Abstract

BackgroundThe association between subclinical hypothyroidism (SCH) and metabolic risk factors in the general health examination-based population has been widely explored. However, the results have been inconclusive. Additionally, the sex differences in the prevalence of SCH and the association of SCH with metabolic risk factors remain unknown.MethodsWe conducted this cross-sectional study using data from health examination-based participants between June 2016 and April 2018 in our health examination centre. Sex differences SCH and the association of SCH with metabolic risk factors were explored.ResultsThe total prevalence of SCH was 3.40% among the 5319 included participants, and 4.90% among the 2306 female participants, which was much higher than the prevalence of 2.26% among the 3013 male participants (p < 0.05). In males, the difference between participants younger than 60 and aged 60 or older was not significant (p = 0.104); while in females, the difference between participants younger than 40 and participants aged 40 or older was statistically significant (p = 0.023). Multivariate logistic regression analysis demonstrated that age (OR = 0.568, p = 0.004), body-mass index (BMI) (OR = 5.029, p < 0.001) and systolic/diastolic blood pressure (SBP/DBP) (OR = 5.243, p < 0.001) were independent predictors of SCH in females, but no metabolic risk factor was significantly associated with SCH in males. Further analysis revealed that the prevalence was much higher in participants with one or two metabolic risk factors than in those with no above metabolic risk factors regardless of age (p < 0.01).ConclusionsOur study demonstrates that high BMI and/or high blood pressure are associated with SCH in female participants, and the prevalence of SCH among women with one or two metabolic risk factors ranges from 7.69–14.81%, which indicates that in such a population, serum concentrations of TSH and FT4 may be routinely screened in mainland China. Certainly, prospective, large-scale studies with long follow-up period are still necessary to further verify our results.

Highlights

  • The association between subclinical hypothyroidism (SCH) and metabolic risk factors in the general health examination-based population has been widely explored

  • Our study demonstrates that high body-mass index (BMI) and/or high blood pressure are associated with SCH in female participants, and the prevalence of SCH among women with one or two metabolic risk factors ranges from 7.69– 14.81%, which indicates that in such a population, serum concentrations of thyroid-stimulating hormone (TSH) and Free tetraiodothyronine (FT4) may be routinely screened in mainland China

  • Numerous studies demonstrate that SCH is associated with cardiac disease [1], higher low-density lipoprotein cholesterol [2], and depression and cognitive dysfunction [3], which together result in an increased risk for cardiovascular disease (CVD)-related death [4]

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Summary

Introduction

The association between subclinical hypothyroidism (SCH) and metabolic risk factors in the general health examination-based population has been widely explored. The sex differences in the prevalence of SCH and the association of SCH with metabolic risk factors remain unknown. Numerous studies demonstrate that SCH is associated with cardiac disease [1], higher low-density lipoprotein cholesterol [2], and depression and cognitive dysfunction [3], which together result in an increased risk for cardiovascular disease (CVD)-related death [4]. When cost-effectiveness is considered, due to the relatively low prevalence of SCH in the general population, TSH screening is not routinely recommended by the leading association of thyroid medicine [12,13,14,15]. In certain population whose risks for SCH is much higher, TSH screening may be an appropriate option, because higher rate of SCH population can be identified, which means more attention should be paid on such population and the risks of CVD may decrease

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