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Relationship of Thyroid Function with Metabolic Parameters in Euthyroid Adults

Yıl 2023, Cilt: 9 Sayı: 1, 169 - 180, 28.02.2023
https://doi.org/10.19127/mbsjohs.1215262

Öz

Objective: Thyroid hormones have a significant effect on carbohydrate, lipid metabolism disorders, and insulin resistance (HOMA-IR) development. Vitamin D (25(OH)D) has been shown also can affect not only the musculoskeletal system, but also almost all tissues in the body, including the thyroid in recent years. In the study, we aim of this study is to investigate the relationship between the levels of thyroid-stimulating hormone (TSH) within the reference range and metabolic parameters in adults.

Methods: 561 adult outpatients were divided into 2 groups low normal range (0.27-2.5 mIU/mL) and high normal range (2.5-4.2 mIU/mL) according to TSH, and HOMA-IR, 25(OH)D, and lipid levels were compared.

Results: A statistically significant positive correlation was found between TSH and HOMA-IR in both the low normal range group (r = 0.123, p = 0.041) and the high normal range group (r = 0.196, p = 0.001). In the high normal range group, the relationship between TSH with vitamin D (r =-0.200, p =0.003), cholesterol (r =0.143, p =0.024), LDL cholesterol (r =0.154, p =0.018), non-HDL cholesterol (r = 0.134, p = 0.035) levels was statistically significant.

Conclusion: Our study shows that high normal TSH levels in euthyroid adults are related to higher insulin resistance and lower 25(OH)D levels, and this interaction is a major contributor to dyslipidemia. Thyroid hormones explain the metabolic disorder in the early stages of T2DM. Therefore, we believe that screening TSH levels and determining the optimal TSH target will be beneficial.

Kaynakça

  • 1. Liu X, Tang HY, Luo ZC. Insulin Resistance and Skin Diseases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020;28;42(2):247-250.
  • 2. Gierach M, Gierach J, Junik R. Insulin resistance and thyroid disorders. Endokrynol Pol. 2014;65(1):70-76.
  • 3. Kim SR, Tull ES, Talbott EO, Vogt MT, Kuller LH. A hypothesis of synergism: the interrelationship of T3 and insulin to disturbances in metabolic homeostasis. Med. Hypotheses. 2002;59(6):660-666.
  • 4. Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol. 2009;160(5):785-90.
  • 5. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocr Metab. 2003;88(6):2438-44.
  • 6. Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ, Feddema P, et al. Thyroid dysfunction and serum lipids: a community-based study. Clin Endocrinol 2005; 63:670–675.
  • 7. Zhao M, Liu L, Wang F, Yuan Z, Zhang X, Xu C, et al. A Worthy Finding: Decrease in Total Cholesterol and Low-Density Lipoprotein Cholesterol in Treated Mild Subclinical Hypothyroidism. Thyroid. 2016;26(8):1019-29.
  • 8. Stumpf WE, Sar M, O’Brien LP. Vitamin D sites of action in the pituitary studied by combined autoradiography-immunohistochemistry. Histochemistry. 1987;88(1):11-6.
  • 9. Nettore IC, Albano L, Ungaro P, Colao A, Macchia PE. Sunshine vitamin and thyroid. Rev Endocr Metab Disord. 2017;18(3): 347–354.
  • 10. Verrusio W, Magro VM, Renzi A, Casciaro B, Andreozzi P, Cacciafesta M. Thyroid hormones, metabolic syndrome and Vitamin D in middle-aged and older euthyroid subjects: a preliminary study. Aging Clin Exp Res. 2019;31(9):1337-1341.
  • 11. Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab. 2002;87 (3):1068 –1072.
  • 12. Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90(7):4019-24.
  • 13. Cevlik T, Haklar G, Sirikci O, Emerk K. TSH değerleri 2,5-4,2 mIU/L aralığında bulunan bireylerin subklinik hipotroidi geliştirme riski. Nobel Med. 2016;12(2): 20-25
  • 14. Mueller A, Schöfl C, Dittrich R, Cupisti S, Oppelt PG, Schild RL, et al. Thyroid-stimulating hormone is associated with insulin resistance independently of body mass index and age in women with polycystic ovary syndrome. Hum Reprod. 2009;24(11):2924-30.
  • 15. Fernandez-Real J-M, Lopez-Bermejo A, Castro A, Casamitjana R, Ricart W. Thyroid function is intrinsically linked to insulin sensitivity and endothelium-dependent vasodilation in healthy euthyroid subjects. J Clin Endocr Metab. 2006; 91:3337–3343.
  • 16. Zhu P, Liu X, Mao X. Thyroid-Stimulating Hormone Levels Are Positively Associated with Insulin Resistance. Med Sci Monit. 2018;17; 24:342-347.
  • 17. Lambadiari V, Mitrou P, Maratou E, Raptis AE, Tountas N, Raptis SA, et al. Thyroid hormones are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine. 2011;39(1):28-32.
  • 18. Nader NS, Bahn RS, Johnson MD, Weaver AL, Singh R, Kumar S. Relationships between thyroid function and lipid status or insulin resistance in a pediatric population Thyroid. 2010; 20(12):1333-9.
  • 19. Brenta G, Celi FS, Pisarev M, Schnitman M, Sinay I, Arias P. Acute thyroid hormone withdrawal in athyreotic patients results in a state of insulin resistance. Thyroid. 2009; 19(6):665-9.
  • 20. Koritschoner NP, Alvarez-Dolado M, Kurz SM, Heikenwälder MF, Hacker C, Vogel F, et al. Thyroid hormone regulates the obesity gene tub. EMBO Rep. 2001; 2:499–504.
  • 21. Ferrannini E, Iervasi G, Cobb J, Ndreu R, Nannipieri M. Insulin resistance and normal thyroid hormone levels: prospective study and metabolomic analysis. Am J Physiol Endocrinol Metab. 2017;1;312(5): E429-E436.
  • 22. Teixeira PFDS, Dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab. 2020; 13;11:2042018820917869.
  • 23. Barber TM, McCarthy MI, Wass JA, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf). 2006;65 (2):137-45.
  • 24. Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord. 2002;26(7):883-96.
  • 25. Senese R, Lasala P, Leanza C, Lange P. New avenues for regulation of lipid metabolism by thyroid hormones and analogs. Front Physiol. 2014;5;5:475.
  • 26. Asvold BO, Vatten LJ, Nilsen TIL, Bjøro T. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study. Eur J Endocrinol. 2007;156(2):181-6.
  • 27. Chubb SAP, Davis WA, Davis TME. Interactions among thyroid function, insulin sensitivity, and serum lipid concentrations: the Fremantle diabetes study. J Clin Endocrinol Metab. 2005;90(9):5317-20.
  • 28. Skoczyńska A, Wojakowska A, Turczyn B, Zatońska K, Wolyniec M, Rogala N, et al. Serum lipid transfer proteins in hypothyroid patients are inversely correlated with Thyroid-Stimulating Hormone (TSH) levels. Med Sci Monit. 2016;30; 22:4661–69.
  • 29. Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord. 2015;2; 15:9.
  • 30. Bakker SJ, Maaten JC, Popp-Snijders C, Slaets JP, Heine RJ, Gans RO. The relationship between thyrotropin and low-density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab. 2001;86(3):1206-11.
  • 31. Michalopoulou G, Alevizaki M, Piperingos G, Mitsibounas D, Mantzos E, Adamopoulos P, et al. High serum cholesterol levels in persons with ‘high-normal’ TSH levels: should one extend the definition of subclinical hypothyroidism? European Journal of Endocrinology. 1998;138 141–145.
  • 32. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid: official journal of the American Thyroid Association. 2011;21(8):891–6.
  • 33. Barchetta I, Baroni MG, Leonetti F, Bernardinis MD, Bertoccini L, Fontana M, et al. TSH levels are associated with vitamin D status and seasonality in an adult population of euthyroid adults. Clin Exp Med. 2015;15(3):389-96.
  • 34. Liu S, Xiong F, Liu EM, Zhu M, Lei PY. Effects of 1,25-dihydroxy vitamin D3 in rats with experimental autoimmune thyroiditis. Nan fang yi ke da Xue Xue bao = Journal of Southern Medical University. 2010;30(7):1573–6.
  • 35. Gelbard HA, Stern PH, U’Prichard DC. 1 alpha, 25-dihydroxyvitamin D3 nuclear receptors in the pituitary. Science. 1980;12;209(4462):1247-9.
  • 36. Brabant G, Beck-Peccoz P, Jarzab B, Laurberg P, Orgiazzi J, Szabolcs I, et al. Is there a need to redefine the upper normal limit of TSH? Eur J Endocrinol. 2006; 154:633– 637.
  • 37. Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clinical Endocrinology. (Oxf) 1995;43(1):55-68.
  • 38. Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002; 8(6):457–469.
Yıl 2023, Cilt: 9 Sayı: 1, 169 - 180, 28.02.2023
https://doi.org/10.19127/mbsjohs.1215262

Öz

Kaynakça

  • 1. Liu X, Tang HY, Luo ZC. Insulin Resistance and Skin Diseases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020;28;42(2):247-250.
  • 2. Gierach M, Gierach J, Junik R. Insulin resistance and thyroid disorders. Endokrynol Pol. 2014;65(1):70-76.
  • 3. Kim SR, Tull ES, Talbott EO, Vogt MT, Kuller LH. A hypothesis of synergism: the interrelationship of T3 and insulin to disturbances in metabolic homeostasis. Med. Hypotheses. 2002;59(6):660-666.
  • 4. Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol. 2009;160(5):785-90.
  • 5. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocr Metab. 2003;88(6):2438-44.
  • 6. Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ, Feddema P, et al. Thyroid dysfunction and serum lipids: a community-based study. Clin Endocrinol 2005; 63:670–675.
  • 7. Zhao M, Liu L, Wang F, Yuan Z, Zhang X, Xu C, et al. A Worthy Finding: Decrease in Total Cholesterol and Low-Density Lipoprotein Cholesterol in Treated Mild Subclinical Hypothyroidism. Thyroid. 2016;26(8):1019-29.
  • 8. Stumpf WE, Sar M, O’Brien LP. Vitamin D sites of action in the pituitary studied by combined autoradiography-immunohistochemistry. Histochemistry. 1987;88(1):11-6.
  • 9. Nettore IC, Albano L, Ungaro P, Colao A, Macchia PE. Sunshine vitamin and thyroid. Rev Endocr Metab Disord. 2017;18(3): 347–354.
  • 10. Verrusio W, Magro VM, Renzi A, Casciaro B, Andreozzi P, Cacciafesta M. Thyroid hormones, metabolic syndrome and Vitamin D in middle-aged and older euthyroid subjects: a preliminary study. Aging Clin Exp Res. 2019;31(9):1337-1341.
  • 11. Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab. 2002;87 (3):1068 –1072.
  • 12. Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90(7):4019-24.
  • 13. Cevlik T, Haklar G, Sirikci O, Emerk K. TSH değerleri 2,5-4,2 mIU/L aralığında bulunan bireylerin subklinik hipotroidi geliştirme riski. Nobel Med. 2016;12(2): 20-25
  • 14. Mueller A, Schöfl C, Dittrich R, Cupisti S, Oppelt PG, Schild RL, et al. Thyroid-stimulating hormone is associated with insulin resistance independently of body mass index and age in women with polycystic ovary syndrome. Hum Reprod. 2009;24(11):2924-30.
  • 15. Fernandez-Real J-M, Lopez-Bermejo A, Castro A, Casamitjana R, Ricart W. Thyroid function is intrinsically linked to insulin sensitivity and endothelium-dependent vasodilation in healthy euthyroid subjects. J Clin Endocr Metab. 2006; 91:3337–3343.
  • 16. Zhu P, Liu X, Mao X. Thyroid-Stimulating Hormone Levels Are Positively Associated with Insulin Resistance. Med Sci Monit. 2018;17; 24:342-347.
  • 17. Lambadiari V, Mitrou P, Maratou E, Raptis AE, Tountas N, Raptis SA, et al. Thyroid hormones are positively associated with insulin resistance early in the development of type 2 diabetes. Endocrine. 2011;39(1):28-32.
  • 18. Nader NS, Bahn RS, Johnson MD, Weaver AL, Singh R, Kumar S. Relationships between thyroid function and lipid status or insulin resistance in a pediatric population Thyroid. 2010; 20(12):1333-9.
  • 19. Brenta G, Celi FS, Pisarev M, Schnitman M, Sinay I, Arias P. Acute thyroid hormone withdrawal in athyreotic patients results in a state of insulin resistance. Thyroid. 2009; 19(6):665-9.
  • 20. Koritschoner NP, Alvarez-Dolado M, Kurz SM, Heikenwälder MF, Hacker C, Vogel F, et al. Thyroid hormone regulates the obesity gene tub. EMBO Rep. 2001; 2:499–504.
  • 21. Ferrannini E, Iervasi G, Cobb J, Ndreu R, Nannipieri M. Insulin resistance and normal thyroid hormone levels: prospective study and metabolomic analysis. Am J Physiol Endocrinol Metab. 2017;1;312(5): E429-E436.
  • 22. Teixeira PFDS, Dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab. 2020; 13;11:2042018820917869.
  • 23. Barber TM, McCarthy MI, Wass JA, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf). 2006;65 (2):137-45.
  • 24. Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord. 2002;26(7):883-96.
  • 25. Senese R, Lasala P, Leanza C, Lange P. New avenues for regulation of lipid metabolism by thyroid hormones and analogs. Front Physiol. 2014;5;5:475.
  • 26. Asvold BO, Vatten LJ, Nilsen TIL, Bjøro T. The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study. Eur J Endocrinol. 2007;156(2):181-6.
  • 27. Chubb SAP, Davis WA, Davis TME. Interactions among thyroid function, insulin sensitivity, and serum lipid concentrations: the Fremantle diabetes study. J Clin Endocrinol Metab. 2005;90(9):5317-20.
  • 28. Skoczyńska A, Wojakowska A, Turczyn B, Zatońska K, Wolyniec M, Rogala N, et al. Serum lipid transfer proteins in hypothyroid patients are inversely correlated with Thyroid-Stimulating Hormone (TSH) levels. Med Sci Monit. 2016;30; 22:4661–69.
  • 29. Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord. 2015;2; 15:9.
  • 30. Bakker SJ, Maaten JC, Popp-Snijders C, Slaets JP, Heine RJ, Gans RO. The relationship between thyrotropin and low-density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab. 2001;86(3):1206-11.
  • 31. Michalopoulou G, Alevizaki M, Piperingos G, Mitsibounas D, Mantzos E, Adamopoulos P, et al. High serum cholesterol levels in persons with ‘high-normal’ TSH levels: should one extend the definition of subclinical hypothyroidism? European Journal of Endocrinology. 1998;138 141–145.
  • 32. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid: official journal of the American Thyroid Association. 2011;21(8):891–6.
  • 33. Barchetta I, Baroni MG, Leonetti F, Bernardinis MD, Bertoccini L, Fontana M, et al. TSH levels are associated with vitamin D status and seasonality in an adult population of euthyroid adults. Clin Exp Med. 2015;15(3):389-96.
  • 34. Liu S, Xiong F, Liu EM, Zhu M, Lei PY. Effects of 1,25-dihydroxy vitamin D3 in rats with experimental autoimmune thyroiditis. Nan fang yi ke da Xue Xue bao = Journal of Southern Medical University. 2010;30(7):1573–6.
  • 35. Gelbard HA, Stern PH, U’Prichard DC. 1 alpha, 25-dihydroxyvitamin D3 nuclear receptors in the pituitary. Science. 1980;12;209(4462):1247-9.
  • 36. Brabant G, Beck-Peccoz P, Jarzab B, Laurberg P, Orgiazzi J, Szabolcs I, et al. Is there a need to redefine the upper normal limit of TSH? Eur J Endocrinol. 2006; 154:633– 637.
  • 37. Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clinical Endocrinology. (Oxf) 1995;43(1):55-68.
  • 38. Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002; 8(6):457–469.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Gülsen Şener 0000-0002-2006-2175

Yayımlanma Tarihi 28 Şubat 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 9 Sayı: 1

Kaynak Göster

Vancouver Şener G. Relationship of Thyroid Function with Metabolic Parameters in Euthyroid Adults. Middle Black Sea Journal of Health Science. 2023;9(1):169-80.

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