Velluzzi Fernanda, Pisanu Silvia, Galletta Maura, Fosci Michele, Secci Gianni, Deledda Andrea, Boi Francesco, Rodia Rossella, Fanciulli Giuseppe, Delitala Alessandro Palmerio, Sainas Gianmarco, Loviselli Andrea
Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.
Hygiene Section, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy.
J Clin Med. 2022 Aug 31;11(17):5125. doi: 10.3390/jcm11175125.
A positive correlation between Thyroid-Stimulating Hormone (TSH) and Body Mass Index (BMI) has been reported in many studies, but data on this topic remain controversial, especially when TSH values are in the normal range. Moreover, few studies have evaluated the co-existence of thyroid autoimmunity. This study investigated the role of thyroid autoimmunity in the interconnection between TSH, BMI, and waist circumference (WC) in euthyroid patients with overweight or obesity. We enrolled 902 patients (213 males; mean age ± SD: 45 ± 14 years; mean BMI ± SD: 35.8 ± 6.5 kg/m), with normal serum TSH concentration; anti-thyroid autoantibodies (ATAs) were evaluated in 752 patients (186 males). Patients were divided into four BMI classes, based on WHO criteria, and the relationship between BMI, WC, and TSH was evaluated in the whole sample and compared to ATAs positivity, observed in 235 patients (44 males). No significant difference was found between TSH levels in the BMI classes. A statistically significant correlation between TSH and BMI was found only in ATAs-positive females (N = 191, Spearman rho: 0.149; -value: 0.040). However, this finding was not confirmed when considering the WC. Our study shows a positive correlation only between TSH and BMI in obese women with positive ATAs, suggesting that in these patients, the high normal levels of TSH could be attributed to a mild thyroid failure with a possible worsening obesity-related effect, and both need a careful evaluation.
许多研究报告了促甲状腺激素（TSH）与体重指数（BMI）之间存在正相关，但关于这一主题的数据仍存在争议，尤其是当TSH值处于正常范围时。此外，很少有研究评估甲状腺自身免疫的共存情况。本研究调查了甲状腺自身免疫在超重或肥胖的甲状腺功能正常患者中TSH、BMI和腰围（WC）之间相互关系中的作用。我们纳入了902例患者（213例男性；平均年龄±标准差：45±14岁；平均BMI±标准差：35.8±6.5kg/m²），其血清TSH浓度正常；对752例患者（186例男性）进行了抗甲状腺自身抗体（ATA）评估。根据世界卫生组织标准将患者分为四个BMI类别，并在整个样本中评估BMI、WC和TSH之间的关系，并与235例患者（44例男性）中观察到的ATA阳性情况进行比较。在不同BMI类别之间未发现TSH水平有显著差异。仅在ATA阳性的女性中发现TSH与BMI之间存在统计学显著相关性（N = 191，Spearman等级相关系数：0.149；P值：0.040）。然而，在考虑WC时这一发现未得到证实。我们的研究表明，仅在ATA阳性的肥胖女性中TSH与BMI之间存在正相关，这表明在这些患者中，TSH的高正常水平可能归因于轻度甲状腺功能减退以及可能加重的肥胖相关影响，两者都需要仔细评估。
