https://scholars.lib.ntu.edu.tw/handle/123456789/626877
標題: | High TSH Level within Normal Range Is Associated with Obesity, Dyslipidemia, Hypertension, Inflammation, Hypercoagulability, and the Metabolic Syndrome: A Novel Cardiometabolic Marker | 作者: | YI-CHENG CHANG Hua, Shih-Che CHIA-HSUIN CHANG Kao, Wei-Yi Lee, Hsiao-Lin LEE-MING CHUANG Huang, Yen-Tsung Lai, Mei-Shu |
關鍵字: | cardiometabolic risks; hypertension; metabolic syndrome; obesity; thyroid-stimulating hormone | 公開日期: | 7-六月-2019 | 出版社: | MDPI | 卷: | 8 | 期: | 6 | 來源出版物: | Journal of clinical medicine | 摘要: | (1) Background: Overt and subclinical hypothyroidism has been associated with increased cardiometabolic risks. Here we further explore whether thyroid function within normal range is associated with cardiometabolic risk factors in a large population-based study. (2) Methods: We screened 24,765 adults participating in health examinations in Taiwan. Participants were grouped according to high-sensitive thyroid-stimulating hormone (hsTSH) level as: <50th percentile (0.47-1.48 mIU/L, the reference group), 50-60th percentile (1.49-1.68 mIU/L), 60-70th percentile (1.69-1.94 mIU/L), 70-80th percentile (1.95-2.3 mIU/L), 80-90th percentile (2.31-2.93 mIU/L), and >90th percentile (>2.93 mIU/L). Cardiometabolic traits of each percentile were compared with the reference group. (3) Results: Elevated hsTSH levels within normal range were dose-dependently associated with increased body mass index, body fat percentage, waist circumferences, blood pressure, hemoglobin A1c (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), high homeostasis model of assessment of beta-cell (HOMA-β), triglycerides, total cholesterols, fibrinogen, and uric acids (p-for-trend <0.001), but not with fasting glucose levels. The association remained significant after adjustment of age, sex, and lifestyle. As compared to the reference group, subjects with the highest hsTSH percentile had significantly increased risk of being overweight (adjusted odds ratio (adjOR): 1.35), increased body fat (adjOR: 1.29), central obesity (adjOR: 1.36), elevated blood pressure (adjOR: 1.26), high HbA1c (adjOR: 1.20), hyperinsulinemia (adjOR: 1.75), increased HOMA-IR (adjOR: 1.45), increased HOMA-β (adjOR: 1.40), hypertriglyceridemia (adjOR: 1.60), hypercholesterolemia (adjOR: 1.25), elevated hsCRP (adjOR: 1.34), increased fibrinogen (adjOR: 1.45), hyperuricemia (adjOR: 1.47), and metabolic syndrome (adjOR: 1.42), but significant risk of low fasting glucose (adjOR: 0.89). Mediation analysis indicates that insulin resistance mediates the majority of the association between thyroid hormone status and the metabolic syndrome. (4) Conclusion: Elevated hsTSH within the normal range is a cardiometabolic risk marker associated with central obesity, insulin resistance, elevated blood pressure, dyslipidemia, hyperuricemia, inflammation, and hypercoagulability. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/626877 | ISSN: | 2077-0383 | DOI: | 10.3390/jcm8060817 |
顯示於: | 醫學系 |
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