The association between obesity and hormonal imbalances in children: a prospective study

Abstract

Background: Hormonal alterations, may complicate the metabolic consequences linked to childhood obesity. To study the relation between pediatric obesity and hormonal abnormalities, along with the correlation between body mass index (BMI) and other metabolic and endocrine markers. Methods: A prospective observational study including 325 children aged 6 to 14 years was conducted at a tertiary care teaching hospital in north India over 30 months (January 2024 to July 2026). Individuals were classified into three categories based on their BMI percentiles for age and gender as normal weight, overweight, and obese. In addition to blood pressure and anthropometric data, fasting biochemical markers such as cortisol, free thyroxine (free T4), glucose, insulin, and thyroid-stimulating hormone (TSH) were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated to determine insulin resistance. One-way analysis of variance and multivariate linear regression with age and gender adjustments were used for statistical analysis. Results: Obese children demonstrated markedly elevated levels of cortisol, TSH, HOMA-IR, and fasting insulin compared to their normal-weight counterparts, along with reduced levels of free T4 (p<0.05). A multivariate regression analysis, after controlling for age and gender, indicated that BMI was significantly associated with indicators of insulin resistance and thyroid hormone levels. Conclusions: Childhood obesity is associated with significant hormonal and metabolic alterations, suggesting early endocrine adaptations that may have metabolic implications. While these changes (particularly thyroid-related shifts) represent reversible, adaptive responses rather than primary pathology, findings highlight need for early identification and intervention to prevent potential long-term cardiometabolic risks associated with pediatric-onset obesity.