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Chiu HH, Villanueva E, Larrazabal R, Arcellana AE, Jimeno C. Characteristics and Prevalence of Metabolic Syndrome Among Adult Filipinos with Hypothyroidism: A Cross-sectional Study. J ASEAN Fed Endocr Soc 2024; 39:53-60. [PMID: 38863914 PMCID: PMC11163316 DOI: 10.15605/jafes.039.01.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/30/2023] [Indexed: 06/13/2024] Open
Abstract
Objectives We determined the clinical characteristics and prevalence of metabolic syndrome among adult Filipinos with overt hypothyroidism. Methodology This is a cross-sectional study of 151 adults. Patients were recruited by sequential enrollment. Anthropometric and blood pressure measurements were performed followed by blood extraction for metabolic parameters and thyroid function tests. Clinical and laboratory characteristics were compared between patients with and without metabolic syndrome. Results The prevalence of metabolic syndrome is 40.4% (95%CI: 32.5%, 48.7%). Patients with metabolic syndrome have a waist circumference of 88.4 ± 7.7 cm in females and 93.3 ± 9.0 cm in males. The median fasting blood glucose was 111.4 (52.2) mg/dL, median systolic blood pressure of 120 (30) mm Hg and diastolic blood pressure of 80 (20) mmHg, median serum triglycerides of 174.3 (114.2) mg/dL, median HDL-C of 42.3 (19.2) mg/dL and a proportion of patients with diabetes (23.0%) and hypertension (44.3%), respectively. The presence of increased waist circumference is the most prevalent component seen among hypothyroid patients. There were no differences in terms of age, sex, etiology of hypothyroidism and anti-TPO levels in those with and without metabolic syndrome. Conclusion The prevalence of metabolic syndrome in adult Filipinos with hypothyroidism is high. Emphasis must be placed on early screening using waist circumference and metabolic parameters among hypothyroid patients who are at high risk of developing metabolic syndrome.
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Affiliation(s)
- Harold Henrison Chiu
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
- Department of Biochemistry and Molecular Biology, UP College of Medicine, University of the Philippines Manila
- Section of Endocrinology, Department of Internal Medicine, Cardinal Santos Medical Center
| | - Emilio Villanueva
- Department of Pathology, College of Medicine, University of the Philippines Manila
| | - Ramon Larrazabal
- Department of Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Anna Elvira Arcellana
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Cecilia Jimeno
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
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Xie Y, Wang Z, Chen Z. Analysis of Subclinical Thyroid Dysfunction and Metabolic Abnormality in 28568 Healthy People. Int J Endocrinol 2023; 2023:5216945. [PMID: 37876378 PMCID: PMC10593554 DOI: 10.1155/2023/5216945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/26/2023] [Accepted: 09/29/2023] [Indexed: 10/26/2023] Open
Abstract
We analyzed the detection rates of metabolic syndrome (MetS) and subclinical thyroid dysfunction, including subclinical hyperthyroidism (SCHyper) and subclinical hypothyroidism (SCH), in healthy people, as well as their relationship. Clinical data were collected from 28,568 healthy individuals who underwent physical examinations. The detection rates of SCHyper, SCH, and MetS, as well as in different genders and ages, were analyzed. The detection rate of SCHyper and SCH in females was significantly higher than that in males (P < 0.001), but that of MetS in males was significantly higher than that in females (P < 0.001). In each age group, the detection rate of SCH in females was higher than that in males (P < 0.001). The detection rate of SCH was significantly different in different age groups (P < 0.001). The detection rates of hyperlipidemia (P < 0.001), obesity (P = 0.004), hypertension (P = 0.009), and hyperglycemia (P < 0.001) in the female SCH group were significantly higher than those in the normal group. The detection rates of hyperlipidemia (P = 0.006), obesity (P = 0.04), and hypertension (P = 0.04) in the male SCH group were higher than those in the normal group. The males with SCHyper were more prone to hyperlipidemia (P = 0.02) and obesity (P = 0.03). In addition, the female SCHyper group was not significantly different from the normal group (P > 0.05). Conclusively, the detection rate of SCHyper and SCH in females is higher than that in males, which increases with age. Attention should be paid to subclinical thyroid dysfunction in elderly people, especially females. Early individualized screening and early intervention should be carried out for people with abnormal metabolism.
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Affiliation(s)
- Yan Xie
- Health Management Centre, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Zhixue Wang
- Department of Clinical Laboratory, Bishan Hospital of Chongqing Medical University (Bishan Hospital of Chongqing), Chongqing 402760, China
| | - Zongtao Chen
- Health Management Centre, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
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Wu Z, Jiang Y, Zhou D, Chen S, Zhao Y, Zhang H, Liu Y, Li X, Wang W, Zhang J, Kang X, Tao L, Gao B, Guo X. Sex-specific Association of Subclinical Hypothyroidism With Incident Metabolic Syndrome: A Population-based Cohort Study. J Clin Endocrinol Metab 2022; 107:e2365-e2372. [PMID: 35213715 DOI: 10.1210/clinem/dgac110] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Subclinical hypothyroidism is known to increase the risk of cardiovascular diseases and mortality. However, the longitudinal association between subclinical hypothyroidism and incident metabolic syndrome remains unclear. METHODS A total of 3615 participants from Beijing Health Management Cohort were enrolled from 2012 to 2014 and followed through 2019. People were placed into subclinical hypothyroidism and euthyroidism groups according to serum-free thyroxine and TSH concentrations. We used Cox proportional hazards regression models to investigate the relationship between TSH level and incident metabolic syndrome considering the modification effect of sex and age. RESULTS Of 3615 participants, 1929 were men (53.4%); mean (SD) age was 43.51 (11.73) years. Throughout the follow-up (median [interquartile range], 3.0 [2.8-3.2] years), 738 individuals developed metabolic syndrome. Subclinical hypothyroidism was significantly associated with metabolic syndrome development only in men, and the adjusted hazard ratio was 1.87 (95% CI, 1.21-2.90) compared with euthyroidism group. Of note, there was no increased risk of metabolic syndrome in people aged 50 years or older with subclinical hypothyroidism. CONCLUSIONS Subclinical hypothyroidism is associated with incident metabolic syndrome in young men. Further studies are needed to evaluate the targeted threshold and benefit of thyroid hormone replacement therapy for metabolic health.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
- Centre for Precision Health, Edith Cowan University, Perth 6027, Australia
| | - Yue Jiang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Di Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences; School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing 100068, China
| | - Yu Zhao
- Beijing Physical Examination Center, Beijing 100068, China
| | - Haiping Zhang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yue Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, 3086, Australia
| | - Wei Wang
- Centre for Precision Health, Edith Cowan University, Perth 6027, Australia
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing 100068, China
| | - Xiaoping Kang
- Beijing Xiaotangshan Hospital, Beijing 102211, China
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Bo Gao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing 100069, China
- Centre for Precision Health, Edith Cowan University, Perth 6027, Australia
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Ding X, Zhao Y, Zhu CY, Wu LP, Wang Y, Peng ZY, Deji C, Zhao FY, Shi BY. The association between subclinical hypothyroidism and metabolic syndrome: an update meta-analysis of observational studies. Endocr J 2021; 68:1043-1056. [PMID: 33883332 DOI: 10.1507/endocrj.ej20-0796] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) has been widely discussed. This study aimed to conduct an update and comprehensive meta-analysis to reveal the risk of MetS and its components in SCH. PubMed, Embase and ISI Web of Knowledge were searched to identify relevant studies through February 20th, 2020. Review Manager 5.3 and Stata 14.0 were used to conduct the meta-analysis. Both fixed-effects and random-effects models were used. In total, 18 articles (19 studies) incorporating 79,727 participants were included. The pooled OR for MetS comparing subjects with SCH with euthyroid subjects was 1.28 (95% CI: 1.19 to 1.39, p = 0.04, I2 = 40%). Subgroup analysis results showed significant associations of SCH and MetS in the adult subgroup (OR = 1.28, 95% CI: 1.18-1.40), Asian population subgroup (OR = 1.30, 95% CI: 1.19-1.42) and cross-sectional study design subgroup (OR = 1.31, 95% CI: 1.16-1.47). Significant associations of SCH and MetS also existed in all MetS definition criteria subgroups except the Chinese Diabetes Society (CDS) subgroup. SCH was correlated with MetS and was not affected by the subgroup analysis stratified by the proportion of females in the total population, the TSH cutoff value in SCH diagnostic criteria, or the adjustment for confounding factors. SCH was identified to be associated with an increased risk of obesity, hypertension, high triglyceride (TG) levels and low high-density lipoprotein cholesterol (HDL-C) levels. In conclusion, SCH is significantly associated with an increased risk of MetS and four out of five components of MetS.
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Affiliation(s)
- Xi Ding
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yang Zhao
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Chun-Ying Zhu
- Department of Disease Prevention And Control, Shaanxi Xi'an Electric Power Center Hospital, Xi'an 710000, China
| | - Li-Ping Wu
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yue Wang
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Zhao-Yi Peng
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Cuomu Deji
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Feng-Yi Zhao
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Bing-Yin Shi
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
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Chrysant SG. The current debate over treatment of subclinical hypothyroidism to prevent cardiovascular complications. Int J Clin Pract 2020; 74:e13499. [PMID: 32159256 DOI: 10.1111/ijcp.13499] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) is an asymptomatic condition associated with increased thyroid-stimulating hormone (TSH) >4 mIU/L with normal thyroxine (T4) and triidothyronine (T3) levels. It is more common in older subjects and especially in women with an overall incidence of 10%. OBJECTIVE Because the normal TSH levels increase with age up to 7.5 mIU/L in older people, several studies have reported either no benefits whereas others have reported the benefits of treatment. These studies have caused a great debate over the treatment of SCH, especially in older subjects. Therefore, the objective of this study was to review the current evidence over this debate by reviewing the recent literature on the subject to discern whether treatment of SCH is necessary and under what circumstances. METHODS To get a better perspective on the current debate over treatment of SCH, a focused Medline search of the English language literature was conducted from 2012 to 2019 using the terms, hypothyroidism, subclinical, dyslipidaemia, cardiovascular disease, heart failure and 38 papers with pertinent information were selected. RESULTS The analysis of results from these papers indicated that the normal levels of TSH are increasing with the advancement of age from 4 mIU/L up to 7.5 mIU/L for patients ≥75 years of age. Also, several of reviewed studies have shown no benefits of treatment whereas, others have shown definite benefits of treatment with levothyroxine supplementation on the clinical and metabolic effects of SBH with reductions in CVD, HF and mortality. The treatment is more effective in younger persons and less so in older persons. CONCLUSIONS Based on the overall evidence, treatment of SCH is indicated in younger persons with a TSH level >4.0 mIU/L. In older subjects, treatment should be individualised and based on the presence of symptoms, the level of TSH, and initiated at TSH levels ≥10 mIU/L and at low doses to avoid adverse cardiovascular effects from overtreatment.
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Affiliation(s)
- Steven G Chrysant
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Teixeira PDFDS, dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab 2020; 11:2042018820917869. [PMID: 32489580 PMCID: PMC7238803 DOI: 10.1177/2042018820917869] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/03/2020] [Indexed: 12/17/2022] Open
Abstract
Metabolic syndrome (MetS) and thyroid dysfunction are common in clinical practice. The objectives of this review are to discuss some proposed mechanisms by which thyroid dysfunctions may lead to MetS, to describe the bidirectional relationship between thyroid hormones (THs) and adiposity and finally, to resume a list of recent studies in humans that evaluated possible associations between thyroid hormone status and MetS or its clinical components. Not solely THs, but also its metabolites regulate metabolic rate, influencing adiposity. The mechanisms enrolled are related to its direct effect on adenosine triphosphate (ATP) utilization, uncoupling synthesis of ATP, mitochondrial biogenesis, and its inotropic and chronotropic effects. THs also act controlling core body temperature, appetite, and sympathetic activity. In a bidirectional way, thyroid function is affected by adiposity. Leptin is one of the hallmarks, but the pro-inflammatory cytokines and also insulin resistance impact thyroid function and perhaps its structure. MetS development and weight gain have been positively associated with thyroid-stimulating hormone (TSH) in several studies. Adverse glucose metabolism may be related to hyperthyroidism, but also to reduction of thyroid function or higher serum TSH, as do abnormal serum triglyceride levels. Hypo- and hyperthyroidism have been related to higher blood pressure (BP), that may be consequence of genomic or nongenomic action of THs on the vasculature and in the heart. In summary, the interaction between THs and components of MetS is complex and not fully understood. More longitudinal studies controlling each of all confounding variables that interact with endpoints or exposure factors are still necessary.
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Affiliation(s)
- Patrícia de Fátima dos Santos Teixeira
- Endocrine Clinic, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Rocco, 255 – Cidade Universitária, Rio de Janeiro, RJ 21941-617, Brazil
| | - Patrícia Borges dos Santos
- Research Fellow, Medicine School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Endocrinologist, Instituto Estadual de Endocrinologia Luiz Capriglione, Rio de Janeiro, Brazil
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