Wei Ying, Yang Mengge, Liu Jia, Wang Ying, Wang Guang
Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Health Management Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
J Clin Endocrinol Metab. 2024 Nov 18. doi: 10.1210/clinem/dgae806.
The study aimed to explore the association between thyroid hormone (TH) sensitivity and obesity assessed by body mass index (BMI) and visceral adiposity index (VAI) in euthyroid adults.
This cross-sectional study used the thyroid feedback quantile-based index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotrophic T4 resistance index (TT4RI) to indicate central TH sensitivity, and VAI to assess visceral obesity. Participants were categorized according to tertiles. We used logistic and linear regressions to explore the association stratified by sex.
The study enrolled 5411 men and 5749 women with normal thyroid function. Men with the highest tertile of TT4RI had 1 kg/m2 higher BMI compared with men with the lowest tertile of TT4RI (P=0.001) after adjustment for age, hypertension, hyperlipidemia, diabetes, hyperuricemia, and renal function. There was no significant difference in BMI across tertiles of TFQI and TSHI in men, and TFQI, TSHI, and TT4RI in women after adjustment for other risk factors. TH sensitivity indices were positively related to VAI after adjustment for confounders in women but not in men. There were 1.21 (95%CI:1.02-1.44, P=0.03), 1.43 (95%CI: 1.20-1.70, P<0.001), and 1.47 (95%CI: 1.23 - 1.75, P<0.001) times higher odds of having high VAI among women in the highest TFQI, TSHI, and TT4RI tertiles respectively, compared to women in the lowest tertile.
Reduced central TH sensitivity was associated with increased visceral adiposity in women but not men. Our findings supplemented the evidence of the importance of TH sensitivity to metabolic disorders, especially among women.
本研究旨在探讨甲状腺功能正常的成年人中，甲状腺激素（TH）敏感性与通过体重指数（BMI）和内脏脂肪指数（VAI）评估的肥胖之间的关联。
这项横断面研究使用基于甲状腺反馈分位数的指数（TFQI）、促甲状腺激素指数（TSHI）和促甲状腺素T4抵抗指数（TT4RI）来表示中枢TH敏感性，并使用VAI评估内脏肥胖。参与者按三分位数进行分类。我们使用逻辑回归和线性回归来探讨按性别分层的关联。
该研究纳入了5411名男性和5749名甲状腺功能正常的女性。在调整年龄、高血压、高脂血症、糖尿病、高尿酸血症和肾功能后，TT4RI最高三分位数的男性比TT4RI最低三分位数的男性BMI高1kg/m²（P = 0.001）。在调整其他危险因素后，男性中TFQI和TSHI三分位数之间的BMI无显著差异，女性中TFQI、TSHI和TT4RI三分位数之间的BMI也无显著差异。在调整混杂因素后，TH敏感性指数与女性的VAI呈正相关，但与男性无关。与最低三分位数的女性相比，TFQI、TSHI和TT4RI最高三分位数的女性发生高VAI的几率分别高1.21倍（95%CI：1.02 - 1.44，P = 0.03）、1.43倍（95%CI：1.20 - 1.70，P < 0.001）和1.47倍（95%CI：1.23 - 1.75，P < 0.001）。
中枢TH敏感性降低与女性内脏脂肪增多有关，与男性无关。我们的研究结果补充了TH敏感性对代谢紊乱重要性的证据，尤其是在女性中。
