06120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/02/2022] [Indexed: 11/08/2022]
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Is the prevalence of thyroid disease higher in children receiving antiepileptic medication? A systematic review and meta-analysis. Seizure 2021; 94:117-125. [PMID: 34896814 DOI: 10.1016/j.seizure.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Antiseizure medications (ASM) have long been examined for their potential to induce thyroid dysfunction. The aim of this systematic review and meta-analysis was to assess the prevalence of thyroid disease in children up to 16 years receiving monotherapy with valproate (VPA), carbamazepine (CBZ) and levetiracetam (LEV). METHODS PubMed/MEDLINE, Cochrane/CENTRAL databases and the gray literature were searched to identify observational studies providing the prevalence of thyroid dysfunction in the target population under VPA, CBZ, or LEV monotherapy schemes. The results were pooled using a random-effects model, and additional subgroup analyses were performed for the three ASM groups. RESULTS Fifteen and thirteen studies met inclusion criteria for the qualitative and the quantitative analysis, respectively, with a total of 945 pediatric patients with prevalence data. Only VPA and CBZ were associated with thyroid dysfunction. The overall prevalence of thyroid abnormality was higher in children receiving ASM [odds ratio (OR) 6.82, 95% confidence interval (CI) 3.96-11.75]. In the subgroup analysis, the prevalence of biochemical thyroid abnormality with increased TSH was higher in the VPA (OR 9.54, 95%CI 5.25-17.34) and the CBZ group (OR 4.08, 95%CI 1.84-9.04) compared with controls. CONCLUSION This study confirms the higher prevalence of biochemical thyroid abnormality in children under VPA and CBZ monotherapy, whereas no such evidence is present for LEV. In children with a predisposition for thyroid disease, LEV should be considered over VPA and CBZ, if appropriate for seizure type and epilepsy syndrome. More studies are needed to reach a consensus on monitoring and management of thyroid dysfunction in children receiving ASM therapy.
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Jia W, Song Y, Yang L, Kong J, Boczek T, He Z, Wang Y, Zhang X, Hu H, Shao D, Tang H, Xia L, Xu X, Guo F. The changes of serum zinc, copper, and selenium levels in epileptic patients: a systematic review and meta-analysis. Expert Rev Clin Pharmacol 2020; 13:1047-1058. [PMID: 32856976 DOI: 10.1080/17512433.2020.1816821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION It is widely accepted that trace elements have been implicated in various metabolic processes. Valproic acid (VPA) is a remarkably safe and effective antiepileptic drug. There is no consensus option regarding the fluctuations in serum zinc (Zn), copper (Cu), and selenium (Se) in epileptic patients treated with VPA. We applied a meta-analysis to systematically assess the effects of VPA on serum ions in these patients. AREAS COVERED In this study, we performed a meta-analysis of the changes in serum Zn, Cu, and Se levels in human samples of healthy controls, epileptic patients, and patients treated with VPA. Twenty-two published analyzable studies were selected by searching the databases of PubMed, China National Knowledge Infrastructure (CNKI), Google Scholar, Web of Science, EMBASE, WAN FANG and Vip. EXPERT OPINION Serum Se levels in epileptic patients were decreased compared to healthy controls. Serum Zn levels in patients with VPA treatment were significantly lower than those in epileptic patients. The results of this meta-analysis are instructive for the intake of trace elements such as Zn, Cu, and Se in the diet balance of patients with epilepsy treated with VPA. Meanwhile, this study provides a theoretical basis for the combined use of other drugs that affect the intake and absorption of trace elements and VPA.
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Affiliation(s)
- Wanying Jia
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Yang Song
- School of Humanities and Social Sciences, China Medical University , Shenyang, China
| | - Lei Yang
- Tianjin Customs, Technical Center for Safety of Industrial Products , Tianjin, China
| | - Jingjing Kong
- Department of Gerontology, The First Affiliated Hospital of Dalian Medical University , Dalian, China
| | - Tomasz Boczek
- Department of Ophthalmology, Stanford University School of Medicine , Palo Alto, CA, USA
| | - Zhenwei He
- Department of Neurology, The Fourth Affiliated Hospital of China Medical University , Shenyang, China
| | - Yuting Wang
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Xiaohong Zhang
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Huiyuan Hu
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Dongxue Shao
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Hong Tang
- School of Public Health, China Medical University , Shenyang, China
| | - Liguang Xia
- Department of Pediatric Surgery, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, China
| | - Xiaoxue Xu
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
| | - Feng Guo
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University , Shenyang, China
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Eissa MA, Abdulghani KO, Nada MA, Elkhawas HM, Shouman AE, Ahmed NS. Serum zinc and copper levels in a sample of Egyptian epileptic children. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00210-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Epilepsy is among the most common disabling neurological disorders among children. Altered serum levels of zinc and copper may facilitate seizure occurrence and repetition, and antiepileptic drugs may disturb their serum levels affecting disease control and outcome.
Objective
To investigate the association between serum levels of zinc and copper and epilepsy and antiepileptic treatment in a group of Egyptian epileptic children.
Methods
Case-control study on 100 epileptic patients, aged from 2 to 16 years, from neurology outpatient clinic and 50 apparently healthy children with matched age and sex. Venous samples were withdrawn from patients and controls then serum levels of zinc and copper were measured with graphite furnace atomic absorption spectrometer-A Analyst 800.
Results
Serum zinc level of patients’ group was significantly lower than that of controls with a mean of 59.1 μ/dL ± 22.7 and 85 μ/dL ± 22.2, respectively (P < 0.01). Serum zinc level of patients with history of febrile seizures was significantly decreased compared to patients without history of febrile seizures with a mean of 41.5 μ/dL ± 20.1 and 67.9 μ/dL ± 19.3, respectively (P < 0.01). Patient on carbamazepine intake showed significantly lower zinc serum level than patients without carbamazepine intake, with a mean of 49.0 μ/dL ± 17 and 61.8 μ/dL ± 23.4, respectively (P < 0.01). A significant negative correlation was noted between the duration of illness of epilepsy and the mean copper serum level (P < 0.05).
Conclusion
Zinc and copper altered homeostasis have mounting evidence about their role in the pathogenesis of epilepsy. Designing treatment plans that selectively restore zinc and copper normal levels may be a beneficial strategy in the future.
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Zevenbergen C, Korevaar TIM, Schuette A, Peeters RP, Medici M, Visser TJ, Schomburg L, Visser WE. Association of antiepileptic drug usage, trace elements and thyroid hormone status. Eur J Endocrinol 2016; 174:425-32. [PMID: 26701870 DOI: 10.1530/eje-15-1081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 12/23/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Levels of thyroid hormone (TH) and trace elements (copper (Cu) and selenium (Se)) are important for development and function of the brain. Anti-epileptic drugs (AEDs) can influence serum TH and trace element levels. As the relationship between AEDs, THs, and trace elements has not yet been studied directly, we explored these interactions. METHOD In total 898 participants, from the Thyroid Origin of Psychomotor Retardation study designed to investigate thyroid parameters in subjects with intellectual disability (ID), had data available on serum Se, Cu, thyroid stimulating hormone (TSH), free thyroxine (FT4), tri-iodothyronine (T3), reverse T3, T4, and thyroxine-binding globulin (TBG); 401 subjects were on AED treatment. Differences in trace elements according to medication usage was investigated using ANOVA, and associations between trace elements and thyroid parameters were analysed using (non-) linear regression models. RESULTS Study participants were not deficient in any of the trace elements analyzed. AED (carbamazepine, valproate and phenytoin) usage was negatively associated with serum Se and showed compound-specific associations with Cu levels. After correction for drug usage, Se was positively associated with TSH levels, negatively associated with FT4 levels, and positively with T3 levels. Cu was positively associated with T4, T3, and rT3, which was largely dependent on TBG levels. CONCLUSION The subjects with ID did not display profound deficiencies in trace element levels. AEDs were associated with serum Se and Cu levels, while serum Se and Cu were also associated with thyroid parameters. Further studies on the underlying mechanisms and potential clinical importance are warranted.
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Affiliation(s)
- Chantal Zevenbergen
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Tim I M Korevaar
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Andrea Schuette
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Robin P Peeters
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Marco Medici
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Theo J Visser
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Lutz Schomburg
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - W Edward Visser
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
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Zhang YX, Shen CH, Lai QL, Fang GL, Ming WJ, Lu RY, Ding MP. Effects of antiepileptic drug on thyroid hormones in patients with epilepsy: A meta-analysis. Seizure 2016; 35:72-9. [DOI: 10.1016/j.seizure.2016.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 12/26/2022] Open
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Hamed SA. The effect of antiepileptic drugs on thyroid hormonal function: causes and implications. Expert Rev Clin Pharmacol 2015; 8:741-50. [PMID: 26437373 DOI: 10.1586/17512433.2015.1091302] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sherifa Ahmed Hamed
- a Department of Neurology and Psychiatry, Assiut University Hospital , Floor 7, Room 4, P.O.Box 71516, Assiut, Egypt
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9
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Saghazadeh A, Mahmoudi M, Meysamie A, Gharedaghi M, Zamponi GW, Rezaei N. Possible role of trace elements in epilepsy and febrile seizures: a meta-analysis. Nutr Rev 2015; 73:760-79. [DOI: 10.1093/nutrit/nuv026] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Effects of long-term valproic acid treatment on hematological and biochemical parameters in adolescent psychiatric inpatients: a retrospective naturalistic study. Int Clin Psychopharmacol 2015; 30:241-8. [PMID: 26020713 DOI: 10.1097/yic.0000000000000084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in psychiatric adolescent inpatients. A retrospective naturalistic study design was used. Participants were psychiatric inpatients treated with VPA, alone or in combination with other medications. Electronic medical files were reviewed for changes in hematological and biochemical parameters following a course of VPA treatment. One hundred and four adolescents aged 12-18 (mean 15.76±1.58) years fulfilled the study criteria. The mean blood level and duration of VPA treatment were 65.81±22.18 mcg/ml and 98.57±135.94 days, respectively. The mean levels of thyroid-stimulating hormones and triglyceride levels increased significantly from the first to the last measurement. Platelet count decreased significantly following VPA treatment. No correlation was observed between these parameters and age, duration of treatment, or VPA levels. No serious adverse events were reported. Long-term VPA treatment in adolescents with psychiatric disorders is associated with significant increases in triglyceride levels. Moreover, VPA-treated adolescent psychiatric inpatients may be at risk of developing pituitary-thyroid axis dysregulation and decreased platelet count. Therefore, baseline measurement of thyroid functions and metabolic and hematological parameters and monitoring throughout the treatment are recommended.
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Paragliola RM, Prete A, Kaplan PW, Corsello SM, Salvatori R. Treatment of hypopituitarism in patients receiving antiepileptic drugs. Lancet Diabetes Endocrinol 2015; 3:132-40. [PMID: 24898833 DOI: 10.1016/s2213-8587(14)70081-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Evidence suggests that there may be drug interactions between antiepileptic drugs and hormonal therapies, which can present a challenge to endocrinologists dealing with patients who have both hypopituitarism and neurological diseases. Data are scarce for this subgroup of patients; however, data for the interaction of antiepileptic drugs with the pituitary axis have shown that chronic use of many antiepileptic drugs, such as carbamazepine, oxcarbazepine, and topiramate, enhances hepatic cytochrome P450 3A4 (CYP3A4) activity, and can decrease serum concentrations of sex hormones. Other antiepileptic drugs increase sex hormone-binding globulin, which reduces the bioactivity of testosterone and estradiol. Additionally, the combined oestrogen-progestagen contraceptive pill might decrease lamotrigine concentrations, which could worsen seizure control. Moreover, sex hormones and their metabolites can directly act on neuronal excitability, acting as neurosteroids. Because carbamazepine and oxcarbazepine can enhance the sensitivity of renal tubules, a reduction in desmopressin dose might be necessary in patients with central diabetes insipidus. Although the effects of antiepileptic drugs in central hypothyroidism have not yet been studied, substantial evidence indicates that several antiepileptic drugs can increase thyroid hormone metabolism. However, although it is reasonable to expect a need for a thyroxine dose increase with some antiepileptic drugs, the effect of excessive thyroxine in lowering seizure threshold should also be considered. There are no reports of significant interactions between antiepileptic drugs and the efficacy of human growth hormone therapy, and few data are available for the effects of second-generation antiepileptic drugs on hypopituitarism treatment.
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Affiliation(s)
- Rosa Maria Paragliola
- Unit of Endocrinology, Facoltà di Medicina Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Prete
- Unit of Endocrinology, Facoltà di Medicina Università Cattolica del Sacro Cuore, Rome, Italy
| | - Peter W Kaplan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD, USA
| | | | - Roberto Salvatori
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes and Pituitary Center, Johns Hopkins University School of Medicine, Baltimore MD, USA.
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Cayir A, Doneray H, Kurt N, Orbak Z, Kaya A, Turan MI, Yildirim A. Thyroid functions and trace elements in pediatric patients with exogenous obesity. Biol Trace Elem Res 2014; 157:95-100. [PMID: 24390903 DOI: 10.1007/s12011-013-9880-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
Abstract
Obesity is a multifactorial disease developing following impairment of the energy balance. The endocrine system is known to be affected by the condition. Serum thyroid hormones and trace element levels have been shown to be affected in obese children. Changes in serum thyroid hormones may result from alterations occurring in serum trace element levels. The aim of this study was to evaluate whether or not changes in serum thyroid hormone levels in children with exogenous obesity are associated with changes in trace element levels. Eighty-five children diagnosed with exogenous obesity constituted the study group, and 24 age- and sex-matched healthy children made up the control group. Serum thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), thyroglobulin (TG), selenium (Se), zinc (Zn), copper (Cu), and manganese (Mn) levels in the study group were measured before and at the third and sixth months of treatment, and once only in the control group. Pretreatment fT4 levels in the study group rose significantly by the sixth month (p = 0.006). Zn levels in the patient group were significantly low compared to the control group (p = 0.009). Mn and Se levels in the obese children before and at the third and sixth months of treatment were significantly higher than those of the control group (p = 0.001, p = 0.001). In conclusion, fT4, Zn, Cu, Mn, and Se levels are significantly affected in children diagnosed with exogenous obesity. The change in serum fT4 levels is not associated with changes in trace element concentrations.
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Affiliation(s)
- Atilla Cayir
- Departments of Pediatric Endocrinology, Regional Training and Research Hospital, Erzurum, Turkey,
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