Thyroid-Related Hormones Changes Predict Changes in Anthropometric Measures and Incidence of Obesity in Chinese Euthyroid Persons

Abstract

The purpose of this study was to investigate the correlation of thyroid-related hormones changes within the reference range with the changes in anthropometric measures and incidence of obesity. The study included 4850 subjects with normal thyroid-related hormones at baseline and at follow-up. We evaluated the relationship of changes in thyroid-related biomarkers with anthropometric measures changes and incidence of obesity. In euthyroid persons, changes in serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) concentrations and FT3/FT4 ratio were independent predictors of changes in body mass index (BMI) and waist circumference (WC) in men, changes in serum FT3 and FT4 concentrations and FT3/FT4 ratio were independent predictors of changes in BMI and WC in women. Every single unit increment in ΔFT3/FT4 was accompanied by a 7.144 and 7.572 times risk of having obesity in men and women, respectively. Every single unit decrement in ΔFT4 was accompanied by a 21.0% and 26.9% lower risk of having obesity in men and women, respectively. In conclusion, in euthyroid individuals, changes in thyroid-related hormones were associated with anthropometric measures changes and incidence of obesity.

Key words

thyroid-related hormone - anthropometric measure - obesity - euthyroid person

Publication History

Received: 06 June 2022

Accepted after revision: 09 August 2023

Accepted Manuscript online:
09 August 2023

Article published online:
09 October 2023

• References

• 1 GBD 2015 Obesity Collaborators. Afshin A, Forouzanfar MH. et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017; 377: 13-27
• 2 Hales CM, Carroll MD, Fryar CD. et al. Prevalence of obesity among adults and youth: United States, 2015-2016. NCHS Data Brief 2017; 288: 1-8
• 3 Flegal KM, Kit BK, Orpana H. et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013; 309: 71-82
• 4 Brent GA. Mechanisms of thyroid hormone action. J Clin Invest 2012; 122: 3035-3043
• 5 Biondi B. Thyroid and obesity: an intriguing relationship. J Clin Endocrinol Metab 2010; 95: 3614-3617
• 6 Pasquali R, Casanueva F, Haluzik M. et al. European society of endocrinology clinical practice guideline: endocrine work-up in obesity. Eur J Endocrinol 2020; 182: G1-G32
• 7 Sakurai M, Nakamura K, Miura K. et al. Association between a serum thyroid-stimulating hormone concentration within the normal range and indices of obesity in Japanese men and women. Intern Med 2014; 53: 669-674
• 8 Kitahara CM, Platz EA, Ladenson PW. et al. Body fatness and markers of thyroid function among U.S. men and women. PLoS One 2012; 7: e34979
• 9 Ambrosi B, Masserini B, Iorio L. et al. Relationship of thyroid function with body mass index and insulin-resistance in euthyroid obese subjects. J Endocrinol Invest 2010; 33: 640-643
• 10 Díez JJ, Iglesias P. Relationship between thyrotropin and body mass index in euthyroid subjects. Exp Clin Endocrinol Diabetes 2011; 119: 144-150
• 11 Iacobellis G, Ribaudo MC, Zappaterreno A. et al. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol (Oxf) 2005; 62: 487-491
• 12 Galofré JC, Pujante P, Abreu C. et al. Relationship between thyroid-stimulating hormone and insulin in euthyroid obese men. Ann Nutr Metab 2008; 53: 188-194
• 13 Rotondi M, Leporati P, La Manna A. et al. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?. Eur J Endocrinol 2009; 160: 403-408
• 14 Zhang X, Li Y, Zhou X. et al. Association between serum thyrotropin within the euthyroid range and obesity. Endocr J 2019; 66: 451-457
• 15 Kouidhi S, Berhouma R, Ammar M. et al. Relationship of thyroid function with obesity and type 2 diabetes in euthyroid Tunisian subjects. Endocr Res 2013; 38: 15-23
• 16 De Pergola G, Ciampolillo A, Paolotti S. et al. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrinol (Oxf) 2007; 67: 265-269
• 17 Shon HS, Jung ED, Kim SH. et al. Free T4 is negatively correlated with body mass index in euthyroid women. Korean J Intern Med 2008; 23: 53-57
• 18 Shin JA, Mo EY, Kim ES. et al. Association between lower normal free thyroxine concentrations and obesity phenotype in healthy euthyroid subjects. Int J Endocrinol 2014; 104318
• 19 Xu R, Huang F, Zhang S. et al. Thyroid function, body mass index, and metabolic risk markers in euthyroid adults: a cohort study. BMC Endocr Disord 2019; 19: 58
• 20 Nyrnes A, Jorde R, Sundsfjord J. Serum TSH is positively associated with BMI. Int J Obes (Lond) 2006; 30: 100-105
• 21 Gopinath B, Liew G, Flood VM. et al. The association between weight gain and thyroid function in an older population. Arch Intern Med 2008; 168: 2283-2284
• 22 Fox CS, Pencina MJ, D'Agostino RB. et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med 2008; 168: 587-592
• 23 Svare A, Nilsen TI, Bjøro T. et al. Serum TSH related to measures of body mass: longitudinal data from the HUNT Study, Norway. Clin Endocrinol (Oxf) 2011; 74: 769-775
• 24 Bjergved L, Jørgensen T, Perrild H. et al. Thyroid function and body weight: a community-based longitudinal study. PLoS One 2014; 9: e93515
• 25 Abdi H, Kazemian E, Gharibzadeh S. et al. Association between thyroid function and body mass index: a 10-year follow-up. Ann Nutr Metab 2017; 70: 338-345
• 26 Soriguer F, Valdes S, Morcillo S. et al. Thyroid hormone levels predict the change in body weight: a prospective study. Eur J Clin Invest 2011; 41: 1202-1209
• 27 Karavani G, Strich D, Edri S. et al. Increases in thyrotropin within the near-normal range are associated with increased triiodothyronine but not increased thyroxine in the pediatric age group. J Clin Endocrinol Metab 2014; 99: E1471-E1475
• 28 Strich D, Karavani G, Edri S. et al. TSH enhancement of FT4 to FT3 conversion is age dependent. Eur J Endocrinol 2016; 175: 49-54
• 29 Park SY, Park SE, Jung SW. et al. Free triiodothyronine/free thyroxine ratio rather than thyrotropin is more associated with metabolic parameters in healthy euthyroid adult subjects. Clin Endocrinol (Oxf) 2017; 87: 87-96
• 30 WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157-163
• 31 Zhou BF. Cooperative Meta-Analysis Group of the Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci 2002; 15: 83-96
• 32 McKenney JM. Update on the national cholesterol education program adult treatment panel III guidelines: getting to goal. Pharmacotherapy 2003; 23: 26S-33S
• 33 Ishii H, Inada M, Tanaka K. et al. Induction of outer and inner ring monodeiodinases in human thyroid gland by thyrotropin. J Clin Endocrinol Metab 1983; 57: 500-505
• 34 Silvestri E, Schiavo L, Lombardi A. et al. Thyroid hormones as molecular determinants of thermogenesis. Acta Physiol Scand 2005; 184: 265-283
• 35 Tarcin O, Abanonu GB, Yazici D. et al. Association of metabolic syndrome parameters with TT3 and FT3/FT4 ratio in obese Turkish population. Metab Syndr Relat Disord 2012; 10: 137-142
• 36 Song RH, Wang B, Yao QM. et al. The Impact of obesity on thyroid autoimmunity and dysfunction: A systematic review and meta-analysis. Front Immunol 2019; 10: 2349
• 37 Wang B, Song R, He W. et al. Sex differences in the associations of obesity with hypothyroidism and thyroid autoimmunity among Chinese adults. Front Physiol 2018; 9: 1397
• 38 Amouzegar A, Kazemian E, Abdi H. et al. Abdominal obesity phenotypes and incidence of thyroid autoimmunity: a 9-year follow-up. Endocr Res 2020; 45: 202-209
• 39 Shan Z, Chen L, Lian X. et al. Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in China: a cross-sectional study in 10 cities. Thyroid 2016; 26: 1125-1130
• 40 Li Y, Shan Z, Teng W. et al. The iodine status and prevalence of thyroid disorders among women of childbearing age in China: national cross-sectional study. Endocr Pract 2021; 27: 1028-1033