Are Thyroid Autoimmune Diseases Associated with Cardiometabolic Risks in a Population with Normal Thyroid-Stimulating Hormone?

Abstract

Background The interrelation between thyroid autoimmunity and cardiovascular risks is complex and has not been confirmed. This study aimed at evaluating whether there exists a relationship between thyroid autoimmune diseases (AITDs) and cardiometabolic risks in a large population with normal thyroid-stimulating hormone (TSH) levels. Methods The data was obtained from a cross-sectional study (SPECT-China study). This study enrolled 9082 subjects (3948 males and 5134 females) above 18 years with normal TSH levels. AITD was defined according to the positivity of TPOAb and TgAb as well as thyroid ultrasonography (US) findings. Results After full adjustment, TPOAb and/or TgAb positivity (TPO/TgAb (+)) was significantly associated with higher BMI, waist circumference (WC), and HbA1c only in women (P = 0.004, 0.026 and 0.032, respectively), while both TPO/TgAb positivity and US positivity (TPO/TgAb (+) and US (+)) were positively associated with BMI and WC in both genders (P = 0.002 and 0.020 in men; P < 0.001and <0.001 in women). TPO/TgAb (+) and US (+) were positively associated with HOMA-IR in women (P = 0.021) as well. Binary logistic analysis showed that AITDs had increased risks of central obesity, hyperlipidemia, and metabolic syndrome only in women (all P < 0.05). Moreover, TPO/TgAb (+) and US (+) were associated with an increased risk of obesity for both genders (P = 0.014 in men and P = 0.006 in women). Conclusions Thyroid autoimmunity was positively associated with HbA1c, HOMA-IR, obesity, central obesity, hyperlipidemia, and metabolic syndrome, especially in women. This highlighted that AITDs may be potential risk factors for cardiometabolic disorders even if one's TSH was within the reference range.

The Correlation Between Metabolic Disorders And Tpoab/Tgab: A Cross-Sectional Population-Based Study

“…(3) fat secretes adipokines (such as adiponectin and leptin), recruits immune and inflammatory cells, and activates inflammatory pathways (20); (4) hyperlipidemia causes an imbalance in intestinal flora and then affects the differentiation of Th17 cells (35); and (5) hyperlipidemia induces metabolic changes and alterations in the immune cell shape (a greater degree of lipid raft formation), leading to increased T-cell receptor-mediated signal transduction and inflammation (36). In this study, only women with high LDL-C levels were found to be associated with positive TgAb risk, similar to that in previous studies (37). In addition, the emerging concept of the role of immune regulation by statins, pioglitazone, avasimibe, and other drugs in the treatment of autoimmune diseases may promote the development of next-generation immunotherapies (38).…”

Thyroid autoimmunity has no negative impact on insulin dynamics in pre-diabetic patients with normal thyroid function

“…Although there are studies in agreement with this finding (13,38,39), other studies did not document any association between AITD and DM2 as in the present study (13,36,37,40). In addition, the presence of metabolic syndrome, with or without obesity, has been shown to be related to AITD in some but not all studies (41-43) while similarly discordant results were published regarding the association of dyslipidemia with AITD (15,41,42,44,45). In favor of an association between AITD and cardiovascular risk factors is the fact that AITD has been related to indirect indices of atherosclerosis such as carotid intima-media thickness (46).…”

“…Recently, in a large series of 9082 euthyroid subjects, AITD was positively related to HbA1c, IRI, obesity, central obesity, hyperlipidemia, and metabolic syndrome, especially in women (15). This specific study highlighted that AITD per se may be a potential risk factor for the development of cardiometabolic disorders since the investigators abrogated the negative effect of abnormal TSH (hypothyroidism or hyperthyroidism) on glucose metabolism (15)(16).…”

Thyroid Autoimmunity Has No Negative Impact On Insulin Dynamics In Prediabetic Patients With Normal Thyroid Function

“…Although there are studies in agreement with this finding 13,38,39 , other studies did not document any association between AITD and DM2, as in the present study 13,33,36,37 . In addition, the presence of metabolic syndrome, with or without obesity, has been shown to be related to AITD in some, but not all studies [40][41][42] , while similarly discordant results were published regarding the association of dyslipidemia with AITD 15,40,41,43,44 . In favor of an association between AITD and cardiovascular risk factors is the fact that AITD has been related to indirect indices of atherosclerosis, such as carotid intima-media thickness 44 .…”

“…Recently, in a large series of 9082 euthyroid subjects, AITD was positively related to HbA1c, IRI, obesity, central obesity, hyperlipidemia, and metabolic syndrome, especially in women 15 . This specific study highlighted that AITD per se may be a potential risk factor for the development of cardiometabolic disorders since the investigators abrogated the negative effect of abnormal thyroid stimulating hormone (TSH) (hypothyroidism or hyperthyroidism) on glucose metabolism [15][16] .…”