Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
ARO, Clinical Trial Center, Pusan National University Hospital, Busan, Korea.
Diabetes Metab J. 2019 Dec;43(6):867-878. doi: 10.4093/dmj.2018.0130. Epub 2019 Apr 3.
Thyroid disease and metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to investigate the correlation between thyroid hormones and obesity sub-phenotypes using nationwide data from Korea, a country known to be iodine replete.
This study was based on data obtained from the sixth Korea National Health and Nutrition Examination Survey, administered from 2013 to 2015. A total of 13,873 participants aged ≥19 years were included, and classified into four groups: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO) by body fat on the basis of body mass index and metabolic health.
At baseline, serum free thyroxine (fT4) values were significantly higher in the MHNO phenotype (MHNO, 1.27±0.01 ng/dL; MHO, 1.25±0.01 ng/dL; MUNO, 1.24±0.01 ng/dL; MUO, 1.24±0.01 ng/dL, <0.001) in total study population. However, this significant association no longer remained after adjustment for age, urine iodine concentration, and smoking (=0.085). After adjustment for confounders, statistically significant association was observed between lower thyroid stimulating hormone (TSH) and MHNO phenotype (=0.044). In men participants (not women), higher fT4 values were significantly associated with MHNO phenotype (<0.001). However, no significant association was observed between thyroid function (TSH or fT4) and obesity phenotypes in groups classified by age (cutoff age of 55 years).
Although there was a difference by age and sex, we found that the decrease of TSH and the increase of fT4 values were associated with MHNO.
甲状腺疾病和代谢综合征均与心血管疾病相关。本研究旨在使用来自碘充足的韩国的全国性数据，探究甲状腺激素与肥胖亚表型之间的相关性。
本研究基于 2013 年至 2015 年进行的第六次韩国国家健康与营养调查的数据。共纳入 13873 名年龄≥19 岁的参与者，并根据体脂（基于 BMI 和代谢健康的体脂）将其分为四组：代谢健康非肥胖（MHNO）、代谢健康肥胖（MHO）、代谢不健康非肥胖（MUNO）和代谢不健康肥胖（MUO）。
在基线时，MHNO 表型的血清游离甲状腺素（fT4）值显著较高（MHNO，1.27±0.01ng/dL；MHO，1.25±0.01ng/dL；MUNO，1.24±0.01ng/dL；MUO，1.24±0.01ng/dL，<0.001）。然而，在调整年龄、尿碘浓度和吸烟后，这种显著关联不再存在（=0.085）。在调整混杂因素后，较低的促甲状腺激素（TSH）与 MHNO 表型之间存在统计学显著关联（=0.044）。在男性参与者中（非女性），较高的 fT4 值与 MHNO 表型显著相关（<0.001）。然而，在按年龄分类的组中（年龄截定点为 55 岁），甲状腺功能（TSH 或 fT4）与肥胖表型之间未观察到显著关联。
尽管存在年龄和性别差异，但我们发现 TSH 降低和 fT4 值升高与 MHNO 相关。
