Association between subclinical hypothyroidism and motor, cognitive, and physical activity outcomes in overweight adolescents with developmental coordination disorder

Abstract

Subclinical hypothyroidism (SCH) often presents with nonspecific symptoms that overlap with neurodevelopmental challenges. This study investigated the relationship between SCH and neuropsychological manifestations in overweight/obese youth with developmental coordination disorder (DCD), comparing outcomes against a control group with normal body mass index (BMI). Thirty-two adolescents (16–18 years) with a BMI ≥ 25 were enrolled. The study group (n = 16) comprised participants with elevated thyroid-stimulating hormone (TSH), while the control group (n = 16) had normal TSH levels. DCD was confirmed via the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-SF). Assessment tools included the Windows-based Word Memory Test (WMT), Wechsler Intelligence Scale for Children-IV (WISC-IV), Wechsler Individual Achievement Test-II (WIAT-II) for reading, and Wide Range Assessment of Memory and Learning-II (WRAML-II). Physical activity was monitored using the PAQ-A questionnaire and paedometry. Data were analysed using Spearman correlation and regression. The control group demonstrated significantly superior cognitive and motor performance compared to the study group. While both groups averaged fewer than 5,000 steps/day, the study group’s mean physical activity was markedly lower. A moderate-to-strong negative monotonic correlation was identified between plasma TSH levels and physical activity (rs = –0.66) within the study group. While motor and cognitive impairments characterise DCD, remarkable deterioration in these domains – especially when coupled with increased BMI – strongly correlates with elevated TSH. This link suggests that subclinical hypothyroidism may exacerbate DCD manifestations, highlighting the necessity for biochemical screening and modified treatment approaches in managing overweight adolescents with coordination disorders.