Abdi Hengameh, Kazemian Elham, Gharibzadeh Safoora, Amouzegar Atieh, Mehran Ladan, Tohidi Maryam, Rashvandi Zahra, Azizi Fereidoun
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ann Nutr Metab. 2017;70(4):338-345. doi: 10.1159/000477497. Epub 2017 Jun 16.
BACKGROUND/AIMS: We aimed to evaluate the association between change in thyroid function tests within the euthyroid range and body mass index (BMI) in persons with normal weight at baseline.
This study investigated 1,100 normal-weight euthyroid persons in a population-based cohort study, Tehran Thyroid Study. BMI was calculated and serum concentrations of thyrotropin (TSH) and free T4 (FT4) were assayed at baseline and after 10 years of follow-up. We evaluated the relationship between thyroid and obesity based on 2 definitions for outcome: (1) a binary outcome as BMI <25 or ≥25 kg/m2, and (2) a multinomial outcome as normal BMI, overweight, and obese.
A total of 569 women and 531 men, aged 36.3 ± 13.5 years, were included. Modified Poisson regression analysis for binary outcome, after adjustment for age, sex, smoking, and anti-thyroid peroxidase antibody status, revealed a negative association between delta serum FT4 and follow-up BMI (relative risk 0.55 [95% CI 0.37-0.80]) without any significant association between change in serum TSH and follow-up BMI. However, in multinomial logistic regression analysis, we found no relationship between delta serum FT4 or TSH and follow-up BMI categories, for either overweight or obese vs. normal-weight participants.
In normal-weight euthyroid individuals, changes in serum concentrations of FT4, but not TSH, may contribute to change in body weight.
背景/目的:我们旨在评估甲状腺功能测试在正常甲状腺功能范围内的变化与基线体重正常者体重指数(BMI)之间的关联。
在一项基于人群的队列研究——德黑兰甲状腺研究中,对1100名体重正常的甲状腺功能正常者进行了调查。在基线和随访10年后计算BMI,并测定血清促甲状腺激素(TSH)和游离T4(FT4)的浓度。我们基于两种结局定义评估了甲状腺与肥胖之间的关系:(1)二元结局,即BMI<25或≥25kg/m²;(2)多项结局,即正常BMI、超重和肥胖。
共纳入569名女性和531名男性,年龄为36.3±13.5岁。对二元结局进行修正泊松回归分析,在调整年龄、性别、吸烟和抗甲状腺过氧化物酶抗体状态后,发现血清FT4变化与随访BMI之间呈负相关(相对风险0.55[95%CI 0.37 - 0.80]),而血清TSH变化与随访BMI之间无显著关联。然而,在多项逻辑回归分析中,对于超重或肥胖与体重正常的参与者,我们发现血清FT4或TSH变化与随访BMI类别之间均无关系。
在体重正常的甲状腺功能正常个体中,血清FT4浓度的变化而非TSH浓度的变化可能导致体重改变。