3 years ago

Weight Gain After Treatment of Graves’ Disease in Children

G Todd Alonso, Perrin C White, Shona Rabon
Objective The frequency of and risk factors for weight gain in children treated for Graves disease have not been described. We evaluated change in BMI Z score and predictors of weight gain in this population. Design Retrospective review of data from January 2000 to July 2011. Patients 222 children and adolescents with Graves’ disease (ages 2-18 years) evaluated following radioactive iodine administration (RAI) (n=101), thyroidectomy (n=9), and initiation of medical therapy (n=112). Measurements Changes in body mass index Z score over 12 months (ΔBMI-Z0-12). Results All treatment groups in each gender and race increased BMI-Z (median ΔBMI-Z0-12 was positive). T3 levels following RAI (p=.04) and weight lost at time of administration (p=.02) in the RAI group, and free T4 levels in the medical therapy group (p=.03) were positively correlated with ΔBMI-Z0-12. Race was a significant predictor only in the medical therapy group (p=.01). Age negatively correlated with ΔBMI-Z0-12 in both the RAI (p<.001) and medical therapy groups (p=.003). Gender, maximum TSH in the 12 months after RAI, and initial dose of LT4 replacement did not correlate with ΔBMI-Z0-12. The prevalence of overweight and obesity in our cohort was similar to US children. Conclusions Weight gain during treatment for Graves’ disease is common in children, and many children become overweight or obese during treatment. Risk factors include greater degree of hyperthyroidism at presentation and time of RAI and younger age. Weight lost upon presentation may also predict greater weight gain. Control of subsequent hypothyroidism does not appear to affect weight gain. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/cen.13493

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