Cumulative Effects of Thyroid Hormones Over 10 Years and Risk of General and Abdominal Obesity

Ladan Mehran; Atieh Amouzegar; Safoora Gharibzadeh; Hengameh Abdi; Mohammad Ali Mansournia; Maryam Tohidi; Fereidoun Azizi

doi:10.1055/a-1393-5864

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2021; 53(05): 335-340
DOI: 10.1055/a-1393-5864

Endocrine Care

Cumulative Effects of Thyroid Hormones Over 10 Years and Risk of General and Abdominal Obesity

Authors

Ladan Mehran‡

¹Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Atieh Amouzegar‡

¹Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Safoora Gharibzadeh

²Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging infectious Disease Pasteur Institute of Iran, Tehran, Iran
Hengameh Abdi

¹Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohammad Ali Mansournia

³Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Maryam Tohidi

⁴Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Fereidoun Azizi

¹Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

We aimed to assess if changes in thyrotropin (TSH) and free thyroxine (FT4) over 10 years of follow-up would be associated with changes in body mass index (BMI) and waist circumference (WC) or risk of obesity. We enrolled 2317 out of 4179 participants in Tehran Thyroid Study with serum TSH between 0.1–10 mU/l and without history of thyroid medication or surgery. Serum concentrations of FT4 and TSH were measured at baseline and three follow-ups (1999–2011). To account for within-subject correlation, the generalized estimating equation was used to assess the association between one standard deviation(SD) change in the main exposures [cumulative excess (CE)TSH and CEFT4] and changes in BMI and WC; calculated scores of CETSH and CEFT4 were included in models as time-varying exposures. Cumulative excess of TSH or FT4 was not associated with increased incidence of general or abdominal obesity. However, CEFT4 was negatively associated with BMI only in overweight and obese subjects. In GEE analysis, one unit increase in TSH was associated with 0.02 kg/m² increase in BMI (95% CI: 0.01, 0.03), which remained significant only in women; although the association was not significant after adding FT4 to model. One unit increase in FT4 was associated with 1.5 kg/m² decrease in BMI (95% CI:−1.8,−1.2) and 4.1 cm decrease in WC (95% CI:−5.1,−3.1) in both sexes independent of TSH and other confounders. Cumulative excess of TSH or FT4 indicated no risk for general or abdominal obesity. However, FT4 was negatively associated with BMI and WC independent of TSH.

Key words

thyroid - obesity - overweight - thyroxine - thyroid stimulating hormone

Volltext

Referenzen

References
1 Hoogwerf BJ, Nuttall FQ. Long-term weight regulation in treated hyperthyroid and hypothyroid subjects. Am J Med 1984; 76: 963-970
2 Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev 2014; 94: 355-382
3 Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol 2010; 316: 165-171
4 Mehran L, Amouzegar A, Tohidi M. et al. Serum free thyroxine concentration is associated with metabolic syndrome in euthyroid subjects. Thyroid 2014; 24: 1566-1574
5 Roef GL, Rietzschel ER, Van Daele CM. et al. Triiodothyronine and free thyroxine levels are differentially associated with metabolic profile and adiposity-related cardiovascular risk markers in euthyroid middle-aged subjects. Thyroid 2014; 24: 223-231
6 Taylor PN, Razvi S, Pearce SH. et al. Clinical review: A review of the clinical consequences of variation in thyroid function within the reference range. J Clin Endocrinol Metab 2013; 98: 3562-3571
7 Fox CS, Pencina MJ, D’Agostino RB. et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med 2008; 168: 587-592
8 Wolters B, Lass N, Reinehr T. TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children. Eur J Endocrinol 2013; 168: 323-329
9 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: 4019-4024
10 Manji N, Boelaert K, Sheppard MC. et al. Lack of association between serum TSH or free T4 and body mass index in euthyroid subjects. Clin Endocrinol (Oxf) 2006; 64: 125-128
11 Mehran L, Amouzegar A, Bakhtiyari M. et al. 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: 886-893
12 Nyrnes A, Jorde R, Sundsfjord J, Serum TSH. is positively associated with BMI. Int J Obes (Lond) 2006; 30: 100-105
13 Azizi F, Amouzegar A, Delshad H. et al. Natural course of thyroid disease profile in a population in nutrition transition: Tehran Thyroid Study. Arch Iran Med 2013; 16: 418-423
14 Azizi F, Ghanbarian A, Momenan AA. et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials 2009; 10: 5
15 Amouzegar A, Delshad H, Mehran L. et al. Reference limit of thyrotropin (TSH) and free thyroxine (FT4) in thyroperoxidase positive and negative subjects: a population based study. J Endocrinol Invest 2013; 36: 950-954
16 Sesso HD, Paffenbarger RS, Lee IM. Physical activity and coronary heart disease in men: The Harvard Alumni Health Study. Circulation 2000; 102: 975-980
17 Shao J, Zhong B. Last observation carry-forward and last observation analysis. Stat Med 2003; 22: 2429-2441
18 Williamson J. Models for Discrete Longitudinal Data. London: Taylor & Francis; 2006
19 Mansournia MA, Etminan M, Danaei G. et al. Handling time varying confounding in observational research. BMJ 2017; 359: j4587
20 Gopinath B, Liew G, Flood VM. et al. The association between weight gain and thyroid function in an older population. Arch Intern Med 2008; 168: 2283-2284
21 Bjergved L, Jorgensen T, Perrild H. et al. Thyroid function and body weight: a community-based longitudinal study. PLoS One 2014; 9: e93515
22 Svare A, Nilsen TI, Bjoro T. et al. Serum TSH related to measures of body mass: Longitudinal data from the HUNT Study, Norway. Clin Endocrinol (Oxf) 2011; 74: 769-775
23 Soriguer F, Valdes S, Morcillo S. et al. Thyroid hormone levels predict the change in body weight: a prospective study. Eur J Clin Invest 2011; 41: 1202-1209
24 Abdi H, Kazemian E, Gharibzadeh S. et al. Association between thyroid function and body mass index: A 10-year follow-up. Ann Nutr Metab 2017; 70: 338-345
25 Kim BJ, Kim TY, Koh JM. et al. Relationship between serum free T4 (FT4) levels and metabolic syndrome (MS) and its components in healthy euthyroid subjects. Clin Endocrinol 2009; 70: 152-160
26 Kitahara CM, Platz EA, Ladenson PW. et al. Body fatness and markers of thyroid function among US men and women. PLoS One 2012; 7: e34979
27 Garduno-Garcia Jde J, Alvirde-Garcia U, Lopez-Carrasco G. et al. TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects. Eur J Endocrinol 2010; 163: 273-278
28 Alevizaki M, Saltiki K, Voidonikola P. et al. Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals. Eur J Endocrinol 2009; 161: 459-465
29 Shon HS, Jung ED, Kim SH. et al. Free T4 is negatively correlated with body mass index in euthyroid women. Korean J Intern Med 2008; 23: 53-57
30 Brent GA. Mechanisms of thyroid hormone action. J Clin Invest 2012; 122: 3035-3043
31 Flamant F, Samarut J. Thyroid hormone receptors: Lessons from knockout and knock-in mutant mice. Trends Endocrinol Metab 2003; 14: 85-90
32 Hoermann R, Midgley JEM, Larisch R. et al. Recent advances in thyroid hormone regulation: toward a new paradigm for optimal diagnosis and treatment. Front Endocrinol (Lausanne) 2017; 8: 364
33 Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian J Endocrinol Metab 2016; 20: 554-557
34 Rotondi M, Leporati P, La Manna A. et al. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?. Eur J Endocrinol 2009; 160: 403-408
35 Chikunguwo S, Brethauer S, Nirujogi V. et al. Influence of obesity and surgical weight loss on thyroid hormone levels. Surg Obes Relat Dis 2007; 3: 631-635 discussion 5–6
36 Zimmermann-Belsing T, Brabant G, Holst JJ. et al. Circulating leptin and thyroid dysfunction. Eur J Endocrinol 2003; 149: 257-271
37 Lear SA, Chen MM, Birmingham CL. et al. The relationship between simple anthropometric indices and C-reactive protein: ethnic and gender differences. Metabolism 2003; 52: 1542-1546
38 Rossi IA, Bochud M, Bovet P. et al. Sex difference and the role of leptin in the association between high-sensitivity C-reactive protein and adiposity in two different populations. Eur J Epidemiol 2012; 27: 379-384
39 Geer EB, Shen W. Gender differences in insulin resistance, body composition, and energy balance. Gender Med 2009; 6: 60-75

Zusatzmaterial

Supplementary material (PDF)