Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Front Endocrinol (Lausanne). 2023 Mar 10;14:1134983. doi: 10.3389/fendo.2023.1134983. eCollection 2023.
The association between metabolic phenotypes and thyroid function has not yet been established; therefore, this study examined whether different metabolic phenotypes are associated with the development of hypothyroidism.
Study participants were selected from the Tehran Thyroid Study (TTS). A total of 3338 euthyroid adults were included and categorized into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The participants were assessed at baseline and during three follow-up studies at three-year intervals. Multiple logistic regression analysis was used to examine the relationship between metabolic phenotypes and the development of hypothyroidism.
In the total population, the chi-square test was only significant (P=0.008) in 3 year with a higher prevalence of hypothyroidism in the MUNW phenotype, followed by MHO, MUO, and MHNW. Moreover, in the 3 and 9 years of follow-up, hypothyroidism was more prevalent in MUO only in male subjects (P=0.002 and 0.035, respectively). In the unadjusted model, the MHO phenotype increased the odds of hypothyroidism compared with the MHNW phenotype (OR=1.51; 95% CI=1.04, 2.18; P-value=0.031). After adjusting for confounding factors, the odds of hypothyroidism were higher in the MUNW (OR=1.86; 95% CI=1.17, 2.96; P-value=0.008), MHO (OR=1.71; 95% CI=1.09, 2.67; P-value=0.018), and MUO (OR=1.64; 95% CI=1.03, 2.62; P-value=0.036) phenotypes than in the MHNW group. The MUNW phenotype increased the risk of hypothyroidism compared to MHNW, only in males. However, in females, the MHO phenotype increased the risk of hypothyroidism compared to MHNW.
Both obesity and metabolic abnormalities are associated with hyperthyroidism. Healthy metabolic and weight maintenance were associated with a lower risk of hypothyroidism in males and females.
代谢表型与甲状腺功能之间的关系尚未确定；因此，本研究旨在探讨不同代谢表型是否与甲状腺功能减退的发生有关。
研究参与者选自德黑兰甲状腺研究（TTS）。共纳入 3338 例甲状腺功能正常的成年人，并分为 4 种肥胖表型组：代谢健康正常体重（MHNW）、代谢健康肥胖（MHO）、代谢不健康正常体重（MUNW）和代谢不健康肥胖（MUO）。在基线和每 3 年一次的 3 次随访研究中对参与者进行评估。采用多因素逻辑回归分析方法，检验代谢表型与甲状腺功能减退发生之间的关系。
在总人群中，仅在第 3 年时卡方检验具有统计学意义（P=0.008），MUNW 表型组中甲状腺功能减退的患病率较高，其次是 MHO、MUO 和 MHNW。此外，在 3 年和 9 年的随访中，只有男性 MUO 表型中甲状腺功能减退的患病率更高（P=0.002 和 0.035）。在未调整模型中，与 MHNW 表型相比，MHO 表型增加了甲状腺功能减退的几率（OR=1.51；95%CI=1.04，2.18；P 值=0.031）。调整混杂因素后，MUNW（OR=1.86；95%CI=1.17，2.96；P 值=0.008）、MHO（OR=1.71；95%CI=1.09，2.67；P 值=0.018）和 MUO（OR=1.64；95%CI=1.03，2.62；P 值=0.036）表型的甲状腺功能减退的几率均高于 MHNW 组。与 MHNW 组相比，MUNW 表型增加了男性发生甲状腺功能减退的风险，但在女性中，MHO 表型增加了女性发生甲状腺功能减退的风险。
肥胖和代谢异常均与甲状腺功能亢进有关。男性和女性保持健康的代谢和体重与较低的甲状腺功能减退风险相关。
