Mehran Ladan, Amouzegar Atieh, Rahimabad Parnian Kheirkhah, Tohidi Maryam, Tahmasebinejad Zhale, Azizi Fereidoun
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran.
Horm Metab Res. 2017 Mar;49(3):192-200. doi: 10.1055/s-0042-117279. Epub 2017 Mar 28.
The impact of thyroid dysfunction in subclinical ranges on metabolic syndrome (MetS) is not well known. The aim of the present study is to evaluate the association of thyroid dysfunction with MetS and its components. In the cross-sectional population-based Tehran Thyroid Study, out of 5 786 randomly selected participants, aged≥20 years, subjects with thyroid nodules and cancer or any severe systemic disease, those who were pregnant and those using thyroid medication were excluded, leaving 5 422 subjects to be investigated. Body weight, waist circumference, and blood pressure were measured. Fasting blood glucose and concentrations of lipids and lipoproteins, free T4, and TSH were assayed. Mean age of the participants was 40.3±14.4 of whom 101 (2%) had overt hypothyroidism, 294 (5%) subclinical hypothyroidism, 82 (2%) overt hyperthyroidism, and 178 (3%) had subclinical hyperthyroidism; 1 704 (32%) had MetS. Clinically hypothyroid subjects had the highest prevalence of MetS (41.6%), abdominal obesity (45%), and hypertriglyceridemia (58%) compared to other groups (p<0.05). Significant odds ratio for prevalent MetS was observed only in clinically hypothyroid men [OR: 2.9, 95% CI: 1.04, 8.4, p=0.04]. In women, the association between overt hypothyroidism and MetS was marginally significant only in the crude model [OR: 0.068, 95% CI (0.97-2.42), p=0.06]. There was higher risk of Mets in subclinically hypothyroid subjects, aged>50. Overt and subclinical hyperthyroidism had significantly higher odds of hyperglycemia in men and women after full adjustment for age, smoking, and BMI. Overt hypothyroidism and subclinical hypothyroidism especially in the elderly could be associated with MetS. Hyperthyroidism may induce hyperglycemia.
亚临床范围内甲状腺功能障碍对代谢综合征（MetS）的影响尚不清楚。本研究的目的是评估甲状腺功能障碍与代谢综合征及其组分之间的关联。在基于人群的横断面德黑兰甲状腺研究中，从5786名年龄≥20岁的随机选择参与者中，排除患有甲状腺结节、癌症或任何严重全身性疾病的受试者、孕妇以及正在使用甲状腺药物的受试者，留下5422名受试者进行调查。测量体重、腰围和血压。测定空腹血糖、脂质和脂蛋白浓度、游离T4和促甲状腺激素（TSH）。参与者的平均年龄为40.3±14.4岁，其中101人（2%）患有显性甲状腺功能减退，294人（5%）患有亚临床甲状腺功能减退，82人（2%）患有显性甲状腺功能亢进，178人（3%）患有亚临床甲状腺功能亢进；1704人（32%）患有代谢综合征。与其他组相比，临床甲状腺功能减退受试者的代谢综合征患病率最高（41.6%），腹部肥胖患病率最高（45%），高甘油三酯血症患病率最高（58%）（p<0.05）。仅在临床甲状腺功能减退男性中观察到患代谢综合征的显著优势比[比值比（OR）：2.9，95%置信区间（CI）：1.04，8.4，p=0.04]。在女性中，显性甲状腺功能减退与代谢综合征之间的关联仅在粗模型中具有边缘显著性[OR：0.068，95%CI（0.97 - 2.42），p=0.06]。年龄>50岁的亚临床甲状腺功能减退受试者患代谢综合征的风险更高。在对年龄、吸烟和体重指数（BMI）进行完全校正后，显性和亚临床甲状腺功能亢进在男性和女性中发生高血糖的几率显著更高。显性甲状腺功能减退和亚临床甲状腺功能减退，尤其是在老年人中，可能与代谢综合征有关。甲状腺功能亢进可能诱发高血糖。
