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The impact of vitamin A supplementation on thyroid function and insulin sensitivity: implication of deiodinases and phosphoenolpyruvate carboxykinase in male Wistar rats. Eur J Nutr 2022; 61:4091-4105. [PMID: 35804266 PMCID: PMC9596568 DOI: 10.1007/s00394-022-02945-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
Purpose Vitamin A is an essential nutrient with vital biological functions. The present study investigated the effect of different doses of vitamin A palmitate at different time intervals on thyroid hormones and glycemic markers. Methods Male rats were administrated vitamin A palmitate at different doses (0, 0.7, 1.5, 3, 6, and 12 mg/kg, oral) and samples were collected at different time intervals of 2, 4, and 6 weeks. The levels of vitamin A, thyroid hormones (T3, T4, and TSH), deiodinases (Dio1 and Dio3), glycemic markers (blood insulin and fasting glucose levels, HOMA IR and HOMA β), retinol-binding protein 4 (RBP4) and the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK) were measured. Results The findings demonstrated that long-term supplementation with high doses of vitamin A palmitate resulted in hypothyroidism (lower T3 and T4 levels and elevated TSH levels) as well as upregulation of Dio1 and Dio3 expression levels. This effect was associated with elevated glucose and insulin levels, enhanced HOMA IR, and decreased HOMA B index. In addition, prolonged vitamin A supplementation significantly increased RBP4 levels that upregulated the expression of PEPCK. Conclusion High doses of vitamin A supplementation increased the risk of hypothyroidism, modulated insulin sensitivity, and over a long period, increased the incidence of type 2 diabetes mellitus associated with oxidative stress and hepatitis.
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Tawfik M, Fathy N, Mousa AA, Ghonem M, Abdelsalam M. Thyroid dysfunction and insulin resistance in end-stage renal disease patients before and 1 year after starting maintenance hemodialysis: A prospective multicenter study. Semin Dial 2021; 35:138-145. [PMID: 34881448 DOI: 10.1111/sdi.13044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thyroid dysfunction and insulin resistance (IR) are common findings in patients with ESRD. We aimed to evaluate thyroid dysfunction and IR in ESRD before and after 1 year of starting hemodialysis (HD). METHODS This was a prospective study that recruited newly starting HD patients who fulfilled the inclusion criteria. Patients were evaluated for TSH, free T4, free T3, fasting insulin, fasting glucose, HOMA-IR, serum ferritin, and hs-CRP levels before starting their first dialysis session and after 1 year of regular HD. RESULTS Eighty-one patients have completed the 1-year follow-up period. After 1 year of regular HD, there were statistically significant increments of hs-CRP, serum ferritin, and TSH levels. On the other hand, fasting insulin level and HOMA-IR showed statistically significant increments after 1 year of starting HD. After 1 year of regular HD, TSH level showed a positive correlation with hs-CRP and serum ferritin level, while free T3 was negatively correlated with HOMA-IR. On the other hand, there was a significant positive correlation between HOMA-IR, hs-CRP, and serum ferritin levels, while HOMA-IR was negatively correlated with Kt/V. CONCLUSIONS This study suggests overlapping complex pathogenesis of thyroid dysfunction, chronic inflammation, and IR in chronic HD patients.
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Affiliation(s)
- Mona Tawfik
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Noha Fathy
- Internal Medicine Department, Talkha Central Hospital, Talkha, Egypt
| | - Amany A Mousa
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Ghonem
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mostafa Abdelsalam
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Choi YM, Kim MK, Kwak MK, Kim D, Hong EG. Association between thyroid hormones and insulin resistance indices based on the Korean National Health and Nutrition Examination Survey. Sci Rep 2021; 11:21738. [PMID: 34741077 PMCID: PMC8571382 DOI: 10.1038/s41598-021-01101-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/21/2021] [Indexed: 11/09/2022] Open
Abstract
Thyroid dysfunction has been implicated as a potential pathophysiological factor in glucose homeostasis and insulin resistance (IR). This study aimed to identify the correlation between thyroid dysfunction and IR. We used data from the sixth Korean National Health and Nutrition Examination Survey to evaluate a total of 5727 participants. The triglyceride glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated to represent IR. Correlation analysis was performed between thyroid dysfunction and IR. The log-transformed TSH (LnTSH) and free T4 were significantly correlated with the TyG index (TSH, beta coefficient 0.025, 95% confidence interval [CI] 0.014–0.036, p < 0.001; free T4, − 0.110 (− 0.166 to − 0.054), p < 0.001) but not HOMA-IR. Overt hypothyroidism is correlated with increased TyG index in pre-menopausal females (0.215 (0.122–0.309) p < 0.001). On the other hand, overt hyperthyroidism is correlated with increased HOMA-IR in males (0.304 (0.193–0.416), p < 0.001) and post-menopausal females (1.812 (1.717–1.907), p < 0.001). In euthyroid subjects, LnTSH and TyG index were significantly correlated in females. In conclusion, both hyperthyroidism and hypothyroidism might be associated with IR but by different mechanisms. It might be helpful to assess IR with appropriate indexes in patients with thyroid dysfunction.
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Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong, 18450, Korea
| | - Min Kyung Kim
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Mi Kyung Kwak
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong, 18450, Korea
| | - Dooman Kim
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Eun-Gyoung Hong
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong, 18450, Korea.
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Gopal N, Pune AS, Takhelmayum R, Ahirwar AK. Does serum TSH level act as a surrogate marker for psychological stress and cardio-metabolic risk among adolescent and young people? Horm Mol Biol Clin Investig 2021; 43:41-46. [PMID: 34525272 DOI: 10.1515/hmbci-2021-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 08/18/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The incidence of metabolic syndrome is increasing even at younger ages. Metabolic syndrome constitutes a group of cardiovascular risk factors that include high cholesterol, triacylglycerol, hyperglycemia, central obesity, etc., which increases the risk of cardiovascular disease, diabetes mellitus, may be even cancer. Indian students enter colleges just after crossing their adolescent age and will be exposed to greater academic stress. Psychological stress or depression is associated with transient change in thyroid hormones level or dysfunction. To explore an association among serum Thyroid Stimulating Hormone (TSH) levels, fT3:fT4 ratio, psychological stress scores, and selected known cardio-metabolic risk markers. METHODS Forty first year MBBS students were included. Their demographic, anthropometric variables, and the blood pressure were documented. Serum TSH, fT3, fT4, and salivary cortisol level was quantified. The stress level was assessed using Cohen Perceived Stress Scale Scoring. Data were expressed in mean ± standard deviation. Data (parametric/non-parametric) were compared by Independent unpaired ANOVA or Kruskal Wallis test whichever is appropriate. Spearmen correlation analysis was performed. RESULTS Serum TSH and Cohen stress score are negatively correlated (r=-0.152), but serum cortisol showed (r=0.763) a positive correlation. TSH levels and the marks obtained in the summative assessments were negatively correlated and the correlation was not statistically significant. CONCLUSIONS The psychological stress is associated with low serum TSH, high cortisol, and poor academic performance in first year MBBS students. Blood pressure, plasma glucose, and anthropometric measures were not associated with the psychological stress.
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Affiliation(s)
- Niranjan Gopal
- Department of Biochemisty, All India Institute of Medical Sciences, Nagpur, India
| | - Akash Shivaji Pune
- Department of Biochemisty, All India Institute of Medical Sciences, Nagpur, India
| | - Roshan Takhelmayum
- Department of Biochemisty, All India Institute of Medical Sciences, Nagpur, India
| | - Ashok Kumar Ahirwar
- Department of Biochemisty, All India Institute of Medical Sciences, Nagpur, India
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Bardugo A, Derazne E, Zucker I, Bendor CD, Puris G, Lutski M, Pinhas-Hamiel O, Cukierman-Yaffe T, Mosenzon O, Schechter M, Tzur D, Afek A, Tirosh A, Gerstein HC, Raz I, Twig G. Adolescent Thyroid Disorders and Risk for Type 2 Diabetes in Young Adulthood. J Clin Endocrinol Metab 2021; 106:e3426-e3435. [PMID: 34050759 DOI: 10.1210/clinem/dgab382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Indexed: 02/08/2023]
Abstract
CONTEXT Thyroid hormones play a key role in systemic metabolism, yet the relationship between thyroid dysfunction and risk for type 2 diabetes is unclear. OBJECTIVE To assess type 2 diabetes risk in adulthood among adolescents with thyroid disorders. DESIGN AND SETTING A nationwide, population-based study of Israeli adolescents who were examined before military recruitment during 1988 to 2007 and were followed until December 31, 2016. PARTICIPANTS 1 382 560 adolescents (mean age 17.3 years). INTERVENTIONS The diagnosis of thyroid disorders was based on recent thyroid function tests. Data were linked to the Israeli National Diabetes Registry. Cox proportional hazard models were applied. MAIN OUTCOME MEASURES Type 2 diabetes incidence. RESULTS During a mean follow-up of 18.5 years, 1.12% (69 of 6,152) of adolescents with thyroid disorders were diagnosed with type 2 diabetes vs 0.77% of adolescents without thyroid disorders. The hazard ratio (HR) for type 2 diabetes was 2.3 (95% CI, 1.8-2.9) among those with thyroid disorders, after adjustment for sex, birth-year, body mass index, and sociodemographic confounders. The increased diabetes risk was observed in both men and women, with the presence or absence of obesity, and in the absence of other health conditions and was associated with different types of thyroid disorders. It was also similar when the outcome was defined as type 2 diabetes diagnosed at or before the age of 30 years (HR 2.3, 95% CI, 1.5-3.5). CONCLUSIONS Thyroid disorders diagnosed in adolescence are a risk factor for early-onset type 2 diabetes in both men and women.
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Affiliation(s)
- Aya Bardugo
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbar Zucker
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Cole D Bendor
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Gal Puris
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Miri Lutski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tali Cukierman-Yaffe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ofri Mosenzon
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Meir Schechter
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Dorit Tzur
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Amir Tirosh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | | | - Itamar Raz
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Gilad Twig
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Stoica RA, Ancuceanu R, Costache A, Ștefan SD, Stoian AP, Guja C, Ștefan-van Staden RI, Popa-Tudor I, Serafinceanu C, Ionescu-Tîrgoviște C. Subclinical hypothyroidism has no association with insulin resistance indices in adult females: A case-control study. Exp Ther Med 2021; 22:1033. [PMID: 34373719 DOI: 10.3892/etm.2021.10465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022] Open
Abstract
Longitudinal studies have indicated an association between thyroid function and insulin resistance (IR) or a neutral relationship. Both the lowest tertile of free thyroxine (fT4) and the highest tertile of free triiodothyronine (fT3) were found to be associated with IR in cross-sectional studies. The aim of the present study was to analyze the association between IR and subclinical hypothyroidism in a female adult population from Bucharest, Romania. This is a retrospective pilot case-control study that included female patients examined by two endocrinologists and a diabetologist in an outpatient clinic. The retrospective follow-up had a one-year duration and included the evaluation of thyroid function tests and IR indices based on fasting insulinemia and C-peptide. The study included 176 women, 91 with subclinical hypothyroidism, with a median age of 60±17 years and a mean body mass index (BMI) of 27.79±4.76 kg/m2. The majority of the population (50%) was diagnosed with autoimmune thyroiditis, and 17.05% with goitre. The univariate logistic regression using hypothyroidism as the explaining variable found no evidence of a significant relationship between a decreased thyroid function and IR (OR 1.32; P=0.36). Metabolic syndrome was probably the most important determinant of IR in the population group studied. Thus, it was not the thyroid function per se, but the coexistence of other elements of this syndrome that prevailed in determining IR. Advantages to the study are the design that permitted evaluation of IR and the thyroid function at different moments in time as well as the uniformity of the blood tests. The multivariate analyses were adjusted for age, lipid profile and treatment; however, one limiting factor was the absence of other hormonal blood tests. In summary, there was no association between the thyroid function tests (TSH, fT4) and IR indices in adult Romanian women in a case-control study with one-year retrospective follow-up.
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Affiliation(s)
- Roxana Adriana Stoica
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Robert Ancuceanu
- Department of Botanical Pharmaceutics, 'Carol Davila' University of Medicine and Pharmacy, 020956 Bucharest, Romania
| | - Adrian Costache
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Simona Diana Ștefan
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Guja
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Raluca Ioana Ștefan-van Staden
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, 060021 Bucharest, Romania
| | - Ioana Popa-Tudor
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, 060021 Bucharest, Romania
| | - Cristian Serafinceanu
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Constantin Ionescu-Tîrgoviște
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Kocatürk E, Kar E, Küskü Kiraz Z, Alataş Ö. Insulin resistance and pancreatic β cell dysfunction are associated with thyroid hormone functions: A cross-sectional hospital-based study in Turkey. Diabetes Metab Syndr 2020; 14:2147-2151. [PMID: 33395774 DOI: 10.1016/j.dsx.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS The prevalence of thyroid disease in diabetic patients is significantly higher than the general population. This indicates a possible interaction between thyroid functions and insulin sensitivity. This study aimed to investigate the relationship between insulin resistance (IR), pancreatic β cell function, and thyroid function tests. METHODS This cross-sectional study was conducted with adults who applied to Eskişehir Osmangazi University Hospital for general control. Fasting insulin, glucose, TSH, fT3, and fT4 levels in the serum of 1340 adult (18-60 aged) patients without any chronic diseases were examined retrospectively. The fT3/fT4 ratio, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and HOMA-β values were calculated. The correlation between HOMA-IR and HOMA-β values with thyroid function tests and differences between hormone levels of patients with and without IR were evaluated. RESULTS There was a positive correlation between HOMA-IR and TSH, negative with fT4. Also, a positive correlation between HOMA-β and fT3, negative correlation with fT4 were observed. In the IR group, fT3 levels were found significantly higher and fT4 levels were significantly lower. TSH levels were higher in the IR group but not statistically significant. The fT3/fT4 ratio was found significantly higher in the IR group and was correlated positively with both HOMA-IR and HOMA-β. CONCLUSION Our results revealed that thyroid dysfunction prevalence is quite high in adults who have not yet been diagnosed with diabetes but have insulin resistance and the onset of pancreatic β cell dysfunction.
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Affiliation(s)
- Evin Kocatürk
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Ezgi Kar
- Department of Medical Biochemistry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Zeynep Küskü Kiraz
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Özkan Alataş
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
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Ma CG, Shim YS. Association of Thyroid-Stimulating Hormone and Thyroid Hormones with Cardiometabolic Risk Factors in Euthyroid Children and Adolescents Aged 10-18 Years: A Population-Based Study. Sci Rep 2019; 9:15476. [PMID: 31664103 PMCID: PMC6820776 DOI: 10.1038/s41598-019-51963-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/10/2019] [Indexed: 12/20/2022] Open
Abstract
Recent evidence indicates that low-normal thyroid function test results within the reference ranges may be related to increased cardiometabolic risk factors. The current study aimed to evaluate the relationship between thyroid function using thyroid-stimulating hormone (TSH) and free thyroxine (FT4) and cardiometabolic risk factors and the clustering of these risk factors (metabolic syndrome) in euthyroid children and adolescents. A total of 250 euthyroid children and adolescents aged 10-18 years were included using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2015. In the unadjusted correlation analyses, TSH was positively correlated with glucose (r = 0.172, P = 0.006), hemoglobin A1c (HbA1c) (r = 0.149, P = 0.018), insulin (r = 0.144, P = 0.023), homeostatic model assessment for insulin resistance (HOMA-IR) (r = 0.163, P = 0.010), and triglyceride (TG) (r = 0.155, P = 0.014), whereas FT4 was negatively associated with the waist circumference (WC) standard deviation score (SDS) (r = -0.134, P = 0.035), body mass index (BMI) SDS (r = -0.126, P = 0.046), insulin (r = -0.219, P < 0.001), and HOMA-IR (r = -0.211, P < 0.001). In the multiple linear regression analysis, TSH was positively associated with glucose (β = 1.179, P = 0.021), HbA1c (β = 0.044, P = 0.039), and TG (β = 8.158, P = 0.041) after adjustment for possible confounders. FT4 was negatively associated with serum fasting insulin (β = -5.884, P = 0.017) and HOMA-IR (β = -1.364, P = 0.023) in the multiple linear regression analysis. Boys and girls with elevated glucose levels had a higher adjusted mean TSH level compared to those without elevated glucose levels after controlling for confounding factors in the analysis of covariance (2.16 mIU/L vs 3.88 mIU/L, P = 0.004). Our results suggest that higher TSH and/or lower FT4 levels, even within the reference ranges, may be related to increased cardiometabolic risk factors.
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Affiliation(s)
- Cheol Gyu Ma
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
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Wang CY, Yu TY, Shih SR, Huang KC, Chang TC. Low total and free triiodothyronine levels are associated with insulin resistance in non-diabetic individuals. Sci Rep 2018; 8:10685. [PMID: 30013028 PMCID: PMC6048097 DOI: 10.1038/s41598-018-29087-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 07/05/2018] [Indexed: 01/12/2023] Open
Abstract
This study examined associations of thyroid hormone levels and insulin resistance (IR) in non-diabetic individuals. Using a cross-sectional design, 2007-2008 data from the National Health and Nutrition Examination Survey (NHANES) were analyzed. NHANES participants ≥20 years of age with complete data of interest were included. The homeostatic model assessment (HOMA) was used to quantify IR, and treated as a continuous variable. Self-reported diabetes or a fasting glucose ≥7 mmol/L were used as criteria to exclude diabetic subjects. Race, liver function, obesity, hypertension, dyslipidemia, smoking, physical activity, vigorous recreational activity, 2-hour glucose, hemoglobin A1C (HbA1C), high-density lipoprotein, triglyceride, vitamin D and C-reactive protein were covariates significantly associated with HOMA-IR. A total of 1,560 non-diabetic subjects were included in the analysis. When adjusted for all factors significant in the univariate analysis (race, liver function, obesity, hypertension, dyslipidemia, smoking, physical activity, vigorous recreational activity, 2-hour glucose, HbA1C, high-density lipoprotein, triglyceride, vitamin D, and CRP) low total triiodothyronine (TT3) and low free T3 (FT3) were significantly associated with decreased HOMA-IR (adjusted coefficient = -0.486, 95% confidence interval [CI]: -0.936, -0.036; adjusted coefficient = -1.151, 95% CI: -1.952, -0.350, respectively). Insulin resistance is associated with low thyroid hormone levels in non-diabetic individuals.
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Affiliation(s)
- Chih-Yuan Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan.
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, 100, Taiwan.
| | - Tse-Ya Yu
- Health Management Center, Far-Eastern Memorial Hospital, New Taipei City, 222, Taiwan
| | - Shyang-Rong Shih
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Tien-Chun Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
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10
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Benites-Zapata VA, Urrunaga-Pastor D, Torres-Mallma C, Prado-Bravo C, Guarnizo-Poma M, Lázaro-Alcántara H. Is free triiodothyronine important in the development of insulin resistance in healthy people? Diabetes Metab Syndr 2017; 11 Suppl 2:S663-S667. [PMID: 28487105 DOI: 10.1016/j.dsx.2017.04.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 04/27/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine the association between thyroid hormones and insulin resistance in a population of healthy individuals. MATERIALS AND METHODS We conducted an analytical cross-sectional study in adults who attended a private clinic from 2012 to 2014. We excluded those participants with fasting glucose values compatible with diabetes mellitus, abnormal thyroid hormone values, chronic use of corticosteroids, and incomplete medical records. Participants were divided into tertiles (low, intermediate and high) according to their free triiodothyronine and free thyroxine values. We defined Insulin resistance as a Homeostasis Model Assessment (HOMA-IR) value greater than 3.8. We conducted a univariate and multivariate Poisson regression model to assess the association between thyroid hormones and insulin resistance. The association measure reported was the prevalence ratio (PR) with their confidence interval (CI) at 95%. RESULTS We evaluated 600 participants. The mean age was 36.8±14.2years and 33% were male. The frequency of insulin resistance was 29.5%. In the univariate regression, we found association between free triiodothyronine tertiles and insulin resistance. In the multivariate regression adjusted for age, sex, body mass index and thyroid stimulating hormone, the association between free triiodothyronine tertiles and insulin resistance remained; intermediate tertile (PR=1.54; CI95%: 1.10-2.15) and high tertile (PR=1.70; CI95%: 1.21-2.39). We found no association between T4 and insulin resistance. CONCLUSIONS High levels of free triiodothyronine are associated with insulin resistance. The use of free trioodothyronine to assess insulin resistance in healthy patients should be considered.
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Affiliation(s)
- Vicente A Benites-Zapata
- Centre for Public Health Research, Research Institute, Faculty of Medicine, Universidad de San Martín de Porres, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Scientific Society of Medical Students at the University of San Martin de Porres, Universidad de San Martín de Porres, Lima, Peru
| | - Cristina Torres-Mallma
- Scientific Society of Medical Students at the University of San Martin de Porres, Universidad de San Martín de Porres, Lima, Peru
| | - Christian Prado-Bravo
- Scientific Society of Medical Students at the University of San Martin de Porres, Universidad de San Martín de Porres, Lima, Peru
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Aldhoon-Hainerová I, Zamrazilová H, Hill M, Hainer V. Insulin sensitivity and its relation to hormones in adolescent boys and girls. Metabolism 2017; 67:90-98. [PMID: 28081782 DOI: 10.1016/j.metabol.2016.10.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/08/2016] [Accepted: 10/17/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS A subset of obese individuals lacks cardiometabolic impairment. We aimed to analyze hormonal profiles of insulin-sensitive obese (ISO) and insulin-resistant obese (IRO) adolescents and determine hormonal predictors of homeostasis model of insulin resistance (HOMA-IR). MATERIALS AND METHODS A threshold of 3.16 of HOMA-IR was used to classify ISO (<3.16) IRO (≥3.16). In 702 individuals aged 13-18years (55.8% girls) anthropometric and laboratory [blood glucose, insulin, thyrotropin (TSH), free thyroxine (fT4), free triiodothyronine (fT3), sex hormone-binding globulin (SHBG), steroid hormones, luteinizing hormone, follicle stimulating hormone, prolactin, ghrelin, glucose-dependent insulinotropic polypeptide, glucagon-like-peptide 1glucagon, leptin, resistin, visfatin, leptin, adiponectin and adipsin] assessments were performed. Orthogonal projections to latent structures and Mann-Whitney tests with Bonferroni correction were applied for statistical analysis. RESULTS 52.6% girls and 42.9% boys were insulin sensitive. In the predictive model of HOMA-IR thyroid function tests, adiponectin, ghrelin and leptin concentrations played an important role in both genders. Prolactin, testosterone and glucagon contributed to the model only in boys, while progesterone and dehydroepiandrosterone sulfate levels only in girls. After Bonferroni correction levels of leptin, adiponectin, leptin/adiponectin ratio, SHBG and fT4/TSH ratio in both genders, testosterone and glucagon levels in boys and levels of TSH and fT3 in girls were related to insulin sensitivity. CONCLUSION Metabolic health defined by HOMA-IR is partly predicted by various hormones. Some of them are gender specific. Free T4/TSH and leptin/adiponectin ratios are related to insulin sensitivity in both genders.
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Affiliation(s)
- Irena Aldhoon-Hainerová
- Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94, Prague 1, Czech Republic; Department of Pediatrics and Center for Research of Diabetes, Metabolism and Nutrition, Third Faculty of Medicine, Charles University, Šrobárova 50, 100 34, Prague 10, Czech Republic.
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94, Prague 1, Czech Republic.
| | - Martin Hill
- Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94, Prague 1, Czech Republic.
| | - Vojtěch Hainer
- Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94, Prague 1, Czech Republic.
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Le TN, Celi FS, Wickham EP. Thyrotropin Levels Are Associated with Cardiometabolic Risk Factors in Euthyroid Adolescents. Thyroid 2016; 26:1441-1449. [PMID: 27599541 PMCID: PMC5067795 DOI: 10.1089/thy.2016.0055] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Increased thyrotropin (TSH) levels and free triiodothyronine to free thyroxine (fT3:fT4) ratios, even within the euthyroid range, have been associated with cardiometabolic risk factors in adults but are less characterized in youth. This study sought to determine relations between TSH, thyroid hormones, and cardiometabolic risk factors in euthyroid adolescents. METHODS Data were extracted from the United States National Health and Nutrition Examination Survey, 2007-2010, for univariate and multivariate analyses of TSH, thyroid hormones, body mass index (BMI), blood pressure, lipids, and glucose metabolism. Subjects aged 12-18 years, with normal TSH and antithyroid peroxidase antibody levels, and without a history of thyroid disease, diabetes, or treatment of hypertension/dyslipidemia (n = 1167) were included. TSH and thyroid hormones were assessed for impact on BMI Z-score, systolic blood pressure (SBP) diastolic blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, triglycerides, and glucose metabolism. RESULTS Univariate analyses revealed positive linear relations between TSH and SBP, TC, fasting and two-hour glucose, and homeostasis model assessment of insulin resistance (HOMA-IR). The fT3:fT4 ratio negatively correlated with high-density lipoprotein cholesterol but positively with BMI Z-score, SBP, triglycerides, fasting and two-hour glucose, fasting insulin, and HOMA-IR. In multivariate analyses controlling for age, sex, race/ethnicity, and BMI Z-score, relations between TSH and both TC and fasting glucose remained significant, and the fT3:fT4 ratio was positively associated with fasting glucose and HOMA-IR. CONCLUSIONS In an unselected population of euthyroid U.S. adolescents, TSH and thyroid hormones correlate with multiple cardiometabolic risk factors, with age- and sex-independent effects on cholesterol and glucose metabolism.
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Affiliation(s)
- Trang N. Le
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
- Division of Pediatric Endocrinology and Metabolism, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia
| | - Francesco S. Celi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Edmond P. Wickham
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
- Division of Pediatric Endocrinology and Metabolism, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia
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Aksoy N, Yeler MT, Ayan NN, Ozkeskin A, Ozkan Z, Serin NO. Association between thyroid hormone levels and insulin resistance and body mass index. Pak J Med Sci 2016; 31:1417-20. [PMID: 26870107 PMCID: PMC4744292 DOI: 10.12669/pjms.316.7560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective: Previous studies have shown an association between thyroid function and insulin resistance and obesity. We compared insulin resistance and body mass index (BMI) in patients with normal TSH levels (2.5–4.2 µIU/mL), patients diagnosed with subclinical hypothyroidism, and healthy control subjects. Methods: The study included 104 subjects and was conducted at the Taksim Education and Research Hospital. The subjects were divided into three groups according to TSH levels: Group 1 (high-normal), TSH levels were 2.5–4.2 µIU/mL (n=33); Group 2 (subclinical hypothyroidism), TSH levels were 4.2–10 µIU/mL (n=42); and Group 3 (healthy control), TSH levels were 0.27–2.5 µIU/mL (n=29). The fT3 and fT4 levels were within normal limits in all groups. Insulin resistance and BMI were compared among groups. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to estimate insulin resistance. Results: HOMA-IR and BMI were not significantly different among groups (p>0.05). A significant positive correlation was found between BMI and HOMA-IR in the high-normal TSH (p>0.059) and subclinical hypothyroidism (p>0.05) groups. Conclusions: HOMA-IR and BMI are important for the assessment of diabetes and cardiovascular diseases. We found no significant difference in HOMA-IR and BMI values among the three TSH reference range groups.
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Affiliation(s)
- Neval Aksoy
- Neval Aksoy, Gaziosmanpasa Taksim Education and Research Hospital, Department of Biochemistry, Elazig-Turkey
| | - Mustafa Taner Yeler
- Mustafa Taner Yeler, Gaziosmanpasa Taksim Education and Research Hospital, Department of Biochemistry, Elazig-Turkey
| | - Nilhan Nurlu Ayan
- Nilhan Nurlu Ayan, Gaziosmanpasa Taksim Education and Research Hospital, Department of Biochemistry, Elazig-Turkey
| | - Ali Ozkeskin
- Ali Ozkeskin, Gaziosmanpasa Taksim Education and Research Hospital, Department of Internal Medicine, Elazig-Turkey
| | - Zeynep Ozkan
- Zeynep Ozkan, Elazig Education and Research Hospital, Department of General Surgery, Elazig-Turkey
| | - N Ozden Serin
- N.Ozden Serin, Gaziosmanpasa Taksim Education and Research Hospital, Department of Biochemistry, Elazig-Turkey
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Rumińska M, Witkowska-Sędek E, Majcher A, Pyrżak B. Thyroid Function in Obese Children and Adolescents and Its Association with Anthropometric and Metabolic Parameters. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 912:33-41. [DOI: 10.1007/5584_2016_232] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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15
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Hashimoto K, Tagami T, Yamakage H, Muranaka K, Tanaka M, Odori S, Kono S, Shimatsu A, Ogawa Y, Satoh-Asahara N. Serum free thyroxine levels are associated with the efficacy of weight reduction therapy in obese female patients. Endocr J 2016; 63:221-9. [PMID: 26632173 DOI: 10.1507/endocrj.ej15-0498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Thyroid function is strongly associated with obesity. The aim of this study is to investigate whether serum free thyroxine (FT4) and/or thyrotropin (TSH) levels are associated with the efficacy of weight reduction therapy in obese patients. We enrolled a total of 283 obese patients and cross-sectionally investigated the association of serum FT4 and/or TSH levels with metabolic features. Furthermore, in 97 obese patients who received 6-month weight reduction therapy, we assessed the relationship of serum FT4 and/or TSH levels to the efficacy of weight reduction therapy. Neither baseline serum FT4 nor TSH levels showed any correlations with body weight (BW) and body mass index (BMI) in these obese patients. However, in 57 obese female patients who underwent weight reduction therapy for six months, serum FT4 levels prior to the therapy was negatively correlated with the degrees of reduction of BW (r = -0.354, p = 0.007) and BMI (r = -0.373, p = 0.004). The correlation between baseline serum FT4 levels with the efficacy of weight reduction therapy was not observed in obese male or postmenopausal female patients. This study demonstrates that baseline serum FT4 levels are associated with weight reduction in obese female premenopausal patients. Therefore, baseline FT4 levels can be used as a clinical, noninvasive, hormonal predictor of weight reduction efficacy in obese patients.
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Affiliation(s)
- Koshi Hashimoto
- Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
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