Relationship of thyroid function with body mass index and insulin-resistance in euthyroid obese subjects

Ambrosi, Bruno; Masserini, Benedetta; Iorio, Laura; Delnevo, Alessandra; Malavazos, Alexis Elias; Morricone, Lelio; Sburlati, L; Orsi, Emanuela

doi:10.1007/bf03346663

Cited by 63 publications

(65 citation statements)

References 25 publications

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“…observed a positive association of TSH with arterial blood pressure and serum lipids in euthyroid subjects (10). Similar associations of TSH within the normal range have been found with insulin sensitivity and abdominal obesity (11). The direction of the association between TSH and some metabolic parameters such as body mass index (BMI) is not clear, though the existence of an association is beyond doubt (12).…”

Section: Introductionmentioning

confidence: 79%

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects

Shinkov¹,

Borissovа²,

Кovatcheva³

et al. 2014

Arq Bras Endocrinol Metab

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Objective: The aim of the study was to assess the prevalence and characteristics of metabolic syndrome (MetS) and its elements in relation to TSH in euthyroid subjects. Materials and metho ds: In the cross-sectional study, 2,153 euthyroid adults, 47.2 ± 14.5 years (20-94) with no current antithyroid or thyroid replacement therapy were enrolled. All participants filled a questionnaire on past and current morbidities, medication and smoking. Body weight, height, waist circumference, serum TSH, glucose and lipids were measured. The subjects were stratified by quartiles of TSH (QTSH) and the prevalence of the MetS elements was calculated. MetS RESUMOObjetivo: O objetivo deste estudo foi avaliar a prevalência e características da síndrome metabólica (MetS) e seus elementos em relação ao TSH em sujeitos eutireoides. Materiais e mé-todos: Foram analisados, em um estudo transversal, 2.153 adultos eutiroides, de 47,2 ± 14,5 anos (20-94) sem terapia antitiroidiana ou de reposição. Todos os participantes preencheram um questionário sobre doenças atuais e passadas, medicações e tabagismo. O peso corporal, altura, circunferência da cintura, TSH, glicose e lipídios séricos foram medidos. Os sujeitos foram estratificados em quartis de TSH (QTSH) e a prevalência dos elementos da MetS foram calculados. Os critérios da MetS foram determinados pela IDF 2005. Resultados: A prevalência de sobrepeso foi de 37,2% (35,2-39,2), de obesidade -25,1% (23,9), obesidade abdominal -61,4% (59,3-63,5), hipertensão -42,1% (38,9-43,1), diabetes/aumento da glicose de jejum -13,6% (12,1-15), baixo colesterol HDL -27,6% (25,7-29,5), hipertrigliceridemia -24,1% (22,3-25,9), 2% (30,2). A MetS foi mais prevalente no QTSH mais alto (34,9%; 30,9-38,9) do que no mais baixo (27%; 23,3-30,9), p < 0,001, assim como o baixo [28][29][30][31][32][33][34][35]9 contra 25%,21,7; p < 0,001) e hipertrigliceridemia (26,8%; 23-30,5 contra 20,4%, 17-23,8; p = 0,015). Cada QTSH aumentou o risco MetS em 14%, p < 0,001, de hipertrigliceridemia em 20%, p = 0,001 e de baixo LDL-C em 9%, p = 0,042. Outros fatores significativos para a MetS foram idade, sexo masculino e obesidade. Conclusão: A prevalência de MetS aumentou com um maior QTSH dentro da variação eutiroide, principalmente por aumento da dislipidemia. Arq Bras Endocrinol Metab. 2014;58(9):926-32 Descritores Síndrome metabólica; função tiroidiana; eutiroidismo; MetS; elementos da síndrome metabólica

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Section: Introductionmentioning

confidence: 79%

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects

Shinkov¹,

Borissovа²,

Кovatcheva³

et al. 2014

Arq Bras Endocrinol Metab

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“…Contrary to adults (2,15,18,(31)(32)(33), the role of thyroid hormones in glucose dysmetabolism in otherwise healthy obese children has been examined to a limited extent. In our pediatric population, both BMI-SDS and TSH variations were independently associated with HOMA-IR variation.…”

Section: δBmc-sdsmentioning

confidence: 99%

Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study

Santos

Limbert

Marquês

et al. 2015

Journal of Pediatric Endocrinology and Metabolism

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Background: Serum thyroid stimulating hormone (TSH) levels are frequently elevated in obese children and are most likely to be associated with insulin resistance. However, clinical relevance of this association remains unclear. Objectives: To assess the prevalence of hyperthyrotropinemia; to analyze the relationship between TSH and homeostasis model assessment -insulin resistance (HOMA-IR); and to verify whether TSH levels and HOMA-IR vary with weight loss in obese children. Subjects and Methods: Retrospective longitudinal study with data from baseline and 1 year after lifestyle intervention in a pediatric obese group (344 children were recruited and 100 among them completed follow-up). For postintervention analysis, three groups were considered according to body mass index-standard deviation score (BMI-SDS) variations: ≤ -0.5 (significant weight loss); 0.5-0 (weight loss); and > 0 (weight gain). Statistical analysis was performed using SPSS 19.0

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“…While the present dataset lacks FT3 measurements to further explore the possibility of this compensatory mechanism, the observed change in the TSH/FT4 set point with weight is consistent with this. Observational studies in euthyroid nonpregnant adults have also documented an association between low FT4 and the components of the metabolic syndrome (14)(15)(16).…”

mentioning

confidence: 98%

Impact of Adjusting for the Reciprocal Relationship Between Maternal Weight and Free Thyroxine During Early Pregnancy

Haddow

Craig

Palomaki

et al. 2013

Thyroid

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for the First and Second Trimester Risk of Aneuploidy (FaSTER) Research ConsortiumBackground: Among euthyroid pregnant women in a large clinical trial, free thyroxine (FT4) measurements below the 2.5th centile were associated with a 17 lb higher weight (2.9 kg/m 2 ) than in the overall study population. We explore this relationship further. Methods: Among 9351 women with second trimester thyrotropin (TSH) measurements between 1st and 98th centiles, we examine: (i) the weight/FT4 relationship; (ii) percentages of women in three weight categories at each FT4 decile; (iii) FT4 concentrations in three weight categories at each TSH decile; and (iv) impact of adjusting FT4 for weight-in the reference group and in 190 additional women with elevated TSH measurements. Results: FT4 values decrease steadily as weight increases ( p < 0.0001 by ANOVA) among women in the reference group (TSH 0.05-3.8 IU/L). TSH follows no consistent pattern with weight. When stratified into weight tertiles, 48% of women at the lowest FT4 decile are heavy; the percentage decreases steadily to 22% at the highest FT4 decile. Median FT4 is lowest in heaviest women regardless of the TSH level. In the reference group, weight adjustment reduces overall variance by 2.9%. Fewer FT4 measurements are at either extreme (below the 5th FT4 centile: 4.8% before adjustment, 4.7% after adjustment; above the 95th FT4 centile: 5.0% and 4.7%, respectively). Adjustment places more light weight women and fewer heavy women below the 5th FT4 centile; the converse above the 95th centile. Between TSH 3.8 and 5 IU/L, the FT4 percentage below the 5th FT4 centile is not elevated (3.8% before adjustment, 3.1% after adjustment). Percentage of FT4 values above the 95th centile, however, is lower (1.5% before adjustment, 0.8% after adjustment). Above TSH 5 IU/L, 25% of women have FT4 values below the 5th FT4 centile; weight adjustment raises this to 30%; no FT4 values remain above the 95th FT4 centile. Conclusions: During early pregnancy, TSH values are not associated with weight, unlike nonpregnant adults. Lower average FT4 values among heavy women at all TSH deciles partially explain interindividual differences in FT4 reference ranges. The continuous reciprocal relationship between weight and FT4 explains lower FT4 with higher weight. Weight adjustment refines FT4 interpretation.

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Relationship of thyroid function with body mass index and insulin-resistance in euthyroid obese subjects

Cited by 63 publications

References 25 publications

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects

Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study

Impact of Adjusting for the Reciprocal Relationship Between Maternal Weight and Free Thyroxine During Early Pregnancy

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