The relationship between serum thyroid-stimulating hormone, insulin resistance, and cardiovascular risk factors in obese patients with subclinical hypothyroidism

Main Article Content

N.V. Pasiechko
Yu.V. Yevstratieva

Abstract

Background. The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. The putative relationships between thyroid hormones, body weight, and adipose tissue homeostasis have been the focus of several studies in recent years, but the causal relationships between these parameters have not been well established. The purpose of the study: to investigate the relationship between serum thyroid-stimulating hormone (TSH), insulin resistance (IR), and cardiovascular risk factors in a sample of obese people with subclinical hypothyroidism. Materials and methods. A retrospective, longitudinal analysis of 145 obese patients was performed. The TSH and free thyroxine (fT4) levels, anthropometric measurements, and laboratory test results were analyzed. Results. Twenty-three individuals presented with TSH levels above the normal level (subclinical hypothyroidism). Their waist circumference (WC) was significantly higher than that of euthyroid individuals. Serum TSH positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides, and high-density lipoprotein cholesterol (HDL-C). Using TSH and body mass index as independent variables, TSH levels were shown to be independently related to HOMA-IR (p = 0.002) and triglycerides (p = 0.006). Among euthyroid subjects, individuals with TSH values < 2.5 mIU/ml exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values. Conclusions. Subclinical hypothyroidism in overweight and obese people appears to be associated with excess weight, especially visceral weight. In the present sample of obese patients, TSH levels appear to be associated with insulin resistance.

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How to Cite
Pasiechko, N., and Y. Yevstratieva. “The Relationship Between Serum Thyroid-Stimulating Hormone, Insulin Resistance, and Cardiovascular Risk Factors in Obese Patients with subclinical Hypothyroidism”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 8, Apr. 2021, pp. 630-5, doi:10.22141/2224-0721.16.8.2020.222879.
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Original Researches

References

Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015 Jul;33(7):673-89. doi: 10.1007/s40273-014-0243-x.

Dyachuk D, Yaschenko Y, Zabolotna I, Yaschenko L. Prevalence of excessive body weight and obesity among children; organization of prevention of child obesity in Ukraine. Georgian Med News. 2019 Apr;(289):62-67.

Yakovenko V, Henn L, Bettendorf M, et al. Risk Factors for Childhood Overweight and Obesity in Ukraine and Germany. J Clin Res Pediatr Endocrinol. 2019 Sep 3;11(3):247-252. doi: 10.4274/jcrpe.galenos.2019.2018.0157.

Han TS, Lean ME. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease. JRSM Cardiovasc Dis. 2016 Feb 25;5:2048004016633371. doi: 10.1177/2048004016633371.

Laurberg P, Knudsen N, Andersen S, Carlé A, Pedersen IB, Karmisholt J. Thyroid function and obesity. Eur Thyroid J. 2012 Oct;1(3):159-67. doi: 10.1159/000342994.

Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):554-7. doi: 10.4103/2230-8210.183454.

Gajda SN, Kuryłowicz A, Żach M, Bednarczuk T, Wyleżoł M. Diagnosis and treatment of thyroid disorders in obese patients - what do we know? Endokrynol Pol. 2019;70(3):271-276. doi: 10.5603/EP.a2018.0089.

Nyrnes A, Jorde R, Sundsfjord J. Serum TSH is positively associated with BMI. Int J Obes (Lond). 2006 Jan;30(1):100-5. doi: 10.1038/sj.ijo.0803112.

Martin SS, Daya N, Lutsey PL, et al. Thyroid Function, Cardiovascular Risk Factors, and Incident Atherosclerotic Cardiovascular Disease: The Atherosclerosis Risk in Communities (ARIC) Study. J Clin Endocrinol Metab. 2017 Sep 1;102(9):3306-3315. doi: 10.1210/jc.2017-00986.

Ichiki T. Thyroid hormone and atherosclerosis. Vascul Pharmacol. 2010 Mar-Apr;52(3-4):151-6. doi: 10.1016/j.vph.2009.09.004.

Kahaly GJ. Cardiovascular and atherogenic aspects of subclinical hypothyroidism. Thyroid. 2000 Aug;10(8):665-79. doi: 10.1089/10507250050137743.

Rodondi N, den Elzen WP, Bauer DC, et al; Thyroid Studies Collaboration. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA. 2010 Sep 22;304(12):1365-74. doi: 10.1001/jama.2010.1361.

Berta E, Lengyel I, Halmi S, et al. Hypertension in Thyroid Disorders. Front Endocrinol (Lausanne). 2019 Jul 17;10:482. doi: 10.3389/fendo.2019.00482.

Young WF Jr, Calhoun DA, Lenders JWM, Stowasser M, Textor SC. Screening for endocrine hypertension: an endocrine society scientific statement. Endocr Rev. 2017;38(2):103-122.  doi:10.1210/er.2017-00054.

Yin DT, He H, Yu K, et al. The association between thyroid cancer and insulin resistance, metabolic syndrome and its components: A systematic review and meta-analysis. Int J Surg. 2018 Sep;57:66-75. doi: 10.1016/j.ijsu.2018.07.013.

Garber JR, Cobin RH, Gharib H, et al; American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028. doi: 10.4158/EP12280.GL.

Biondi B, Cappola AR, Cooper DS. Subclinical Hypothyroidism: A Review. JAMA. 2019 Jul 9;322(2):153-160. doi: 10.1001/jama.2019.9052.

Deshmukh V, Behl A, Iyer V, Joshi H, Dholye JP, Varthakavi PK. Prevalence, clinical and biochemical profile of subclinical hypothyroidism in normal population in Mumbai. Indian J Endocrinol Metab. 2013 May;17(3):454-9. doi: 10.4103/2230-8210.111641.

Janssen IM, Homan J, Schijns W, et al. Subclinical hypothyroidism and its relation to obesity in patients before and after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2015 Nov-Dec;11(6):1257-63. doi: 10.1016/j.soard.2015.02.021.

Pankiv VI, Yuzvenko TYu, Pankiv IV. Type 2 diabetes mellitus and subclinical hypothyroidism: focusing on the role of cholecalciferol. Problems of Endocrine Pathology. 2019;(2):46-51. doi: 10.21856/j-PEP.2019.2.07.

Jin HY. Prevalence of subclinical hypothyroidism in obese children or adolescents and association between thyroid hormone and the components of metabolic syndrome. J Paediatr Child Health. 2018 Sep;54(9):975-980. doi: 10.1111/jpc.13926.

Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):554-7. doi: 10.4103/2230-8210.183454.