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      Thyroid function, body mass index, and metabolic risk markers in euthyroid adults: a cohort study

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          Abstract

          Background

          In recent years, the relationship between thyroid stimulating hormone (TSH) and obesity has been widely discussed. However, it is unclear how thyroid hormone concentrations relate to body weight and its impact on metabolic risk markers. This study aimed to assess how thyroid function is linked to underweight, overweight, or obesity, and metabolic risk markers in adults.

          Methods

          A total of 16,975 subjects, aged 18–80 years, who attended the Health Management Center of Tongji Hospital, Wuhan, China were enrolled in this study. Anthropometric and laboratory data were collected and analyzed.

          Results

          Serum free triiodothyronine (fT3) and fT3/free thyroxine (fT4) ratio (fT3/fT4) were positively associated with body mass index (BMI) ( P < 0.001), while there was a negative relationship between fT4 and BMI ( P < 0.001) according to multivariable regression analysis adjusted for age and sex. Associations between thyroid hormone concentrations and markers of blood pressure, and lipid and glucose metabolism were identified after adjustment for age, sex, and BMI, with TSH being negatively associated with fasting blood glucose (FBG). fT3 was positively associated with systolic blood pressure and low-density lipoprotein-cholesterol, while fT4 was positively associated with diastolic blood pressure, FBG, and high-density lipoprotein-cholesterol (HDL-C), and negatively associated with hemoglobin A1c (HbA1c) and triglyceride. Finally, fT3/fT4 was positively associated with HbA1c and triglyceride, and negatively associated with HDL-C.

          Conclusions

          Overweight or obese participants had a high serum concentration of fT3, high fT3/fT4 ratio, and a low concentration of fT4. Underweight participants had high concentrations of fT4 and low concentrations of fT3. Thus, relationships between thyroid hormones and metabolic risk markers were identified which suggest that thyroid function might be one factor that influences body weight and the co-morbidities of obesity.

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          Most cited references34

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          Thyroid and obesity: an intriguing relationship.

          Bernadette Biondi (2010)
          Article 0 comments Cited 102 times – based on 0 reviews     Review now
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            Thyroid hormone as a determinant of energy expenditure and the basal metabolic rate.

            Brian Kim (2008)
            It has long been accepted that thyroid hormone is an important determinant of overall energy expenditure and the basal metabolic rate. Indeed, regulating thermogenesis is one of the major tasks of thyroid hormone in adult humans. A wealth of data have demonstrated the effects of thyroid hormone on cellular processes involved with energy expenditure, yet in spite of this body of work it remains unclear which 3,3'-triiodothyronine-responsive energetic processes are most relevant for the determination of the basal metabolic rate. Recently, a novel metabolic role for thyroid hormone has been recognized based on the observation that bile acids can activate local production of thyroid hormone via induction of the type 2 deiodinase. Nevertheless, more work must be done before it can be fully explained how thyroid hormone determines the metabolic rate.
            Article 0 comments Cited 90 times – based on 0 reviews     Review now
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              Thyroid function in humans with morbid obesity.

              Marina Michalaki, V Kyriazopoulou-Dalaina, M Makri … (2005)
              Morbidly obese subjects may present with abnormal thyroid function tests but the reported data are scarce. Therefore, we studied the thyroid parameters in 144 morbidly obese patients, 110 females and 34 males, to assess the prevalence of hypothyroidism. Eleven percent (11.8%) carried the diagnosis of hypothyroidism and were undergoing levothyroxine (LT4) replacement therapy, 7.7% had newly diagnosed subclinical hypothyroidism, 0.7% had subclinical hyperthyroidism and 7.7% were euthyroid with positive antibodies (anti-thyroid peroxidase antibodies [TPOAb]). From the 144 subjects, we selected a cohort of 78 euthyroid subjects with negative TPOAb, who did not receive LT4 replacement or suppression therapy (the experimental group) and compared them to 77 normal-weight euthyroid subjects, TPOA-negative, matched for age and gender who served as controls. The experimental group had higher serum levels of triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), and thyrotropin (TSH) compared to the control group. Serum TSH concentration was associated with fasting serum insulin levels and insulin resistance but not with serum leptin levels, body mass index (BMI), fat mass, and lean body mass. In conclusion, in morbidly obese individuals, the prevalence of overt and subclinical hypothyroidism was high (19.5%). The morbidly obese subjects have higher levels of T3, FT3, T4, and TSH, probably the result of the reset of their central thyrostat at higher level.
              Article 0 comments Cited 73 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Ranran Xu: xuranranxu@126.com
                Fei Huang: 1076476543@qq.com
                Shijie Zhang: 1773122148@qq.com
                Yongman Lv: lvyongman@126.com
                Qingquan Liu:
                ORCID: http://orcid.org/0000-0001-6888-5237
                qqliutj@163.com
                Journal
                Journal ID (nlm-ta): BMC Endocr Disord
                Journal ID (iso-abbrev): BMC Endocr Disord
                Title: BMC Endocrine Disorders
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1472-6823
                Publication date (Electronic): 7 June 2019
                Publication date PMC-release: 7 June 2019
                Publication date Collection: 2019
                Volume: 19
                Electronic Location Identifier: 58
                Affiliations
                [1 ]ISNI 0000 0004 1799 5032, GRID grid.412793.a, Department of Nephrology, , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, ; 1095 Jie Fang Avenue, Hankou, Wuhan, 430030 People’s Republic of China
                [2 ]ISNI 0000 0004 0368 7223, GRID grid.33199.31, Health Management Center, Tongji Hospital, Tongji Medical College, , Huazhong University of Science and Technology, ; 1095 Jie Fang Avenue, Hankou, Wuhan, 430030 People’s Republic of China
                Author information
                http://orcid.org/0000-0001-6888-5237
                Article
                Publisher ID: 383
                DOI: 10.1186/s12902-019-0383-2
                PMC ID: 6555987
                PubMed ID: 31174521
                SO-VID: 29165f87-aafb-4a4d-99cf-8f98edf79556
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 3 November 2018
                Date accepted : 23 May 2019
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: body mass index,obesity,thyroid-stimulating hormone,triiodothyronine,thyroxine,dyslipidemia
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: body mass index, obesity, thyroid-stimulating hormone, triiodothyronine, thyroxine, dyslipidemia

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