Objectives: Although the association between
thyroid stimulating hormone (TSH) and
obesity in children has been investigated in several cross-sectional studies, no study evaluated this association among girls during puberty, which were in a key period closely related to the fluctuations of
thyroid hormones and development of
obesity. Therefore, we conducted a cohort study to investigate the association of general and
abdominal obesity with TSH in girls during puberty. Setting and participants: A cohort study of 481 school-aged girls during puberty was conducted in four regions in east China, with a baseline survey in 2017 and a follow-up survey in 2019. Outcome measures: Anthropometric indexes including height, weight and waist circumference (WC) were measured, and body mass index (BMI) was then calculated. Blood samples were collected to determine TSH and free
thyroxine (FT4). Results: Of the 474 girls at baseline survey, the prevalences of BMI-based general
obesity and WC-based
abdominal obesity were 19.8% (94/474) and 21.7% (103/474), respectively. Compared with normal weight girls, the median serum TSH level was significantly higher in general obese girls (P = 0.037), but not in central obese girls (P = 0.173). Multiple logistic regression models indicated that those in the highest tertile of serum TSH level had a significantly higher risk of BMI-based
overweight/
obesity (OR = 1.83, 95% CI 1.01 to 3.32) compared with the lowest tertile. Analyses from 435 girls prospectively followed-up for 2 years revealed that those with general or
central obesity also had higher follow-up TSH level (P = 0.004 and P = 0.008, respectively). The TSH level for girls with general
obesity at baseline but normal weight at follow-up was 0.45 mU/L (95% CI 0.11 to 0.79) higher than those with normal weight at baseline and follow-up. Conclusions: TSH was positively associated with both general and
abdominal obesity among girls during puberty.