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Bao S, Li F, Duan L, Li J, Jiang X. Thyroid-stimulating hormone may participate in insulin resistance by activating toll-like receptor 4 in liver tissues of subclinical hypothyroid rats. Mol Biol Rep 2023; 50:10637-10650. [PMID: 37884783 DOI: 10.1007/s11033-023-08834-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Thyroid-stimulating hormone (TSH) is an independent risk factor of and closely associated with metabolic disorders. In the present study, we explored the potential mechanism and adverse effects of TSH on insulin resistance in the liver of subclinical hypothyroidism models in vivo. METHODS The mean glucose infusion rate (GIR), free fatty acids (FFAs), the homeostatic model assessment for insulin resistance (HOMA-IR), fasting plasma insulin (FINS), the TLR4 signal pathway and its intracellular negative regulator-toll-interacting protein (Tollip), and the modulators of insulin signaling were evaluated. RESULTS Compared to the normal control group (NC group), the subclinical hypothyroidism rat group (SCH group) showed decreases in GIR and increases in FFAs, FINS, and HOMA-IR. The levels of TLR4 and of its downstream molecules like p-NF-κB, p-IRAK-1, IL-6 and TNF-α were evidently higher in the SCH group than in the NC group. Conversely, the level of Tollip was significantly lower in the SCH group than in the NC group. Compared to the NC group, the levels of phosphorylated IRS-1-Tyr and GLUT2 were decreased in the SCH group. Macrophage infiltration was higher in the SCH group than in the NC group. CONCLUSION TSH may participate in aggravating inflammation by increasing macrophage infiltration; furthermore, it may activate the TLR4-associated inflammatory signaling pathway, thus interfering with insulin signals in liver tissues. Targeting TSH may have therapeutic benefits against metabolic disorders.
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Affiliation(s)
- Suqing Bao
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China.
| | - Fengbo Li
- Department of Orthopedics, Tianjin Hospital, No. 406 Jie fang South Road, Hexi District, Tianjin, 300211, China
| | - Lijun Duan
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Junfeng Li
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Xia Jiang
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
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Li H, Li M, Dong S, Zhang S, Dong A, Zhang M. Assessment of the association between genetic factors regulating thyroid function and microvascular complications in diabetes: A two-sample Mendelian randomization study in the European population. Front Endocrinol (Lausanne) 2023; 14:1126339. [PMID: 36926020 PMCID: PMC10011638 DOI: 10.3389/fendo.2023.1126339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Observational studies have identified a possible link between thyroid function and diabetic microangiopathy, specifically in diabetic kidney disease (DKD) and diabetic retinopathy (DR). However, it is unclear whether this association reflects a causal relationship. OBJECTIVE To assess the potential direct effect of thyroid characteristics on DKD and DR based on Mendelian randomization (MR). METHODS We conducted an MR study using genetic variants as an instrument associated with thyroid function to examine the causal effects on DKD and DR. The study included the analysis of 4 exposure factors associated with thyroid hormone regulation and 5 outcomes. Genomewide significant variants were used as instruments for standardized freethyroxine (FT4) and thyroid-stimulating hormone (TSH) levels within the reference range, standardized free triiodothyronine (FT3):FT4 ratio, and standardized thyroid peroxidase antibody (TPOAB) levels. The primary outcomes were DKD and DR events, and secondary outcomes were estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR) in diabetes, and proliferative diabetic retinopathy (PDR). Satisfying the 3 MR core assumptions, the inverse-variance weighted technique was used as the primary analysis, and sensitivity analysis was performed using MR-Egger, weighted median, and MR pleiotropy residual sum and outlier techniques. RESULTS All outcome and exposure instruments were selected from publicly available GWAS data conducted in European populations. In inverse-variance weighted random-effects MR, gene-based TSH with in the reference range was associated with DKD (OR 1.44; 95%CI 1.04, 2.41; P = 0.033) and eGFR (β: -0.031; 95%CI: -0.063, -0.001; P = 0.047). Gene-based increased FT3:FT4 ratio, decreased FT4 with in the reference range were associated with increased ACR with inverse-variance weighted random-effects β of 0.178 (95%CI: 0.004, 0.353; P = 0.046) and -0.078 (95%CI: -0.142, -0.014; P = 0.017), respectively, and robust to tests of horizontal pleiotropy. However, all thyroid hormone instruments were not associated with DR and PDR at the genetic level. CONCLUSION In diabetic patients, an elevated TSH within the reference range was linked to a greater risk of DKD and decreased eGFR. Similarly, decreased FT4 and an increased FT3:FT4 ratio within the reference range were associated with increased ACR in diabetic patients. However, gene-based thyroid hormones were not associated with DR, indicating a possible pathway involving the thyroid-islet-renal axis. However, larger population studies are needed to further validate this conclusion.
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Affiliation(s)
- Hongdian Li
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mingxuan Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Shaoning Dong
- Department of Nephrology, Tianjin academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Sai Zhang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ao Dong
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mianzhi Zhang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
- Department of Nephrology, Tianjin academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
- *Correspondence: Mianzhi Zhang,
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Torre F, Calogero AE, Condorelli RA, Cannarella R, Aversa A, La Vignera S. Effects of oral contraceptives on thyroid function and vice versa. J Endocrinol Invest 2020; 43:1181-1188. [PMID: 32219692 DOI: 10.1007/s40618-020-01230-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Thyroid gland dysfunction represents an epidemiologically relevant disease in the female gender, where treatment with oral contraceptives (OCs) is frequently prescribed. Although OCs are able to impact the thyroid gland function, scanty data have been released on this matter so far. AIM The aim of this article was to review how hormonal OCs, including estrogen- or progesterone-only containing medications, interact with the hepatic production of thyroid-binding globulin (TBG) and, consequently, their effects on serum levels of thyroxine (T4) and triiodothyronine (T3). We also reviewed the effect of Levo-T4 (LT4) administration in women taking OCs and how they influence the thyroid function in both euthyroid women and in those receiving LT4. REVIEW The estrogenic component of the pills is capable of increasing various liver proteins, such as TBG, sex hormone-binding protein (SHBG) and coagulation factors. On the other hand, the role of progestogens is to modulate estrogen-dependent effects mainly through their anti-androgenic action. In fact, a reduction in the effects of androgens is useful to keep the thromboembolic and cardiovascular risks low, whereas OCs increase it especially in women with subclinical hypothyroidism or in those treated with LT4. Accordingly, subclinical hypothyroidism is known to be associated with a higher mean platelet volume than normal and this increases cardiovascular risk due to platelet hyperactivity caused by incomplete thrombocytopoietic maturation.
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Affiliation(s)
- F Torre
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - R A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - R Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - A Aversa
- Department of Experimental and Clinical Medicine, "Magna Graecia" University, Catanzaro, Italy
| | - S La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
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Jiang F, Wang H, Bao S, Zhou H, Zhang Y, Yan Y, Lai Y, Teng W, Shan Z. Thyrotropin Regulates eNOS Expression in the Endothelium by PGRN Through Akt Pathway. Front Endocrinol (Lausanne) 2018; 9:353. [PMID: 30026730 PMCID: PMC6042313 DOI: 10.3389/fendo.2018.00353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/11/2018] [Indexed: 12/11/2022] Open
Abstract
To investigate the expression of endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) in the aorta of subclinical hypothyroidism (SCH) rat model. The mechanisms underlying thyrotropin (TSH) affecting eNOS and PGRN expression in human umbilical vein endothelial cells (HUVECs) cultured in vitro were investigated. In the current study, SCH rat models were established by the administration of L-T4 injection after thyroidectomy in Wistar rats, as opposed to that in the normal and clinical hypothyroidism (CH) groups. The concentrations of NO (pmol/μL) in the SCH and CH groups were significantly lower than that in the normal group (40.8 ± 7.6 and 32.9 ± 10.8 vs. 51.2 ± 12.1, P < 0.05). However, the expression level of eNOS is increased significantly (P < 0.05) in both SCH and CH groups; a similar result was observed for the PGRN protein. In cultured HUVECs, TSH can also up-regulate the expression of eNOS; however, it is accompanied by a reduced concentration of NO and increased level of superoxide anion, thereby indicating uncoupled eNOS. As eNOS is increased, we found that Akt in HUVECs were upregulated by TSH, as well as PGRN expression. While inhibiting the expression of PGRN in HUVECs using siRNA, the expression of eNOS, as well as Akt were also inhibited. In conclusion, SCH can induce vascular endothelial dysfunction in rats, and PGRN participated in the process of TSH-induced expression of Akt/eNOS in the endothelium.
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Affiliation(s)
- Fengwei Jiang
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
- The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Haoyu Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Suqing Bao
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Haicheng Zhou
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Yuanyuan Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Yumeng Yan
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Yaxin Lai
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology of the First Affiliated Hospital China Medical University, Shenyang, China
- *Correspondence: Zhongyan Shan
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Qi Q, Zhang QM, Li CJ, Dong RN, Li JJ, Shi JY, Yu DM, Zhang JY. Association of Thyroid-Stimulating Hormone Levels with Microvascular Complications in Type 2 Diabetes Patients. Med Sci Monit 2017; 23:2715-2720. [PMID: 28578377 PMCID: PMC5467710 DOI: 10.12659/msm.902006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) is typically featured by elevated serum concentration of thyroid-stimulating hormone (TSH). This study aimed to determine the relationship between TSH levels and microvascular complications in type 2 diabetes patients. MATERIAL AND METHODS A total of 860 type 2 diabetes patients were enrolled in this cross-sectional study. Subjects were evaluated for anthropometric measurements, thyroid function, diabetic retinopathy, and diabetic kidney disease. TSH was divided into 3 levels: 0.27-2.49 mU/l, 2.5-4.2 mU/l, and >4.2 mU/l. RESULTS Among the participants, 76 subjects (8.8%) were diagnosed with subclinical hypothyroidism (SCH) (male: 6.6% and female: 11.8%). The prevalence of diabetic retinopathy did not differ among the groups (P=0.259). Of the 860 type 2 diabetic subjects, we further excluded invalid or missing data. Therefore, 800 and 860 subjects were included in our study of diabetic retinopathy (DR) and diabetic kidney disease (DKD), respectively. The frequencies of microalbuminuria and macroalbuminuria differed significantly among the different groups. The frequency of DKD was significantly different among the 3 groups (P=0.001) and was higher in subjects with higher TSH levels. After an adjustment for confounding variables, TSH levels were significantly associated with DKD (P<0.001). When compared with subjects with TSH 0.27-2.49 mU/l, the frequency of DKD was higher in subjects with TSH >4.20 mU/l (OR 1.531, 95% CI 1.174-1.997) and with TSH 2.50-4.20 mU/l (OR 1.579, 95% CI 1.098-2.270). However, TSH levels was not significantly correlated with DR (P=0.126). CONCLUSIONS Type 2 diabetic patients with higher TSH values had a higher prevalence of DKD.
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Affiliation(s)
- Qi Qi
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - Qiu-Mei Zhang
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - Chun-Jun Li
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - Rong-Na Dong
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - Jin-Jin Li
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - Jian-Ying Shi
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - De-Min Yu
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
| | - Jing-Yun Zhang
- Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China (mainland)
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Soto-Rivera CL, Fichorova RN, Allred EN, Van Marter LJ, Shah B, Martin CR, Agus MSD, Leviton A. The relationship between TSH and systemic inflammation in extremely preterm newborns. Endocrine 2015; 48:595-602. [PMID: 24996532 PMCID: PMC4285685 DOI: 10.1007/s12020-014-0329-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/05/2014] [Indexed: 01/06/2023]
Abstract
Elevated thyrotropin (TSH) levels in critically ill extremely premature infants have been attributed to transient hypothyroidism of prematurity or non-thyroidal illness syndrome. We evaluated the hypothesis that relatively high TSH levels in the first 2 postnatal weeks follow recovery from systemic inflammation, similar to non-thyroidal illness syndrome. The study was conducted in 14 Neonatal Intensive Care Units and approved by each individual Institutional Review Board. We measured the concentrations of TSH and 25 inflammation-related proteins in blood spots obtained on postnatal days 1, 7, and 14. We then evaluated the temporal relationships between hyperthyrotropinemia (HTT), defined as a TSH concentration in the highest quartile for gestational age and postnatal day, and elevated levels of inflammation-related proteins. 880 newborns less than 28 weeks of gestation were included. Elevated concentrations of inflammation-related proteins during the first or second week did not precede day-14 HTT. Systemic inflammation on day 7 was associated with day-14 HTT only if inflammation persisted through the end of the 2 week period. HTT frequently accompanied elevated concentrations of inflammation-related proteins on the same day. The hypothesis that HTT follows recovery from severe illness, defined as preceding systemic inflammation, is weakly supported by our study. Our findings more prominently support the hypothesis that TSH conveys information about concomitant inflammation in the extremely premature newborn.
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Affiliation(s)
- Carmen L Soto-Rivera
- Department of Medicine, Divisions of Endocrinology and Medicine Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA,
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Yu YT, Ho CT, Hsu HS, Li CI, Davidson LE, Liu CS, Li TC, Shih CM, Lin CC, Lin WY. Subclinical hypothyroidism is associated with elevated high-sensitive C-reactive protein among adult Taiwanese. Endocrine 2013; 44:716-22. [PMID: 23468096 DOI: 10.1007/s12020-013-9915-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/26/2013] [Indexed: 01/07/2023]
Abstract
Subjects with subclinical hypothyroidism (SCH) are at increased risk for cardiovascular disease (CVD). High-sensitivity C-reactive protein (hsCRP) is one of the inflammatory markers related to CVD. It is unclear whether inflammation is a mechanistic intermediary between SCH and CVD. We aimed to investigate the association between SCH and hsCRP in a Taiwanese population. A baseline cohort of 2,494 participants over the age of 19 was recruited in Taiwan from 2006 to 2008. SCH was defined as a serum thyroid-stimulating hormone (TSH) level of 5.61-19.9 mIU/L with normal thyroxine concentrations (a total T4 level of 4.9-12.0 μg/dL). Euthyroidism was defined as a serum TSH level of 0.34-5.60 mIU/L. HsCPR was grouped using quartiles. Multiple logistic and linear regression analyses were used to evaluate the relationship between hsCRP and SCH. After adjusting for gender and betel nut chewing, stepwise multiple logistic regression analyses revealed that hsCRP groups were significantly associated with SCH. Compared to the lowest hsCRP quartile, the adjusted odds ratio of having SCH for hsCRP quartile II, III, and IV were 1.38 (0.48-3.98), 1.48 (0.56-3.96), and 2.59 (1.01-6.67), respectively. The significant increase in odds ratios for SCH in progressive hsCRP quartiles reveals a dose-response effect (p < 0.05). Moreover, stepwise multiple linear regression analyses showed that hsCRP was significantly positively associated with serum TSH level after adjusting for potential confounders. Adult Taiwanese with SCH were associated with elevated hsCRP quartiles.
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Affiliation(s)
- Ya-Ting Yu
- Department of Family Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 404, Taiwan
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