Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong, 18450, Korea.
Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Sci Rep. 2021 Nov 5;11(1):21738. doi: 10.1038/s41598-021-01101-z.
Thyroid dysfunction has been implicated as a potential pathophysiological factor in glucose homeostasis and insulin resistance (IR). This study aimed to identify the correlation between thyroid dysfunction and IR. We used data from the sixth Korean National Health and Nutrition Examination Survey to evaluate a total of 5727 participants. The triglyceride glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated to represent IR. Correlation analysis was performed between thyroid dysfunction and IR. The log-transformed TSH (LnTSH) and free T4 were significantly correlated with the TyG index (TSH, beta coefficient 0.025, 95% confidence interval [CI] 0.014-0.036, p < 0.001; free T4, - 0.110 (- 0.166 to - 0.054), p < 0.001) but not HOMA-IR. Overt hypothyroidism is correlated with increased TyG index in pre-menopausal females (0.215 (0.122-0.309) p < 0.001). On the other hand, overt hyperthyroidism is correlated with increased HOMA-IR in males (0.304 (0.193-0.416), p < 0.001) and post-menopausal females (1.812 (1.717-1.907), p < 0.001). In euthyroid subjects, LnTSH and TyG index were significantly correlated in females. In conclusion, both hyperthyroidism and hypothyroidism might be associated with IR but by different mechanisms. It might be helpful to assess IR with appropriate indexes in patients with thyroid dysfunction.
甲状腺功能障碍与葡萄糖稳态和胰岛素抵抗（IR）有关。本研究旨在确定甲状腺功能障碍与 IR 之间的相关性。我们使用了第六次韩国国家健康和营养检查调查的数据，共评估了 5727 名参与者。使用甘油三酯葡萄糖（TyG）指数和稳态模型评估的胰岛素抵抗（HOMA-IR）来表示 IR。分析甲状腺功能障碍与 IR 之间的相关性。未校正的促甲状腺激素（TSH）和游离甲状腺素（FT4）与 TyG 指数呈显著正相关（TSH，β系数 0.025，95%置信区间[CI]0.014-0.036，p<0.001；FT4，-0.110（-0.166 至-0.054），p<0.001），但与 HOMA-IR 无关。绝经前女性的显性甲状腺功能减退症与 TyG 指数升高有关（0.215（0.122-0.309），p<0.001）。另一方面，男性的显性甲状腺功能亢进症与 HOMA-IR 升高有关（0.304（0.193-0.416），p<0.001），绝经后女性的显性甲状腺功能亢进症与 HOMA-IR 升高有关（1.812（1.717-1.907），p<0.001）。在甲状腺功能正常的受试者中，女性的未校正 TSH 和 TyG 指数显著相关。总之，甲状腺功能亢进和甲状腺功能减退症可能与 IR 有关，但机制不同。在甲状腺功能障碍患者中，使用适当的指标评估 IR 可能会有所帮助。
