Association between different obesity phenotypes and hypothyroidism: a study based on a longitudinal health management cohort

Yupeng Wang,Honglin Guo,Fang Zhong,Meng Zhao,Ling Gao,Qihang Li,Zhongshang Yuan,Yongfeng Song,Jiajun Zhao,Haiyan Lin,Jing Liu,Liying Guan

doi:10.1007/s12020-021-02677-2

Abstract

PurposeObese individuals have an increased risk of hypothyroidism. This study investigated the sex-specific association between obesity phenotypes and the development of hypothyroidism.MethodsThe study population was derived from a health management cohort in Shandong Provincial Hospital from 2012 to 2016. In total, 9011 baseline euthyroid adults were included and classified into four groups according to obesity phenotype: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO). The median follow-up time was 1.92 (1.00–2.17) years. Incidence density was evaluated and a generalized estimation equation method was used to investigate the associations between obesity phenotypes and the development of hypothyroidism.ResultsThe incidence densities of hypothyroidism in males with a consistent obesity phenotype were 12.19 (8.62–16.76), 15.87 (11.39–21.56), 14.52 (6.74–27.57), and 19.88 (14.06–27.34) per 1000 person-years in the MHNO, MHO, MUNO, and MUO groups, respectively. After adjusting for confounding factors, compared with the MHNO phenotype, the MHO, MUNO, and MUO phenotypes were independent risk factors for developing hypothyroidism in males. In the subgroup analysis, the MHO and MUO phenotypes were independent risk factors for developing hypothyroidism in males under 55 years, while the MUNO phenotype was an independent risk factor in males over 55 years. The MHO, MUNO, and MUO phenotypes were not independent risk factors for hypothyroidism in females.ConclusionBoth obesity and metabolic abnormities are associated with a higher risk of hypothyroidism in males. The underlying mechanism of the sex and age differences in this association needs further investigation.

Highlights

Materials and methodsHypothyroidism refers to the common pathological condition of thyroid hormone deficiency and includes overt hypothyroidism and subclinical hypothyroidism [1]
Of the 97,679 participants who underwent health examination in Shandong Provincial Hospital between 2012 and 2016, 11,190 adults who were euthyroid at baseline and had thyroid function tests at each visit were examined for eligibility
The results of generalized estimation equation (GEE) analysis for developing hypothyroidism based on different obesity phenotypes during follow-up according to sex are presented in Table 2 and Fig. 3. These results showed that in males, the metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO) phenotypes were all risk factors for developing hypothyroidism compared with the metabolically healthy nonobese (MHNO) phenotype

Summary

Introduction

Materials and methodsHypothyroidism refers to the common pathological condition of thyroid hormone deficiency and includes overt hypothyroidism and subclinical hypothyroidism [1]. Many studies have found that subclinical hypothyroidism is associated with an increased risk of cardiovascular disease events and mortality [3, 4]. These facts highlight the need to identify the risk factors for hypothyroidism to prevent the increase in its incidence. A meta-analysis including 22 studies showed that the obese population had increased risks of both overt hypothyroidism and subclinical hypothyroidism [8]. A prospective cohort study found that participants with metabolic syndrome at baseline had an increased risk of developing subclinical hypothyroidism [9]

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