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身体成分和代谢参数与甲状腺激素水平在甲状腺功能正常的年轻男性中的变化有关。

Body composition and metabolic parameters are associated with variation in thyroid hormone levels among euthyroid young men.

机构信息

Department of Endocrinology and Metabolic Bone Diseases, Ghent University Hospital, Belgium.

出版信息

Eur J Endocrinol. 2012 Nov;167(5):719-26. doi: 10.1530/EJE-12-0447. Epub 2012 Sep 6.

Abstract

OBJECTIVE

Thyroid disorders affect metabolism and body composition. Existing literature has been conflicting on whether this is also the case for thyroid hormone levels within the euthyroid range. Therefore, we have investigated the relationship between thyroid hormone concentrations and body composition together with metabolic parameters in a population of healthy euthyroid men.

METHODS

Healthy male siblings (n=941, 25-45 years, median BMI 24.6) were recruited in a cross-sectional, population-based study; a history or treatment of thyroid disease and thyroid autoimmunity were exclusion criteria. Body composition and muscle cross-sectional area were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Total (triiodothyronine (T(3); TT(3)) thyroxine and (T(4); TT(4))) and free thyroid hormones (FT(3) and FT(4)), TSH, and reverse T(3) (rT(3)) and thyroid-binding globulin (TBG) were determined using immunoassays.

RESULTS

BMI was positively associated with (F)T(3) (P<0.0001). Whole body fat mass displayed positive associations with TT(3) and with (F)T(4) and TBG (P≤0.0006). Positive associations were further observed between leptin and (F)T(3), TT(4), and TBG (P≤0.0002). Inverse associations between lean mass and muscle cross-sectional area and (F)T(3), (F)T(4), and TBG were observed (P≤0.0003). Higher levels of (F)T(3) and TBG were associated with lower insulin sensitivity, assessed by homeostatic model assessment of insulin resistance (IR; P≤0.0001). No associations between TSH and body composition or metabolic parameters were seen.

CONCLUSION

We show that a less favorable body composition (with higher fat and lower muscle mass and accompanying higher leptin concentrations) and IR are associated with higher thyroid hormone levels in healthy young men with well characterized euthyroidism.

摘要

目的

甲状腺疾病会影响新陈代谢和身体成分。现有的文献对于甲状腺功能正常范围内的甲状腺激素水平是否也存在这种情况存在争议。因此,我们研究了健康甲状腺功能正常男性人群中甲状腺激素浓度与身体成分和代谢参数之间的关系。

方法

在一项横断面、基于人群的研究中,共招募了 941 名健康男性同胞(25-45 岁,平均 BMI 为 24.6);有甲状腺疾病或自身免疫性甲状腺病史或治疗史者被排除在外。通过双能 X 射线吸收法和外周定量计算机断层扫描评估身体成分和肌肉横截面积。使用免疫分析法测定总(三碘甲状腺原氨酸(T(3); TT(3))甲状腺素和(T(4); TT(4)))和游离甲状腺激素(FT(3)和 FT(4))、促甲状腺激素(TSH)、反三碘甲状腺原氨酸(rT(3))和甲状腺结合球蛋白(TBG)。

结果

BMI 与(F)T(3)呈正相关(P<0.0001)。全身脂肪量与 TT(3)以及(F)T(4)和 TBG 呈正相关(P≤0.0006)。瘦素与(F)T(3)、TT(4)和 TBG 之间也存在正相关(P≤0.0002)。瘦体重和肌肉横截面积与(F)T(3)、(F)T(4)和 TBG 呈负相关(P≤0.0003)。较高水平的(F)T(3)和 TBG 与胰岛素敏感性降低相关,这是通过稳态模型评估的胰岛素抵抗(IR;P≤0.0001)。TSH 与身体成分或代谢参数之间无关联。

结论

我们发现,在甲状腺功能正常的年轻男性中,与更好的甲状腺功能相关的较低的身体成分(更高的脂肪和更低的肌肉量以及随之而来的更高的瘦素浓度)和 IR 与较高的甲状腺激素水平相关。

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