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甲状腺激素在正常范围内与肥胖中国育龄妇女肥胖指数之间的关联。

Associations Between Thyroid Hormones Within the Euthyroid Range and Indices of Obesity in Obese Chinese Women of Reproductive Age.

机构信息

Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.

Department of Endocrinology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang Province, China.

出版信息

Metab Syndr Relat Disord. 2019 Oct;17(8):416-422. doi: 10.1089/met.2019.0036. Epub 2019 Jul 29.

Abstract

A number of researches have reported that thyroid hormones are associated with obesity. However, the relationship of serum levels of thyroid hormones in the normal range with obesity and parameters of obesity in women of childbearing age remains controversial. The purpose of this study was to examine serum levels of thyroid hormones within the normal range in obese Chinese women of reproductive age and to investigate the relationship between concentration of thyroid hormones and indices of obesity, including body mass index (BMI), waist-to-hip ratio (WHR), insulin resistance, blood glucose, blood lipids, and blood pressure. One hundred fifty-one obese women of reproductive age and 160 nonobese women of reproductive age were enrolled in this study. Serum levels of thyroid-stimulating hormone (TSH) of all subjects were within the normal reference range (0.35-4.94 mIU/L). The serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and TSH, height, body weight, BMI, waist and hip circumferences, WHR, fasting blood glucose (FBG), fasting insulin (FI), homeostasis model assessment of insulin resistance (HOMA-IR), total triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured in all subjects. Quantile regression analysis was used to analyze the associations of serum levels of FT3, FT4, and TSH with values of BMI, WHR, FBG, FI, HOMA-IR, TG, TC, LDL-C, HDL-C, SBP, and DBP. In the group of obese women, serum levels of FT4 were lower ( < 0.001) and serum levels of TSH were higher ( < 0.001) compared with nonobese controls. After adjusting for covariables, quantile regression analysis showed that serum levels of FT4 were inversely associated with BMI values between the quantile levels of 0.29 and 0.60 of BMI (., BMI level of 22.49 and 28.31 kg/m, respectively). Meanwhile, we found that serum levels of TSH positively correlated with BMI values after the quantile level of 0.51 (., BMI level of 27.06 kg/m), positively associated with TC after the quantile level of 0.6 (., TC level of 4.86 mM), and positively associated with LDL-C after the quantile level of 0.39 (., LDL level of 1.96 mM). No significant associations were found between serum levels of thyroid hormones and values of WHR, FBG, FI, HOMA-IR, TG, HDL-C, SBP, and DBP. FT4 and TSH play an important role in regulating the weight in women with normal thyroid function during their reproductive years. Women with decreased serum FT4 or increased serum TSH levels have a higher risk of developing obesity. Besides, TSH has a significant influence on metabolism of blood lipids. Women with higher serum levels of TSH have a higher risk of incidence of lipid metabolism disorders.

摘要

一些研究报告指出,甲状腺激素与肥胖有关。然而,在生育年龄的妇女中,甲状腺激素在正常范围内的血清水平与肥胖以及肥胖的参数之间的关系仍存在争议。本研究的目的是检查中国生育年龄肥胖妇女的甲状腺激素在正常范围内的血清水平,并研究甲状腺激素浓度与肥胖指数的关系,包括体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗、血糖、血脂和血压。本研究纳入了 151 名生育年龄的肥胖妇女和 160 名非肥胖生育年龄的妇女。所有受试者的促甲状腺激素(TSH)血清水平均在正常参考范围内(0.35-4.94 mIU/L)。游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和 TSH 血清水平、身高、体重、BMI、腰围和臀围、WHR、空腹血糖(FBG)、空腹胰岛素(FI)、稳态模型评估的胰岛素抵抗(HOMA-IR)、总甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、收缩压(SBP)和舒张压(DBP)均在所有受试者中进行了测量。使用分位数回归分析来分析 FT3、FT4 和 TSH 血清水平与 BMI、WHR、FBG、FI、HOMA-IR、TG、TC、LDL-C、HDL-C、SBP 和 DBP 值之间的关系。在肥胖组中,FT4 血清水平较低(<0.001),TSH 血清水平较高(<0.001),与非肥胖对照组相比。在调整了协变量后,分位数回归分析表明,FT4 血清水平与 BMI 水平在 0.29 到 0.60 的分位数水平之间呈负相关(分别为 BMI 水平 22.49 和 28.31kg/m)。同时,我们发现 TSH 血清水平在 0.51 分位数水平后与 BMI 值呈正相关(BMI 水平为 27.06kg/m),在 0.6 分位数水平后与 TC 呈正相关(TC 水平为 4.86mM),在 0.39 分位数水平后与 LDL-C 呈正相关(LDL 水平为 1.96mM)。在甲状腺激素血清水平与 WHR、FBG、FI、HOMA-IR、TG、HDL-C、SBP 和 DBP 值之间未发现显著相关性。FT4 和 TSH 在调节生育期女性正常甲状腺功能的体重方面起着重要作用。血清 FT4 水平降低或血清 TSH 水平升高的女性患肥胖症的风险更高。此外,TSH 对血脂代谢有显著影响。血清 TSH 水平较高的女性发生血脂代谢紊乱的风险较高。

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