Top

Published in:

Open Access 01-12-2023 | Research

The association between the thyroid feedback quantile-based index and serum uric acid in U.S. adults

Authors: Haitao Xie, Ning Li, Guowei Zhou, Zhiyuan He, Xiaoqing Xu, Qian Liu, Haiyan Wang, Jie Han, Le Shen, Peng Yu, Jiandong Chen, Xiaohu Chen

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

Abstract

Objectives

Previous studies have shown that there may be a positive correlation between serum uric acid levels and hyperthyroidism. However, the relationship between thyroid function and serum uric acid in healthy people is unclear. This study analyzed the relationship between impaired thyroid hormone sensitivity and serum uric acid levels, and presented them in quantitative form.

Research design and methods

This is a cross-sectional study of 4460 adults (male: 2300; female: 2160) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2010. Parameters representing central sensitivity to thyroid hormones were calculated as: thyroid feedback quantile-based index (TFQI_FT4), thyroid stimulating hormone index (TSHI), and total thyroxine (T4) resistance index (TT4RI); Peripheral sensitivity to thyroid hormone was evaluated by FT3/FT4 ratio. In addition, we have innovated total triiodothyronine (T3) resistance index (TT3RI) and TFQI_FT3 indexes based on FT3 and TSH. Multiple linear regression models were used to evaluate the correlation between thyroid resistance index and serum uric acid, and the results were presented graphically as smooth curve fittings.

Results

Higher levels of serum uric acid were associated with decreased sensitivity to thyroid hormones in euthyroid individuals. In conjunction with an increase in the thyroid hormone sensitivity index value, uric acid levels gradually increased as well. Furthermore, we found a segmented relationship between TT3RI and serum uric acid changes. The saturation and threshold analyses indicated that 18.85 was the turning point (logarithmic likelihood ratio test = 0.036). When TT3RI < 18.85, the relationship between serum uric acid and TT3RI was not significant [β(95% CI) 0.47 (− 0.05, 1.00), P = 0.077], but when TT3RI > 18.85, there was a significant rise in serum uric acid with an increase in TT3RI [β(95% CI) 3.94 (0.94, 6.95), P = 0.010]. A further finding of the interaction test was that impaired thyroid hormone sensitivity and uric acid changes vary among different age groups and BMI levels.

Conclusions

Decreased sensitivity to thyroid hormones was associated with high levels of serum uric acid in people with normal thyroid function. The interaction test shows that different age groups and BMI groups impact the association between impaired thyroid hormone sensitivity and serum uric acid. Furthermore, smooth curve fitting revealed a segmental relationship between TT3RI and serum uric acid levels.

Available only for authorised users

Lee JJ, Pedley A, Marqusee E, et al. Thyroid function and cardiovascular disease risk factors in euthyroid adults: a cross-sectional and longitudinal study. Clin Endocrinol (Oxf). 2016;85(6):932–41. https://doi.org/10.1111/cen.13124.CrossRefPubMed

van Tienhoven-Wind LJ, Dullaart RP. Low-normal thyroid function and novel cardiometabolic biomarkers. Nutrients. 2015;7(2):1352–77. https://doi.org/10.3390/nu7021352.CrossRefPubMedPubMedCentral

Un Y, Teng D, Zhao L, et al. Impaired sensitivity to thyroid hormones is associated with hyperuricemia, obesity, and cardiovascular disease risk in subjects with subclinical hypothyroidism. Thyroid. 2022;32(4):376–84. https://doi.org/10.1089/thy.2021.0500.CrossRef

Johnson RJ, Kang DH, Feig D, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41(6):1183–90. https://doi.org/10.1161/01.HYP.0000069700.62727.C5.CrossRefPubMed

Seki K, Oshiro S, Tozawa M, et al. Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res. 2001;24(6):691–7. https://doi.org/10.1291/hypres.24.691.CrossRef

Tjørve E, Tjørve KM, Olsen JO, Senum R, Oftebro H. On commonness and rarity of thyroid hormone resistance: a discussion based on mechanisms of reduced sensitivity in peripheral tissues. Med Hypotheses. 2007;69(4):913–21. https://doi.org/10.1016/j.mehy.2006.12.056.CrossRefPubMed

Azizi F, Vagenakis AG, Portnay GI, Rapoport B, Ingbar SH, Braverman LE. Pituitary-thyroid responsiveness to intramuscular thyrotropin-releasing hormone based on analyses of serum thyroxine, tri-iodothyronine and thyrotropin concentrations. N Engl J Med. 1975;292(6):273–7. https://doi.org/10.1056/NEJM197502062920601.CrossRefPubMed

Laclaustra M, Moreno-Franco B, Lou-Bonafonte JM, et al. Impaired sensitivity to thyroid hormones is associated with diabetes and metabolic syndrome. Diabetes Care. 2019;42(2):303–10. https://doi.org/10.2337/dc18-1410.CrossRefPubMed

Zipf G, Chiappa M, Porter KS, Ostchega Y, Lewis BG, Dostal J. National health and nutrition examination survey: plan and operations, 1999–2010. Vital Health Stat. 2013;1(56):1–37.

10.

Yagi H, Pohlenz J, Hayashi Y, Sakurai A, Refetoff S. Resistance to thyroid hormone caused by two mutant thyroid hormone receptors beta, R243Q and R243W, with marked impairment of function that cannot be explained by altered in vitro 3,5,3′-triiodothyroinine binding affinity. J Clin Endocrinol Metab. 1997;82(5):1608–14. https://doi.org/10.1210/jcem.82.5.3945.CrossRefPubMed

11.

Jostel A, Ryder WD, Shalet SM. The use of thyroid function tests in the diagnosis of hypopituitarism: definition and evaluation of the TSH Index. Clin Endocrinol (Oxf). 2009;71(4):529–34. https://doi.org/10.1111/j.1365-2265.2009.03534.x.CrossRefPubMed

12.

Dietrich JW, Landgrafe-Mende G, Wiora E, et al. Calculated parameters of thyroid homeostasis: emerging tools for differential diagnosis and clinical research. Front Endocrinol (Lausanne). 2016;7:57. https://doi.org/10.3389/fendo.2016.00057.CrossRefPubMed

13.

Zipf G, Chiappa M, Porter KS, et al. National health and nutrition examination survey: plan and operations, 1999–2010. Vital Health Stat. 2013;1(56):1–37.

14.

Ye Y, Gai X, Xie H, et al. Association between serum free thyroxine (FT4) and uric acid levels in populations without overt thyroid dysfunction. Ann Clin Lab Sci. 2015;45(1):49–53.PubMed

15.

Wang XJ, Qian XW, Zhang X, et al. Association of serum uric acid with thyroid function in health check-up participants. Chin Med J (Engl). 2020;133(12):1409–14. https://doi.org/10.1097/CM9.0000000000000840.CrossRefPubMed

16.

Giordano N, Santacroce C, Mattii G, et al. Hyperuricemia and gout in thyroid endocrine disorders. Clin Exp Rheumatol. 2001;19(6):661–5.PubMed

17.

Gu Y, Meng G, Zhang Q, et al. Predictive value of thyroid hormones for incident hyperuricemia in euthyroid subjects: the Tianjin chronic low-grade systemic inflammation and health cohort study. Endocr Pract. 2021;27(4):291–7. https://doi.org/10.1016/j.eprac.2020.10.009.CrossRefPubMed

18.

Laclaustra M, Corella D, Ordovas JM. Met-abolic syndrome pathophysiology: the role of adipose tissue. Nutr Metab Cardiovasc Dis. 2007;17:125–39.CrossRefPubMed

19.

Teixeira PFDS, Dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab. 2020;13(11):2042018820917869. https://doi.org/10.1177/2042018820917869.CrossRef

20.

Meng X, Xu S, Chen G, et al. Metformin and thyroid disease. J Endocrinol. 2017;233(1):R43–51. https://doi.org/10.1530/JOE-16-0450.CrossRefPubMed

21.

Engin A. The definition and prevalence of obesity and metabolic syndrome. Adv Exp Med Biol. 2017;960:1–17. https://doi.org/10.1007/978-3-319-48382-5_1.CrossRefPubMed

22.

Després JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881–7. https://doi.org/10.1038/nature05488.CrossRefPubMed

23.

Tahboub R, Arafah BM. Sex steroids and the thyroid. Best Pract Res Clin Endocrinol Metab. 2009;23(6):769–80. https://doi.org/10.1016/j.beem.2009.06.005.CrossRefPubMed

24.

Antón FM, García Puig J, Ramos T, et al. Sex differences in uric acid metabolism in adults: evidence for a lack of influence of estradiol-17 beta (E2) on the renal handling of urate. Metabolism. 1986;35(4):343–8. https://doi.org/10.1016/0026-0495(86)90152-6.CrossRefPubMed

25.

Kjaergaard AD, Marouli E, Papadopoulou A, et al. Thyroid function, sex hormones and sexual function: a Mendelian randomization study. Eur J Epidemiol. 2021;36(3):335–44. https://doi.org/10.1007/s10654-021-00721-z.CrossRefPubMedPubMedCentral

26.

Wan H, Zhang K, Wang Y, et al. The associations between gonadal hormones and serum uric acid levels in men and postmenopausal women with diabetes. Front Endocrinol (Lausanne). 2020;20(11):55. https://doi.org/10.3389/fendo.2020.00055.CrossRef

27.

Hadlow NC, Rothacker KM, Wardrop R, Brown SJ, Lim EM, Walsh JP. The relationship between TSH and free T₄ in a large population is complex and nonlinear and differs by age and sex. J Clin Endocrinol Metab. 2013;98(7):2936–43. https://doi.org/10.1210/jc.2012-4223.CrossRefPubMed

28.

Deng B, Yuan Y, Zhong M, Ren R, Deng W, Duan X. The relationship between metabolic parameters, age, and thyroid status: a cross-sectional study-based national survey of iodine nutrition, Thyroid Disease. Risk Manag Healthc Policy. 2021;14:1723–30. https://doi.org/10.2147/RMHP.S306122.CrossRefPubMedPubMedCentral

29.

Chahal HS, Drake WM. The endocrine system and ageing. J Pathol. 2007;211(2):173–80. https://doi.org/10.1002/path.2110.CrossRefPubMed

30.

Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab. 2007;92(12):4575–82. https://doi.org/10.1210/jc.2007-1499.CrossRefPubMed

31.

Bremner AP, Feddema P, Leedman PJ, et al. Age-related changes in thyroid function: a longitudinal study of a community-based cohort. J Clin Endocrinol Metab. 2012;97(5):1554–62. https://doi.org/10.1210/jc.2011-3020.CrossRefPubMed

Title: The association between the thyroid feedback quantile-based index and serum uric acid in U.S. adults
Authors: Haitao Xie
Ning Li
Guowei Zhou
Zhiyuan He
Xiaoqing Xu
Qian Liu
Haiyan Wang
Jie Han
Le Shen
Peng Yu
Jiandong Chen
Xiaohu Chen
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01214-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The association between the thyroid feedback quantile-based index and serum uric acid in U.S. adults

Abstract

Objectives

Research design and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Research design and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

GREB1L overexpression is associated with good clinical outcomes in breast cancer

Participant attention on the intervention target during repetitive passive movement improved spinal reciprocal inhibition enhancement and joint movement function

Monocyte to high-density lipoprotein cholesterol ratio predicts poor outcomes in ischaemic heart failure patients combined with diabetes: a retrospective study

A real-world case–control study on the efficacy and safety of pulsed field ablation for atrial fibrillation

A predictive model for the risk of sepsis within 30 days of admission in patients with traumatic brain injury in the intensive care unit: a retrospective analysis based on MIMIC-IV database

Effects of metformin therapy on HMGB1 levels in rheumatoid arthritis patients