Thyrotropin Levels Are Associated with Cardiometabolic Risk Factors in Euthyroid Adolescents
Open accessAbstract
Background: Increased thyrotropin (TSH) levels and free triiodothyronine to free thyroxine (fT3:fT4) ratios, even within the euthyroid range, have been associated with cardiometabolic risk factors in adults but are less characterized in youth. This study sought to determine relations between TSH, thyroid hormones, and cardiometabolic risk factors in euthyroid adolescents. Methods: Data were extracted from the United States National Health and Nutrition Examination Survey, 2007–2010, for univariate and multivariate analyses of TSH, thyroid hormones, body mass index (BMI), blood pressure, lipids, and glucose metabolism. Subjects aged 12–18 years, with normal TSH and antithyroid peroxidase antibody levels, and without a history of thyroid disease, diabetes, or treatment of hypertension/dyslipidemia ( n = 1167) were included. TSH and thyroid hormones were assessed for impact on BMI Z-score, systolic blood pressure (SBP) diastolic blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, triglycerides, and glucose metabolism. Results: Univariate analyses revealed positive linear relations between TSH and SBP, TC, fasting and two-hour glucose, and homeostasis model assessment of insulin resistance (HOMA-IR). The fT3:fT4 ratio negatively correlated with high-density lipoprotein cholesterol but positively with BMI Z-score, SBP, triglycerides, fasting and two-hour glucose, fasting insulin, and HOMA-IR. In multivariate analyses controlling for age, sex, race/ethnicity, and BMI Z-score, relations between TSH and both TC and fasting glucose remained significant, and the fT3:fT4 ratio was positively associated with fasting glucose and HOMA-IR. Conclusions: In an unselected population of euthyroid U.S. adolescents, TSH and thyroid hormones correlate with multiple cardiometabolic risk factors, with age- and sex-independent effects on cholesterol and glucose metabolism.
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Previous studies reported that low thyroid function even within the normal range is associated with metabolic syndrome owing to an increase in insulin resistance.
“Previous studies,5,6,7,40 including those using NHANES data,5,7 reported that low thyroid function even within the normal range is associated with metabolic syndrome owing to an increase in insulin resistance and might contribute to the progression of atherosclerosis and CVD risk.41”
From Association of subclinical hypothyroidism and cardiovascular disease with mortality (2020) · cites this paper as [7]
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Association of subclinical hypothyroidism and cardiovascular disease with mortality
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- Authors
- Le, T. N., Celi, F. S., & Wickham, E. P.
- Affiliations
- Virginia Commonwealth University (US)
- Corresponding author
- Le, Trang N.
- ORCID
- Celi, Francesco S.
- Venue
- Thyroid®
- Publisher
- SAGE Publications
- Published
- 2016-10
- Volume
- 26
- Issue
- 10
- Pages
- 1441-1449
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- PMC
- PMC5067795
- OpenAlex
- W2529378906
- Cited by
- 53
- References
- 15
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 8 · 2018: 7 · 2017: 1
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Thyroid (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD053742)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- thyroid-stimulating hormone, thyroid hormones, cardiometabolic risk factors, insulin resistance, blood pressure, cholesterol, triglycerides, fasting blood glucose, body mass index, dyslipidemia
- MeSH terms
- Adolescent, Cardiovascular Diseases, Child, Cross-Sectional Studies, Female, Humans, Insulin Resistance, Male, Nutrition Surveys, Predictive Value of Tests, Risk Factors, Thyroid Gland, Thyrotropin, Thyroxine, Triiodothyronine, United States, Cohort Studies, Biomarkers, Metabolic Syndrome, Early Diagnosis, Glucose Metabolism Disorders, Dyslipidemias
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