Thyroid function, body mass index, and metabolic risk markers in euthyroid adults: a cohort study
Open accessAbstract
BACKGROUND: In recent years, the relationship between thyroid stimulating hormone (TSH) and obesity has been widely discussed. However, it is unclear how thyroid hormone concentrations relate to body weight and its impact on metabolic risk markers. This study aimed to assess how thyroid function is linked to underweight, overweight, or obesity, and metabolic risk markers in adults. METHODS: A total of 16,975 subjects, aged 18-80 years, who attended the Health Management Center of Tongji Hospital, Wuhan, China were enrolled in this study. Anthropometric and laboratory data were collected and analyzed. RESULTS: Serum free triiodothyronine (fT3) and fT3/free thyroxine (fT4) ratio (fT3/fT4) were positively associated with body mass index (BMI) (P < 0.001), while there was a negative relationship between fT4 and BMI (P < 0.001) according to multivariable regression analysis adjusted for age and sex. Associations between thyroid hormone concentrations and markers of blood pressure, and lipid and glucose metabolism were identified after adjustment for age, sex, and BMI, with TSH being negatively associated with fasting blood glucose (FBG). fT3 was positively associated with systolic blood pressure and low-density lipoprotein-cholesterol, while fT4 was positively associated with diastolic blood pressure, FBG, and high-density lipoprotein-cholesterol (HDL-C), and negatively associated with hemoglobin A1c (HbA1c) and triglyceride. Finally, fT3/fT4 was positively associated with HbA1c and triglyceride, and negatively associated with HDL-C. CONCLUSIONS: Overweight or obese participants had a high serum concentration of fT3, high fT3/fT4 ratio, and a low concentration of fT4. Underweight participants had high concentrations of fT4 and low concentrations of fT3. Thus, relationships between thyroid hormones and metabolic risk markers were identified which suggest that thyroid function might be one factor that influences body weight and the co-morbidities of obesity.
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Obese adults often have higher FT3 levels and a higher FT3:FT4 ratio than the general population.
“a similar effect is still observed in obese adults who often have higher FT3 levels and a higher FT3:FT4 ratio than the general population [50].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [50]
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- Authors
- Xu, R., Huang, F., Zhang, S., Lv, Y., & Liu, Q.
- Affiliations
- Tongji Hospital (CN)
- Corresponding author
- Lv, Yongman
- Liu, Qingquan
- Venue
- BMC Endocrine Disorders
- Published
- 2019-06-07
- Volume
- 19
- Issue
- 1
- Pages
- 58-58
- ISSN
- 1472-6823 (ISSN-L)
- PMC
- PMC6555987
- OpenAlex
- W2948798330
- Cited by
- 75
- References
- 38
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 4 · 2023: 14 · 2022: 16 · 2021: 11 · 2020: 11
- FWCI
- 7.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Endocrine Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Tongji University
- 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 › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- thyroid function, thyroid-stimulating hormone, free triiodothyronine, free thyroxine, FT3/FT4 ratio, body mass index, obesity, underweight, overweight, metabolic risk markers, blood pressure, lipid metabolism, glucose metabolism, fasting blood glucose, HbA1c, triglycerides, HDL cholesterol, LDL cholesterol
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Prognosis, Thyroid Function Tests, Thyroid Gland, Thyroid Hormones, Cohort Studies, Biomarkers, Body Mass Index, Incidence, Case-Control Studies, Metabolic Syndrome, Dyslipidemias, Overweight, Young Adult
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