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European Journal of Medical Research
Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Obesity | Research

Association between thyroid function and obesity phenotypes in healthy euthyroid individuals: an investigation based on Tehran Thyroid Study

Authors: Behnaz Abiri, Amirhossein Ramezani Ahmadi, Maryam Mahdavi, Atieh Amouzegar, Majid Valizadeh

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Aims

We investigated whether thyroid function could be associated with obesity phenotypes amongst euthyroid individuals.

Materials and methods

A cross-sectional analysis was conducted among healthy, euthyroid subjects. The study participants were chosen from the Tehran Thyroid Study (TTS). We analyzed 2988 euthyroid adults and classified them into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The statistical differences between thyroid hormones between various obesity phenotypes according to age and sex was compared using analysis of covariance (ANCOVA).

Results

It was found that MHNW participants had higher levels of FT4 when compared with metabolically healthy or unhealthy obese subjects (P < 0.001), even after adjustment for the confounding variables. No difference was observed in the levels of TSH (P = 0.260) among obesity phenotypes. In the subgroup analysis according to the age, a significant difference was observed in the level of FT4 only in subjects with age < 55 years (P = 0.001). However, analyzing men and women separately did not show a significant difference in the FT4 level among obesity phenotypes (P > 0.05).

Conclusion

“Metabolically abnormality” was independently related to low normal FT4 levels in overweight/obese euthyroid individuals. There is a need for further research to understand how low FT4 levels are linked to metabolically unhealthy states in euthyroid individuals.
Literature
1.
Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.CrossRefPubMedPubMedCentral
2.
Khandekar MJ, Cohen P, Spiegelman BM. Molecular mechanisms of cancer development in obesity. Nat Rev Cancer. 2011;11:886–95.CrossRefPubMed
3.
Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444:840–6.CrossRefPubMed
4.
van Gaal LF, Mertens IL, de Block CE. Mechanisms linking obesity with cardiovascular disease. Nature. 2006;444:875–80.CrossRefPubMed
5.
Stefan N, Häring H-U, Hu FB, Schulze MB. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. Lancet Diabetes Endocrinol. 2013;1(2):152–62.CrossRefPubMed
6.
van Vliet-Ostaptchouk JV, Nuotio ML, Slagter SN, Doiron D, Fischer K, Foco L, Gaye A, Gogele M, Heier M, Hiekkalinna T, Joensuu A, Newby C, Pang C, Partinen E, Reischl E, Schwienbacher C, Tammesoo ML, Swertz MA, Burton P, Ferretti V, Fortier I, Giepmans L, Harris JR, Hillege HL, Holmen J, Jula A, Kootstra-Ros JE, Kvaloy K, Holmen TL, Mannisto S, Metspalu A, Midthjell K, Murtagh MJ, Peters A, Pramstaller PP, Saaristo T, Salomaa V, Stolk RP, Uusitupa M, van der Harst P, van der Klauw MM, Waldenberger M, Perola M, Wolffenbuttel BH. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocr Disord. 2014;14:9.CrossRefPubMedPubMedCentral
7.
St-Onge MP, Janssen I, Heymsfield SB. Metabolic syndrome in normal-weight Americans: new definition of the metabolically obese, normal-weight individual. Diabetes Care. 2004;27(9):2222–8.CrossRefPubMed
8.
Arnlov J, Ingelsson E, Sundstrom J, Lind L. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation. 2010;121(2):230–6.CrossRefPubMed
9.
Michalaki MA, Vagenakis AG, Leonardou AS, Argentou MN, Habeos IG, Makri MG, et al. Thyroid function in humans with morbid obesity. Thyroid. 2006;16:73–8.CrossRefPubMed
10.
Boekholdt SM, Titan SM, Wiersinga WM, Chatterjee K, Basart DC, Luben R, Wareham NJ, Khaw KT. Initial thyroid status and cardiovascular risk factors: the EPICNorfolk prospective population study. Clin Endocrinol (Oxf). 2010;72:404–10.CrossRefPubMed
11.
Ruhla S, Weickert MO, Arafat AM, Osterhoff M, Isken F, Spranger J, Schofl C, Pfeiffer AF, Mohlig M. high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf). 2010A;72:696–701.CrossRefPubMed
12.
Shin JA, Mo EY, Kim ES, Moon SD, Han JH. Association between lower normal free thyroxine concentrations and obesity phenotype in healthy euthyroid subjects. Int J Endocrinol. 2014;2014:104318.CrossRefPubMedPubMedCentral
13.
Amouzegar A, Kazemian E, Abdi H, Mansournia MA, Bakhtiyari M, Hosseini MS, et al. Association between thyroid function and development of different obesity phenotypes in euthyroid adults: a nine-year follow-up. Thyroid. 2018;28:458–64.CrossRefPubMed
14.
Kim JM, Kim BH, Lee H, Kim EH, Kim M, Kim JH, et al. The relationship between thyroid function and different obesity phenotypes in Korean euthyroid adults. Diabetes Metab J. 2019;43:867–78.CrossRefPubMedPubMedCentral
15.
Azizi F, Amouzegar A, Delshad H, Tohidi M, Mehran L, Mehrabi Y. Natural course of thyroid disease profile in a population in nutrition transition: Tehran Thyroid Study. Arch Iran Med. 2013;16:418–23.PubMed
16.
Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, Mehrabi Y, Zahedi-Asl S. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials. 2009;10:5.CrossRefPubMedPubMedCentral
17.
Amouzegar A, Delshad H, Mehran L, Tohidi M, Khafaji F, Azizi F. Reference limit of thyrotropin (TSH) and free thyroxine (fT4) in thyroperoxidase positive and negative subjects: a population based study. J Endocrinol Invest. 2013;36:950–4.PubMed
18.
Hsu WC, Araneta MR, Kanaya AM, Chiang JL, Fujimoto W. BMI cut points to identify at-risk Asian Americans for type 2 diabetes screening. Diabetes Care. 2015;38(1):150–8.CrossRefPubMed
19.
Nie X, Ma X, Xu Y, Shen Y, Wang Y, Bao Y. Characteristics of serum thyroid hormones in different metabolic phenotypes of obesity. Front Endocrinol. 2020;11:68.CrossRef
20.
Kim JM, Kim BH, Lee H, Kim EH, Kim M, Kim JH, Jeon YK, Kim SS, Kim IJ, Kim YK. The relationship between thyroid function and different obesity phenotypes in Korean Euthyroid Adults. Diabetes Metab J. 2019;43(6):867–78.CrossRefPubMedPubMedCentral
21.
Mehran L, Amouzegar A, Bakhtiyari M, Mansournia MA, Rahimabad PK, Tohidi M, Azizi F. Variations in serum free thyroxine concentration within the reference range predicts the incidence of metabolic syndrome in non-obese adults: a cohort study. Thyroid. 2017;27(7):886–93.CrossRefPubMed
22.
Silva JE. The thermogenic effect of thyroid hormone and its clinical implications. Ann Intern Med. 2003;139(3):205–13.CrossRefPubMed
23.
Ruhla S, Weickert MO, Arafat AM, et al. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol. 2010;72(5):696–701.CrossRef
24.
Park HT, Cho GJ, Ahn KH, et al. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas. 2009;62(3):301–5.CrossRefPubMed
25.
Roos A, Bakker SJL, Links TP, Gans ROB, Wolffenbuttel BHR. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab. 2007;92(2):491–6.CrossRefPubMed
26.
Knudsen N, Laurberg P, Rasmussen LB, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90(7):4019–24.CrossRefPubMed
27.
Nannipieri M, Cecchetti F, Anselmino M, et al. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss. Int J Obes. 2009;33(9):1001–6.CrossRef
28.
29.
Huggett RJ, Burns J, Mackintosh AF, Mary DA. Sympathetic neural activation in nondiabetic metabolic syndrome and its further augmentation by hypertension. Hypertension. 2004;44:847–52.CrossRefPubMed
30.
Grassi G, Dell’Oro R, Facchini A, Quarti Trevano F, Bolla GB, Mancia G. Effect of central and peripheral body fat distribution on sympathetic and baroreflex function in obese normotensives. J Hypertens. 2004;22:2363–9.CrossRefPubMed
31.
De Pergola G, Giorgino F, Benigno R, Guida P, Giorgino R. Independent influence of insulin, catecholamines, and thyroid hormones on metabolic syndrome. Obesity (Silver Spring). 2008;16:2405–11.CrossRefPubMed
32.
Roos A, Bakker SJ, Links TP, Gans RO, Wolffenbuttel BH. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab. 2007;92:491–6.CrossRefPubMed
33.
Lai Y, Wang J, Jiang F, Wang B, Chen Y, Li M, Liu H, Li C, Xue H, Li N, Yu J, Shi L, Bai X, Hou X, Zhu L, Lu L, Wang S, Xing Q, Teng X, Teng W, Shan Z. The relationship between serum thyrotropin and components of metabolic syndrome. Endocr J. 2011;58:23–30.CrossRefPubMed
34.
Mehran L, Amouzegar A, Tohidi M, Moayedi M, Azizi F. Serum free thyroxine concentration is associated with metabolic syndrome in euthyroid subjects. Thyroid. 2014;24:1566–74.CrossRefPubMed
35.
36.
Burman KD, Latham KR, Djuh YY, Smallridge RC, Tseng YC, Lukes YG, Maunder R, Wartofsky L. Solubilized nuclear thyroid hormone receptors in circulating human mononuclear cells. J Clin Endocrinol Metab. 1980;51:106–16.CrossRefPubMed
37.
Reinehr T, Isa A, de Sousa G, Dieffenbach R, Andler W. Thyroid hormones and their relation to weight status. Horm Res. 2008;70:51–7.PubMed
Metadata
Title
Association between thyroid function and obesity phenotypes in healthy euthyroid individuals: an investigation based on Tehran Thyroid Study
Authors
Behnaz Abiri
Amirhossein Ramezani Ahmadi
Maryam Mahdavi
Atieh Amouzegar
Majid Valizadeh
Publication date
01-12-2023
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01135-1

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