Tsou Meng-Ting
Department of Family Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan, ROC.
Department of Occupation Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan, ROC.
J Endocr Soc. 2021 Feb 23;5(6):bvab028. doi: 10.1210/jendso/bvab028. eCollection 2021 Jun 1.
From previous studies, decreased thermogenesis and metabolic rate in the patients with overt and subclinical hypothyroidism lead to an increase in visceral adipose tissue (VAT) incidence, and which was associated with cardiovascular diseases. In this paper, we want to explore the relationship between various forms of VAT [pericardial (PCF), and thoracic periaortic adipose tissue (TAT)] and obesity indices [body shape index (ABSI), and body roundness index (BRI), Chinese visceral adiposity index (CVAI)] with subclinical hypothyroidism by gender.
This study aims to evaluate region-specific cardiovascular (CV) fat tissue (pericardial fat [PCF] and thoracic periaortic fat [TAT) and noninvasive visceral adipose indices (a body shape index [ABSI], body roundness index [BRI]), and Chinese visceral adiposity index [CVAI]) in patients with subclinical hypothyroidism (SCH) as compared to a control population and relative to variations in CV risk.
A total of 125 Taiwanese patients recently diagnosed with SCH (age: 52.9 ± 10.16 years, 41.6% female) and 1519 healthy volunteers (age: 49.54 ± 9.77 years, 29.0% female) were evaluated for this study. All participants underwent PCF and TAT assessment using a multidetector computed tomography scanner, ABSI, BRI, and CVAI evaluation using a mathematical formula. CV risk was classified by Framingham risk score (FRS).
Multivariable logistic regression models showed that the independent association of TAT and BRI with SCH were stronger in women than men. The adjusted model associations (odds ratio [OR]; 95% CI) with SCH for TAT and BRI in women were 2.61 (95% CI, 1.03-6.97) and 2.04 (95% CI, 1.07-3.92). The incidences of TAT and BRI third tertile were also higher in women with SCH (SCH vs euthyroid, TAT third tertile, 9 [17.3%] vs 35 [7.9%], = .04; BRI third tertile, 22 [42.3%] vs 111 [25.2%], = .01). In addition to BRI and TAT, there were higher risks of CVAI in SCH with intermediate/high FRS, especially in women (OR; 95% CI, TAT: 4.01; 95% CI, 1.01-6.640; BRI: 6.91; 95% CI, 1.03-10.23; CVAI: 7.81 95% CI, 1.01-12.03).
Our findings show that patients with SCH have significantly greater TAT, BRI, and CVAI values than control groups, especially in women (with different FRS).
既往研究表明，显性和亚临床甲状腺功能减退患者的产热和代谢率降低会导致内脏脂肪组织（VAT）发生率增加，且这与心血管疾病相关。在本文中，我们想按性别探讨不同形式的VAT[心包脂肪（PCF）和胸主动脉周围脂肪组织（TAT）]与肥胖指数[体型指数（ABSI）、体圆度指数（BRI）、中国内脏脂肪指数（CVAI）]与亚临床甲状腺功能减退之间的关系。
本研究旨在评估亚临床甲状腺功能减退（SCH）患者与对照组相比，特定区域的心血管（CV）脂肪组织（心包脂肪[PCF]和胸主动脉周围脂肪[TAT]）以及非侵入性内脏脂肪指数（体型指数[ABSI]、体圆度指数[BRI]）和中国内脏脂肪指数[CVAI]），并探讨其与CV风险变化的关系。
本研究共纳入125例近期诊断为SCH的台湾患者（年龄：52.9±10.16岁，41.6%为女性）和1519名健康志愿者（年龄：49.54±9.77岁，29.0%为女性）。所有参与者均使用多排螺旋CT扫描仪进行PCF和TAT评估，使用数学公式进行ABSI、BRI和CVAI评估。CV风险通过弗明汉风险评分（FRS）进行分类。
多变量逻辑回归模型显示，TAT和BRI与SCH的独立关联在女性中比男性更强。女性中TAT和BRI与SCH的调整后模型关联（比值比[OR]；95%可信区间）分别为2.61（95%CI，1.03 - 6.97）和2.04（95%CI，1.07 - 3.92）。SCH女性中TAT和BRI第三三分位数的发生率也更高（SCH与甲状腺功能正常者相比，TAT第三三分位数，9[17.3%]对35[7.9%]，P = 0.04；BRI第三三分位数，22[42.3%]对111[2 / 5.2%]，P = 0.01）。除BRI和TAT外，FRS为中/高的SCH患者CVAI风险更高，尤其是女性（OR；95%CI，TAT：4.01；95%CI，1.01 - 6.640；BRI：6.91；95%CI，1.03 - 10.23；CVAI：7.81 95%CI，1.01 - 12.03）。
我们的研究结果表明，SCH患者的TAT、BRI和CVAI值显著高于对照组，尤其是女性（不同FRS）。
