Abstract
BackgroundIn recent years, the relationship between thyroid stimulating hormone (TSH) and obesity has been widely discussed. However, it is unclear how thyroid hormone concentrations relate to body weight and its impact on metabolic risk markers. This study aimed to assess how thyroid function is linked to underweight, overweight, or obesity, and metabolic risk markers in adults.MethodsA total of 16,975 subjects, aged 18–80 years, who attended the Health Management Center of Tongji Hospital, Wuhan, China were enrolled in this study. Anthropometric and laboratory data were collected and analyzed.ResultsSerum free triiodothyronine (fT3) and fT3/free thyroxine (fT4) ratio (fT3/fT4) were positively associated with body mass index (BMI) (P < 0.001), while there was a negative relationship between fT4 and BMI (P < 0.001) according to multivariable regression analysis adjusted for age and sex. Associations between thyroid hormone concentrations and markers of blood pressure, and lipid and glucose metabolism were identified after adjustment for age, sex, and BMI, with TSH being negatively associated with fasting blood glucose (FBG). fT3 was positively associated with systolic blood pressure and low-density lipoprotein-cholesterol, while fT4 was positively associated with diastolic blood pressure, FBG, and high-density lipoprotein-cholesterol (HDL-C), and negatively associated with hemoglobin A1c (HbA1c) and triglyceride. Finally, fT3/fT4 was positively associated with HbA1c and triglyceride, and negatively associated with HDL-C.ConclusionsOverweight or obese participants had a high serum concentration of fT3, high fT3/fT4 ratio, and a low concentration of fT4. Underweight participants had high concentrations of fT4 and low concentrations of fT3. Thus, relationships between thyroid hormones and metabolic risk markers were identified which suggest that thyroid function might be one factor that influences body weight and the co-morbidities of obesity.
Highlights
In recent years, the relationship between thyroid stimulating hormone (TSH) and obesity has been widely discussed
Systolic blood pressure (SBP), diastolic blood pressure (DBP), free triiodothyronine (fT3), fT3/free thyroxine (fT4) ratio, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), TG, total cholesterol (TC), Low-density lipoprotein cholesterol (LDL-C), and homocysteine were higher in the higher weight groups, whereas fT4 and high-density lipoprotein-cholesterol (HDL-C) were higher in the lower weight groups (Table 1)
We investigated the relationships between TSH and thyroid hormones, and serum lipid concentrations, and found that individuals in the higher quartiles of TSH concentration have higher risks of hypercholesterolemia, hypertriglyceridemia, and mixed hyperlipidemia, independent of the effect of body mass index (BMI). fT3 concentration was positively linked with LDL-C concentration, the lower quartiles of fT4 were associated with hypertriglyceridemia and low serum HDL-C, and high fT3/free thyroxine (fT4) ratio (fT3/fT4) was associated with a higher risk of low HDL-C concentration
Summary
The relationship between thyroid stimulating hormone (TSH) and obesity has been widely discussed. It is unclear how thyroid hormone concentrations relate to body weight and its impact on metabolic risk markers. Xu et al BMC Endocrine Disorders (2019) 19:58 and fT4 [7], which contrasts with subclinical hypothyroidism, during which serum fT4 and fT3 concentrations are at the lower end of the normal range. This is inconsistent with subclinical hypothyroidism being a cause of obesity, and the relationship between thyroid function and body weight requires further study
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