Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population

Wu, Zhiyuan; Yue, Jiang; Li, Ping-An; Wang, Yutao; Zhang, Haiping; Li, Zhiwei; Li, Xia; Tao, Lixin; Gao, Bo; Guo, Xiuhua

doi:10.1186/s12967-023-04276-3

Cited by 10 publications

(8 citation statements)

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“…People of diabetes or other metabolic disorders should be aware of the thyroid function resistance and its consequences, including lipid pattern ( 35 ), renal and liver functions ( 13 , 36 ), atherosclerosis ( 37 ), cognition performance ( 38 ) and mortality ( 12 ). Meanwhile, previous studies have demonstrated a close association between thyroid hormones sensitivity and metabolic disorders based on cross-sectional designs ( 39 ). The causal and temporal relationship needs more data to interpret the clinical relevance of thyroid hormones sensitivity in depth.…”

Section: Discussionmentioning

confidence: 99%

Thyroid hormone sensitivity and diabetes onset: a longitudinal cross-lagged cohort

Cui,

Sui,

Wang

et al. 2023

Front. Endocrinol.

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PurposeThyroid hormones sensitivity is a newly proposed clinical entity closely related with metabolic health. Prior studies have reported the cross-sectional relationship between thyroid hormones sensitivity and diabetes; however, the longitudinal association is unclear to date. We aimed to explore the relationship between impaired thyroid hormone sensitivity at baseline and diabetes onset using a cohort design.MethodsThis study enrolled 7283 euthyroid participants at the first visit between 2008 and 2009, and then annually followed until diabetes onset or 2019. Thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were measured to calculate thyroid hormone sensitivity by thyroid feedback quantile-based index (TFQI), Chinese-referenced parametric thyroid feedback quantile-based index (PTFQI), thyrotropin index (TSHI), thyrotroph thyroxine resistance index (TT4RI) and FT3/FT4 ratio. Cox proportional hazard model and cross-lagged panel analysis were used.ResultsThe mean baseline age was 44.2 ± 11.9 years, including 4170 (57.3%) male. During a median follow-up of 5.2 years, 359 cases developed diabetes. There was no significant association between thyroid hormones sensitivity indices and diabetes onset, and adjusted hazard ratios per unit (95% CIs) were 0.89 (0.65-1.23) for TFQI, 0.91 (0.57-1.45) for PTFQI, 0.95 (0.70-1.29) for TSHI, 0.98 (0.70-1.01) for TT4RI and 2.12 (0.17-5.78) for FT3/FT4 ratio. Cross-lagged analysis supported the temporal association from fasting glucose to impaired thyroid hormones sensitivity indices.ConclusionsOur findings could not demonstrate that thyroid hormones sensitivity status is a predictor of diabetes onset in the euthyroid population. Elevated fasting glucose (above 7.0 mmol/L) appeared to precede impaired sensitivity indices of thyroid hormones.

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Section: Discussionmentioning

confidence: 99%

Thyroid hormone sensitivity and diabetes onset: a longitudinal cross-lagged cohort

Cui,

Sui,

Wang

et al. 2023

Front. Endocrinol.

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“…We conducted a mediation analysis to assess the direct and indirect associations between the TyG index and CVD events via higher hsCRP. In brief, a higher TyG index (≥ median value of 8.6) was used as a predictor variable (X), a higher hsCRP level (≥ 1.0 mg/L) was used as a mediator (M) and a CVD event was used as the outcome variable (Y), as widely used in previous studies to quantify the mediating effect [ 36 ]. Meanwhile, the mediating effect of hsCPR on CVD events through the TyG index was similarly evaluated.…”

Section: Methodsmentioning

confidence: 99%

Joint association of TyG index and high sensitivity C-reactive protein with cardiovascular disease: a national cohort study

Cui,

Liu,

et al. 2024

Cardiovasc Diabetol

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Background Both the triglyceride-glucose (TyG) index, as a surrogate marker of insulin resistance, and systemic inflammation are predictors of cardiovascular diseases; however, little is known about the coexposures and relative contributions of TyG index and inflammation to cardiovascular diseases. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted longitudinal analyses to evaluate the joint and mutual associations of the TyG index and high-sensitivity C-reactive protein (hsCRP) with cardiovascular events in middle-aged and older Chinese population. Methods This study comprised 8 658 participants aged at least 45 years from the CHARLS 2011 who are free of cardiovascular diseases at baseline. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Cardiovascular events were defined as the presence of physician-diagnosed heart disease and/or stroke followed until 2018.We performed adjusted Cox proportional hazards regression and mediation analyses. Results The mean age of the participants was 58.6 ± 9.0 years, and 3988 (46.1%) were females. During a maximum follow-up of 7.0 years, 2606 (30.1%) people developed cardiovascular diseases, including 2012 (23.2%) cases of heart diseases and 848 (9.8%) cases of stroke. Compared with people with a lower TyG index (< 8.6 [median level]) and hsCRP < 1 mg/L, those concurrently with a higher TyG and hsCRP had the highest risk of overall cardiovascular disease (adjusted hazard ratio [aHR], 1.300; 95% CI 1.155–1.462), coronary heart disease (aHR, 1.294; 95% CI 1.130–1.481) and stroke (aHR, 1.333; 95% CI 1.093–1.628), which were predominant among those aged 70 years or below. High hsCRP significantly mediated 13.4% of the association between the TyG index and cardiovascular disease, while TyG simultaneously mediated 7.9% of the association between hsCRP and cardiovascular risk. Conclusions The findings highlight the coexposure effects and mutual mediation between the TyG index and hsCRP on cardiovascular diseases. Joint assessments of the TyG index and hsCRP should be underlined for the residual risk stratification and primary prevention of cardiovascular diseases, especially for middle-aged adults.

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“…Given the difficulty in directly measuring thyroid hormone sensitivity in clinical practice, we employed the TFQI, TSHI, TT4RI, and fT4/fT3 ratio as surrogate markers. These indices have been validated across numerous studies, underscoring their clinical value and accuracy in evaluating the sensitivity to thyroid hormone [ 20 – 22 ]. Indices of central thyroid hormone sensitivity included the TFQI (TFQI = cdf fT4 − (1 − cdf TSH), where cdf is the cumulative distribution function), TSHI (TSHI = ln TSH (mIU/L) + 0.1345 × fT4 (pmol/L)), and TT4RI (TT4RI = fT4 (pmol/L) × TSH (mIU/L)), and peripheral thyroid sensitivity was calculated as fT4/fT3 [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Impaired Sensitivity to Thyroid Hormones Is Associated With the Change of Abdominal Fat in Euthyroid Type 2 Diabetes Patients: A Retrospective Cohort Study

Cao,

Li,

et al. 2024

Journal of Diabetes Research

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Background and Aims: This study is aimed at investigating the potential correlation of thyroid hormone sensitivity with visceral fat area (VFA), subcutaneous fat area (SFA), and body mass index (BMI) among euthyroid type 2 diabetes mellitus (T2DM) subjects.Methods: Thyroid hormone sensitivity indices were calculated by thyroid feedback quantile–based index (TFQI), TSH index (TSHI), thyrotropin thyroxine resistance index (TT4RI), and free thyroxine (fT4)/free triiodothyronine (fT3) ratio. These indices were then categorized into quartiles for analysis. The outcomes were the change rates in VFA, SFA, and BMI among the participants.Result: The present study included 921 patients, with a median follow-up of 2.2 years. In multivariate linear regression, when compared to the first quartile, SFA demonstrated a notable decline in the fourth quartile of TFQI, TSHI, and TT4RI (β coefficient=−5.78,−7.83,and−6.84 cm2 per year), while it significantly increased in the fourth quartile of fT4/fT3 ratio (β coefficient=6.13 cm2 per year). Similarly, in the fourth quartile of TFQI, TSHI, and TT4RI, VFA decreased significantly, evidenced by β coefficients of −5.14, −4.80, and −4.08 cm2 per year. Yet, among the quartiles of the fT4/fT3 ratio, no discernible trend in VFA was observed. There was no significant association between indices of thyroid hormone sensitivity and change in BMI.Conclusion: Impaired central sensitivity to thyroid hormones was significantly associated with the reduction of VFA and SFA, while impaired peripheral sensitivity was associated with an increase of SFA in euthyroid individuals with T2DM.

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Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population

Cited by 10 publications

References 50 publications

Thyroid hormone sensitivity and diabetes onset: a longitudinal cross-lagged cohort

Thyroid hormone sensitivity and diabetes onset: a longitudinal cross-lagged cohort

Joint association of TyG index and high sensitivity C-reactive protein with cardiovascular disease: a national cohort study

Impaired Sensitivity to Thyroid Hormones Is Associated With the Change of Abdominal Fat in Euthyroid Type 2 Diabetes Patients: A Retrospective Cohort Study

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