Cardiovascular risk factors in children and adolescents with subclinical hypothyroidism: A protocol for meta-analysis and systematic review

INTRODUCTION: Subclinical hypothyroidism (SH) is serum thyrotropin (TSH) slightly increased, while serum free thyroxine (FT4) levels are normal, and patients may have no abnormal symptoms, or only slight hypothyroidism, there are many studies proving that SH does increase cardiovascular risk in adults. However, there are few studies in children and adolescents. In order to explore whether children with subclinical hypothyroidism have a higher cardiovascular risk, we designed this meta-analysis. METHODS: The protocol of this systematic review and meta-analysis was registered on the NPLASY (No. 202040182). The following electronic databases will be searched from the inception through the present to find studies that live up to our standard: PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. And we will include case-control studies, cohort studies, and cross-sectional studies. For including study, we will use the Newcastle-Ottawa Scale to evaluate their quality. Then 2 researchers will independently extract the required information. I(2) statistics and subgroups will be used to analyze heterogeneity. We conduct a sensitivity analysis by excluding literature successively. When the system review contains >10 articles, Egger test will be conducted to evaluate publication bias. RESULTS: From this study, we will assess the cardiovascular risk of children and adolescents with SH from multiple perspectives. CONCLUSION: The conclusion of this paper will provide evidence for cardiovascular risk of SH children and provide basis for prevention and treatment of SH. ETHICS AND DISSEMINATION: This meta-analysis does not collect personal primary data, so there is no need for formal moral recognition. The results of the system review will be presented to national and international conferences for publication.