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. 2025 Aug 8;51(1):249.
doi: 10.1186/s13052-025-02099-0.

Timing of adiposity rebound in children with congenital hypothyroidism diagnosed by newborn screening and treated with Levothyroxine

Cecilia Lugarà  1   2 , Domenico Corica  1   2 , Giorgia Pepe  1   2 , Maria Francesca Messina  1   2 , Mariella Valenzise  1   2 , Giuseppina Zirilli  1   2 , Letteria Anna Morabito  2 , Alessandra Li Pomi  1   2 , Malgorzata Gabriela Wasniewska  1   2 , Tommaso Aversa  3   4
Affiliations

Timing of adiposity rebound in children with congenital hypothyroidism diagnosed by newborn screening and treated with Levothyroxine

Cecilia Lugarà et al. Ital J Pediatr. .

Abstract

Background: Children with congenital hypothyroidism (CH) are at increased risk of developing childhood obesity. Moreover, an adiposity rebound (AR) that occur early is strongly linked with future obesity. The aims of our study were to explore the timing of AR, to identify factors affecting AR and correlation between age and body mass index (BMI) at AR and BMI at eight years of age in children with CH.

Methods: A retrospective, observational study was conducted on Caucasian children with CH. For each child, BMI growth curve was constructed, AR was identified and compared with the Italian national and regional references.

Results: Sixty-nine patients (44 females) were recruited. The age at AR was 3.4 ± 1.2 vs. 4.5 years of the comparison population (p < 0.001) in females and 3.4 ± 1.4 vs. 5.0 years of the comparison population (p < 0.001) in males with CH. Age at AR showed a significant negative correlation with BMI at 8 years (r = − 0.274, p < 0.039). BMI at AR and BMI at 8 years of age correlated positively (r = 0.460, p < 0.001). The prevalence of obesity/overweight at 8 years of age was 30%. BMI at 8 years of age was 22.4 ± 1.8 kg/m2 in overweight/obese subgroup and 16.9 ± 1.8 kg/m2 in normal BMI subgroup (P 0.001).

Conclusion: Children with CH showed earlier AR compared to Italian national references. The higher risk of obesity in patients with early AR is supported by the association between age, BMI at AR, and BMI at eight years.

Keywords: Adiposity rebound; Childhood obesity; Congenital hypothyroidism; Early adiposity rebound; Levothyroxine; Neonatal screening.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki. Ethical review and approval are not required for this study, in accordance with local or national guidelines, due to the observational retrospective data collection. Informed consent was obtained from all parents of the subjects involved in the study. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
BMI growth curves of CH patients, grouped by sex, compared with Italian national references. (a) BMI growth curve for girls with CH compared with national references; (b) BMI growth curve for boys with CH compared with national references
Fig. 2
Fig. 2
Correlation analysis between BMI at 8 years of age, age and BMI at the time of AR. (a) correlational analysis between BMI at AR and BMI at eight years of age; (b) correlational analysis between age at AR and BMI at eight years of age
See this image and copyright information in PMC

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