非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值与血清甲状腺功能指标之间的关联：2007 - 2012年美国国家健康与营养检查调查（NHANES）及孟德尔随机化研究的最新发现

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and serum thyroid function measures: Recent Findings from NHANES 2007-2012 and Mendelian randomization.

作者信息

Tan Mo-Yao, Zhang Ping, Wu Shan, Zhu Si-Xuan, Gao Ming

机构信息

Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China.

Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

出版信息

Front Endocrinol (Lausanne). 2025 Jan 24;16:1467254. doi: 10.3389/fendo.2025.1467254. eCollection 2025.

DOI:10.3389/fendo.2025.1467254

PMID:39926348

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11802436/

Abstract

OBJECTIVE

There is limited epidemiological data regarding the association of blood lipids with thyroid hormones. Thus, the present article aims to explore whether there is an association between non-high-density to high-density lipoprotein cholesterol ratio (NHHR) and thyroid hormones.

METHODS

We analyzed samples from 3,881 adults aged 20 years and above who took part in the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2012. The study tested for thyroid hormones, including total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), as well as thyroid-stimulating hormone (TSH). Survey-weighted linear regression and restricted cubic spline (RCS) models were employed to investigate the relationship between NHHR and thyroid hormones. Subsequently, subgroup analyses were conducted. In Mendelian randomization (MR), the inverse variance weighting method (IVW) is used as the primary analytical approach.

RESULTS

This study finally comprised 3,881 adults aged 20 years and older. After extensive adjustments for covariables, the regression analysis revealed significant negative associations between NHHR and FT4 (β: -0.11, 95% confidence interval [CI]: -0.18, -0.04), FT4/FT3 (β: -0.06, 95% CI: -0.08, -0.04), and TT4/TT3 (β: -0.001, 95% CI: -0.001, 0.000). Both observational and Mendelian randomization studies suggest that high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol may not significantly influence the risk of hyperthyroidism or hypothyroidism.

CONCLUSIONS

The study indicates negative associations between NHHR and FT4, as well as the ratios of FT4/FT3 and TT4/TT3. This suggests that NHHR may reflect changes in thyroid function, highlighting its potential clinical significance in assessing thyroid function and metabolic health.

摘要

目的

关于血脂与甲状腺激素之间关联的流行病学数据有限。因此，本文旨在探讨非高密度脂蛋白与高密度脂蛋白胆固醇比值（NHHR）与甲状腺激素之间是否存在关联。

方法

我们分析了2007年至2012年参加美国国家健康与营养检查调查（NHANES）的3881名20岁及以上成年人的样本。该研究检测了甲状腺激素，包括总三碘甲状腺原氨酸（TT3）、游离三碘甲状腺原氨酸（FT3）、总甲状腺素（TT4）、游离甲状腺素（FT4）以及促甲状腺激素（TSH）。采用调查加权线性回归和受限立方样条（RCS）模型来研究NHHR与甲状腺激素之间的关系。随后进行了亚组分析。在孟德尔随机化（MR）中，采用逆方差加权法（IVW）作为主要分析方法。

结果

本研究最终纳入了3881名20岁及以上的成年人。在对协变量进行广泛调整后，回归分析显示NHHR与FT4（β：-0.11，95%置信区间[CI]：-0.18，-0.04）、FT4/FT3（β：-0.06，95%CI：-0.08，-0.04）以及TT4/TT3（β：-0.001，95%CI：-0.001，0.000）之间存在显著的负相关。观察性研究和孟德尔随机化研究均表明，高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和总胆固醇可能不会显著影响甲亢或甲减的风险。