Small Differences in Thyroid Function May Be Important for Body Mass Index and the Occurrence of Obesity in the Population
Abstract
CONTEXT: Increasing prevalence of overweight in the population is a major concern globally; and in the United States, nearly one third of adults were classified as obese at the end of the 20th century. Few data have been presented regarding an association between variations in thyroid function seen in the general population and body weight. OBJECTIVE: The aim of this study was to investigate the association between thyroid function and body mass index (BMI) or obesity in a normal population. DESIGN: A cross-sectional population study (The DanThyr Study) was conducted. PARTICIPANTS: In all, 4649 participants were investigated, and 4082 were eligible for these analyses after exclusion of subjects with previous or present overt thyroid dysfunction. MAIN OUTCOME MEASURES: The study examined the association between category of serum TSH or serum thyroid hormones and BMI or obesity in multivariate models, adjusting for possible confounding. RESULTS: We found a positive association between BMI and category of serum TSH (P < 0.001) and a negative association between BMI and category of serum free T(4) (P < 0.001). No association was found between BMI and serum free T(3) levels. The difference in BMI between the groups with the highest and lowest serum TSH levels was 1.9 kg/m(2), corresponding to a difference in body weight of 5.5 kg among women. Similarly, the category of serum TSH correlated positively with weight gain during 5 yr (P = 0.04), but no statistically significant association was found with weight gain during 6 months (P = 0.17). There was an association between obesity (BMI > 30 kg/m(2)) and serum TSH levels (P = 0.001). CONCLUSIONS: Our results suggest that thyroid function (also within the normal range) could be one of several factors acting in concert to determine body weight in a population. Even slightly elevated serum TSH levels are associated with an increase in the occurrence of obesity.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
FT4 was strongly negatively associated with BMI.
“In contrast FT4 was strongly negatively associated with BMI [65].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [65]
Higher TSH levels were associated with increased BMI, and in longitudinal studies, individuals with rising TSH levels over time exhibited greater weight gain.
“Higher TSH levels were associated with increased BMI [65, 66], and in longitudinal studies, individuals with rising TSH levels over time exhibited greater weight gain [67, 68].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [65]
None of the studies examining body weight and composition in LT4-treated subjects have shown significant differences in these parameters compared to control subjects or when LT4 doses were altered to lower TSH within the reference range.
“None have shown significant differences in these parameters compared to control subjects (47,48) or when LT4 doses were altered to lower TSH within the reference range (14,41).”
From Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition (2016) · cites this paper as [41]
Cites
Prevalence and trends in obesity among US adults, 1999–2000
Flegal, K. M. (2002) · JAMA · doi:10.1001/jama.288.14.1723 · Cited by 6,190 · see citing works
The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey
Vanderpump, M. P. J., Tunbrldge, W. M. G., French, J. M., Appleton, D., Bates, D., Clark, F., Evans, J. G., Hasan, D. M., Rodgers, H., Tunbridge, F., et al. (1995) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1995.tb01894.x · Cited by 2,432 · see citing works
Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management
Surks, M. I., Ortiz, E., Daniels, G. H., Sawin, C. T., Col, N. F., Cobin, R. H., Franklyn, J. A., Hershman, J. M., Burman, K. D., Denke, M. A., et al. (2004) · JAMA · doi:10.1001/jama.291.2.228 · Cited by 1,800 · see citing works
Hak, A. E., Pols, H. A. P., Visser, T. J., Drexhage, H. A., Hofman, A., & Witteman, J. C. M. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-132-4-200002150-00004 · Cited by 1,336 · see citing works
Recombinant human leptin in women with hypothalamic amenorrhea
Welt, C. K., Chan, J. L., Bullen, J., Murphy, R., Smith, P., DePaoli, A. M., Karalis, A., & Mantzoros, C. S. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa040388 · Cited by 908 · see citing works
Thyroid Status, Disability and Cognitive Function, and Survival in Old Age
Gussekloo, J. (2004) · JAMA · doi:10.1001/jama.292.21.2591 · Cited by 899 · see citing works
Chan, J. L., Heist, K., DePaoli, A. M., Veldhuis, J. D., & Mantzoros, C. S. (2003) · Journal of Clinical Investigation · doi:10.1172/jci17490 · Cited by 697 · see citing works
Andersen, S., Pedersen, K. M., Bruun, N. H., & Laurberg, P. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8165 · Cited by 686 · see citing works
Self-citationZulewski, H., Müller, B., Exer, P., Miserez, A. R., & Staub, J.-J. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.3.3810 · Cited by 389 · see citing works
Subclinical hyperthyroidism and the risk of dementia. The Rotterdam study
Kalmijn, S., Mehta, K. M., Pols, H. A. P., Albert Hofman, D., Drexhage, H. A., & Breteler, M. M. B. (2000) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2000.01146.x · Cited by 319 · see citing works
Rosenbaum, M., Hirsch, J., Murphy, E., & Leibel, R. L. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/71.6.1421 · Cited by 315 · see citing works
Environmental Iodine Intake Affects the Type of Nonmalignant Thyroid Disease
Laurberg, P., Pedersen, I. B., Knudsen, N., Ovesen, L., & Andersen, S. (2001) · Thyroid · doi:10.1089/105072501300176417 · Cited by 307 · see citing works
Self-citationCaraccio, N., Ferrannini, E., & Monzani, F. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.4.8378 · Cited by 294 · see citing works
Hansen, P. S., Brix, T. H., Sørensen, T. I. A., Kyvik, K. O., & Hegedüs, L. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031641 · Cited by 257 · see citing works
Health Care–Associated Bloodstream Infections
Kaye, K. S., Friedman, N. D., & Sexton, D. J. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-3-200308050-00018 · Cited by 232 · see citing works
Al-Adsani, H. (1997) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.82.4.1118 · Cited by 193 · see citing works
The effect of body weight and weight loss on thyroid volume and function in obese women
Sarı, R., Balcı, M. K., Altunbaş, H., & Karayalçın, Ü. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01836.x · Cited by 190 · see citing works
Knudsen, N., Bülow, I., Jørgensen, T., Laurberg, P., Ovesen, L., & Perrild, H. (2000) · European Journal of Endocrinology · doi:10.1530/eje.0.1430485 · Cited by 181 · see citing works
Self-citationCirculating leptin and thyroid dysfunction
Zimmermann‐Belsing, T., Brabant, G. E., Holst, J. J., & Feldt‐Rasmussen, U. (2003) · European Journal of Endocrinology · doi:10.1530/eje.0.1490257 · Cited by 170 · see citing works
Knudsen, N. J., Bülow, I., Jørgensen, T., Laurberg, P., Ovesen, L., & Perrild, H. (2000) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2000.01121.x · Cited by 165 · see citing works
Self-citationThyroid hormones in the pathogenesis and treatment of obesity
Krotkiewski, M. (2002) · European Journal of Pharmacology · doi:10.1016/s0014-2999(02)01420-6 · Cited by 142 · see citing works
METABOLIC ASPECTS OF THE CALORIGENIC EFFECT OF THYROID HORMONE IN MAMMALS
Sestoft, L. (1980) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1980.tb03415.x · Cited by 141 · see citing works
Astrup, A. V., Buemann, B., Christensen, N. J., Madsen, J., Gluud, C. N., Bennett, P. H., & Svenstrup, B. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.74.2.1530952 · Cited by 115 · see citing works
Neuroregulation of adipose tissue: molecular and hormonal mechanisms.
Duntas, L., Hauner, H., Rosenthal, J. H., & Pfeiffer, E. F. (1991) · PubMed · Cited by 101 · see citing works
Lindeman, R. D., Romero, L. J., Schade, D. S., Wayne, S., Baumgartner, R. N., & Garry, P. J. (2003) · Thyroid · doi:10.1089/105072503322238863 · Cited by 100 · see citing works
Schwartz, M. W., & Niswender, K. D. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0906 · Cited by 93 · see citing works
Relationship of ovesity and disease in 73,532 weight-conscious women.
Rimm, A. A., Werner, L. H., Yserloo, B. V., & Bernstein, R. A. (1975) · PubMed Central · Cited by 74 · see citing works
Näslund, E. B., Andersson, I., Degerblad, M., Kogner, P., Kral, J. G., Rössner, S., & Hellström, P. M. (2000) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2000.00737.x · Cited by 71 · see citing works
Toni, R., Malaguti, A., Castorina, S., Roti, E., & Lechan, R. M. (2004) · Journal of Endocrinological Investigation · doi:10.1007/bf03346266 · Cited by 53 · see citing works
Pérez, A., Cubero, J. M., Sucunza, N., Ortega, E., Arcelús, R., Rodrı́guez-Espinosa, J., Ordóñez‐Llanos, J., & Blanco‐Vaca, F. (2004) · Metabolism · doi:10.1016/j.metabol.2004.05.016 · Cited by 52 · see citing works
2-Methoxyestradiol, an endogenous estrogen metabolite, induces thyroid cell apoptosis
Wang, S. (2000) · Molecular and Cellular Endocrinology · doi:10.1016/s0303-7207(00)00249-5 · Cited by 39 · see citing works
Buscemi, S., Verga, S., Maneri, R., Blunda, G., & Galluzzo, A. (1997) · Journal of Endocrinological Investigation · doi:10.1007/bf03350300 · Cited by 38 · see citing works
Boivin, M., Camirand, A., Carli, F., Hoffer, L. J., & Silva, J. E. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.5.6585 · Cited by 38 · see citing works
Some Hormonal Changes Before and After Vertical Banded Gastroplasty for Severe Obesity
Yashkov, Y. I., Vinnitsky, L. I., Poroykova, M. V., & Vorobyova, N. T. (2000) · Obesity Surgery · doi:10.1381/09608920060674111 · Cited by 28 · see citing works
Matzen, L. H., Kvetny, J., & PEDERSEN, K. K. (1989) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365518909089090 · Cited by 25 · see citing works
Thyroid and obesity: survey of some function tests in a large obese population.
Strata, A., Ugolotti, G., Contini, C., Magnati, G., Pugnoli, C., Tirelli, F., & Zuliani, U. (1978) · PubMed · Cited by 23 · see citing works
Papavramidis, T. S., Zisiadis, A., Karamouzis, M. N., Kessissoglou, I. I., Antoniadou, H., & Aidonopoulos, A. P. (1995) · Obesity Surgery · doi:10.1381/096089295765557674 · Cited by 12 · see citing works
Matzen, L. E., & Kvetny, J. (1989) · Metabolism · doi:10.1016/0026-0495(89)90216-3 · Cited by 12 · see citing works
Ireton-Jones, C. S. (1992) · Nutrition in Clinical Practice · doi:10.1177/088453369200700414 · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Thyroid Hormone Regulation of Metabolism
Mullur, R., Liu, Y.-Y., & Brent, G. A. (2014) · Physiological Reviews · doi:10.1152/physrev.00030.2013 · Cited by 2,421 · see citing works
“In healthy individuals, variations in serum TSH, even within the reference range, are associated with body weight and body weight change in both men and women (80, 143).”
BackgroundJonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber, K. A. (2012) · Endocrine Practice · doi:10.4158/ep12280.gl · Cited by 1,567 · see citing works
The Clinical Significance of Subclinical Thyroid Dysfunction
Biondi, B., & Cooper, D. S. (2008) · Endocrine Reviews · doi:10.1210/er.2006-0043 · Cited by 1,418 · see citing works
“The results of this study suggest that even slightly elevated serum TSH levels are important in determining body weight in the population (34).”
BackgroundGarber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber for the American Association, K. A. (2012) · Thyroid · doi:10.1089/thy.2012.0205 · Cited by 1,053 · see citing works
“Some observational studies correlate TSH levels with body mass index (243–245) while others do not (246).”
Cooper, D. S., & Biondi, B. (2012) · The Lancet · doi:10.1016/s0140-6736(11)60276-6 · Cited by 1,039 · see citing works
Obesity in autoimmune diseases: Not a passive bystander
Versini, M., Jeandel, P.-Y., Rosenthal, E., & Shoenfeld, Y. (2014) · Autoimmunity Reviews · doi:10.1016/j.autrev.2014.07.001 · Cited by 694 · see citing works
“Some authors initially postulated that thyroid dysfunction was responsible for obesity [347].”
BackgroundThyroid dysfunction and diabetes mellitus: two closely associated disorders
Biondi, B., Kahaly, G. J., & Robertson, R. P. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00163 · Cited by 598 · see citing works
Reinehr, T. (2009) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2009.06.005 · Cited by 500 · see citing works
Wiersinga, W. M. (2013) · Clinical Endocrinology · doi:10.1111/cen.12222 · Cited by 389 · see citing works
Effects of Thyroid Dysfunction on Lipid Profile
Rizos, C. V., Elisaf, M., & Liberopoulos, E. N. (2011) · The Open Cardiovascular Medicine Journal · doi:10.2174/1874192401105010076 · Cited by 403 · see citing works
“A positive association between TSH and body mass index (BMI) or waist circumference has also been described [22, 23].”
BackgroundHatch, E. E., Nelson, J. W., Qureshi, M. M., Weinberg, J., Moore, L. L., Singer, M., & Webster, T. F. (2008) · Environmental Health · doi:10.1186/1476-069x-7-27 · Cited by 436 · see citing works
“Proposed biologic mechanisms that could underlie an association between endocrine disruptors and obesity include alterations in thyroid and steroid hormone function [5,6], and activation of peroxisome proliferator-activated receptors (PPARs) [7] which play a major role in adipocyte differentiation and energy storage […”
BackgroundThyroid and Obesity: An Intriguing Relationship
Biondi, B. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1245 · Cited by 330 · see citing works
“Progressive fat accumulation was associated with a parallel increase in TSH and FT3 levels irrespective of insulin sensitivity and metabolic parameters (20), and a positive association has been reported between the FT3 to FT4 ratio and both waist circumference and BMI in obese patients (20).”
BackgroundInfluentialFox, C. S. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.6.587 · Cited by 303 · see citing works
The Danish investigation on iodine intake and thyroid disease, DanThyr: status and perspectives
Laurberg, P., Jørgensen, T., Perrild, H., Ovesen, L., Knudsen, N. J., Pedersen, I. B., Rasmussen, L. B., Carlé, A., & Vejbjerg, P. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02210 · Cited by 294 · see citing works
“Participants previously treated for thyroid dysfunction or with overt dysfunction when studied were excluded. Data from Knudsen et al. ( 32 ).”
BackgroundSelf-citationHypothyroidism and obesity: An intriguing link
Sanyal, D., & Raychaudhuri, M. (2016) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.183454 · Cited by 286 · see citing works
“Indian Journal of Endocrinology and Metabolism / Jul-Aug 2016 / Vol 20 | Issue 4 555 variations in serum TSH caused by minimal changes in L‐T4 dosage during replacement therapy are associated with significantly altered REE in hypothyroid patients.[3] However, there is a paucity of data regarding the actual extent of w…”
BackgroundA Review of the Clinical Consequences of Variation in Thyroid Function Within the Reference Range
Taylor, P. N., Razvi, S., Pearce, S. H., & Dayan, C. M. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1315 · Cited by 274 · see citing works
Pergola, G. D., Ciampolillo, A., Paolotti, S., Trerotoli, P., & GIORGINO, R. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.02874.x · Cited by 263 · see citing works
Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels
Leko, M. B., Gunjača, I., Pleić, N., & Zemunik, T. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22126521 · Cited by 276 · see citing works
“Most studies have not observed an association between fT4 and BMI [54,57,59,62,63], although there are studies that have reported negative [9,55,56,60,61,64,65] and even positive association between fT4 and BMI in the general population [66–68] (Table 1).”
BackgroundThe Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis
Song, R., Wang, B., Yao, Q., Li, Q., Jia, X., & Zhang, J. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.02349 · Cited by 258 · see citing works
Santini, F., Marzullo, P., Rotondi, M., Ceccarini, G., Pagano, L., Ippolito, S., Chiovato, L., & Biondi, B. (2014) · European Journal of Endocrinology · doi:10.1530/eje-14-0067 · Cited by 240 · see citing works
Hyperthyrotropinemia in Obese Children Is Reversible after Weight Loss and Is Not Related to Lipids
Reinehr, T., de Sousa, G., & Andler, W. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0095 · Cited by 235 · see citing works
“moderately elevated TSH levels in obese subjects (1, 2).”
BackgroundResultMarzullo, P., Minocci, A., Tagliaferri, A., Guzzaloni, G., Blasio, A. M. D., Medici, C. D., Aimaretti, G., & Liuzzi, A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2798 · Cited by 229 · see citing works
Association of endocrine disruptors and obesity: perspectives from epidemiological studies
Hatch, E. E., Nelson, J. W., Stahlhut, R. W., & Webster, T. F. (2010) · International Journal of Andrology · doi:10.1111/j.1365-2605.2009.01035.x · Cited by 230 · see citing works
High trait self-control predicts positive health behaviors and success in weight loss
Will Crescioni, A., Ehrlinger, J., Alquist, J. L., Conlon, K. E., Baumeister, R. F., Schatschneider, C., & Dutton, G. R. (2011) · Journal of Health Psychology · doi:10.1177/1359105310390247 · Cited by 225 · see citing works
“…of weight loss efforts is affected by multiple factors over which people have little control including individual differences in genetic predispositions (Yang et al., 2007), physiological factors (Knudsen et al., 2005; Turnbaugh et al., 2006), and socioeconomic status (Wang and Beydoun, 2007).”
BackgroundThyroid dysfunction in patients with diabetes: clinical implications and screening strategies
Kadiyala, R. U., Peter, R., & Okosieme, O. E. (2010) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2010.02376.x · Cited by 224 · see citing works
Laurberg, P., Knudsen, N. J., Andersen, S., Carlé, A., Pedersen, I. B., & Karmisholt, J. (2012) · European Thyroid Journal · doi:10.1159/000342994 · Cited by 221 · see citing works
Self-citationTseng, F.-Y., Lin, W.-Y., Lin, C.-C., Lee, L.-T., Li, T.-C., Sung, P.-K., & Huang, K.-C. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.03.047 · Cited by 212 · see citing works
“Our data revealed that subjects with SCH had higher BMI than euthyroid subjects.”
InfluentialAytürk, S., Gürsoy, A., Kut, A., Anıl, C., Nar, A., & Tütüncü, N. B. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0410 · Cited by 216 · see citing works
“Although previous studies evaluating thyroid functional changes in obese patients reported discrepant findings, the most consistently reported finding is that the serum levels of TSH are higher in obese patients than in healthy controls (3-7).”
BackgroundResultRotondi, M., Leporati, P., La Manna, A., Pirali, B., Mondello, T., Fonte, R., Magri, F., & Chiovato, L. (2009) · European Journal of Endocrinology · doi:10.1530/eje-08-0734 · Cited by 214 · see citing works
A high normal TSH is associated with the metabolic syndrome
Ruhla, S., Weickert, M. O., Arafat, A. M., Osterhoff, M. A., Isken, F., Spranger, J., Schöfl, C., Pfeiffer, A. F. H., & Möhlig, M. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03698.x · Cited by 225 · see citing works
Is there a need to redefine the upper normal limit of TSH?
Brabant, G., Beck-Peccoz, P., Jarzab, B., Laurberg, P., Orgiazzi, J., Szabolcs, I., Weetman, A. P., & Wiersinga, W. M. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02136 · Cited by 211 · see citing works
“Genetic influences play a role in the hypothalamo – pituitary setpoint and these alterations in physiological TSH levels may translate into subtle changes in energy homeostasis reflected in body mass index ( 14 ).”
BackgroundSelf-citationNannipieri, M., Cecchetti, F., Anselmino, M., Camastra, S., Niccolini, P., Lamacchia, M., Rossi, M., Iervasi, G., & Ferrannini, E. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.140 · Cited by 194 · see citing works
Nonradiation Risk Factors for Thyroid Cancer in the US Radiologic Technologists Study
Meinhold, C. L., Ron, E., Schonfeld, S. J., Alexander, B. H., Freedman, D. M., Linet, M. S., & de González, A. B. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp354 · Cited by 192 · see citing works
Thyroid Hormones and Their Relation to Weight Status
Reinehr, T., Isa, A., de Sousa, G., Dieffenbach, R., & Andler, W. (2008) · Hormone Research in Paediatrics · doi:10.1159/000129678 · Cited by 185 · see citing works
Walczak, K., & Siemińśka, L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189434 · Cited by 182 · see citing works
van der Ven, L. T. M., van de Kuil, T., Verhoef, A. J., Verwer, C. M., Lilienthal, H., Leonards, P. E. G., Schauer, U. M. D., Cantón, R. F., Litens, S., de Jong, F. H., et al. (2007) · Toxicology · doi:10.1016/j.tox.2007.12.009 · Cited by 179 · see citing works
IQBAL, A., JORDE, R., & FIGENSCHAU, Y. (2006) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2006.01652.x · Cited by 174 · see citing works
Phthalate exposure and childhood obesity
Kim, S. H., & Park, M. J. (2014) · Annals of Pediatric Endocrinology & Metabolism · doi:10.6065/apem.2014.19.2.69 · Cited by 169 · see citing works
Obesity and diabetes: from genetics to epigenetics
Burgio, E., Lopomo, A., & Migliore, L. (2014) · Molecular Biology Reports · doi:10.1007/s11033-014-3751-z · Cited by 168 · see citing works
Lack of association between serum TSH or free T4 and body mass index in euthyroid subjects
Manji, N., Boelaert, K., Sheppard, M. C., Holder, R. L., Gough, S. C. L., & Franklyn, J. A. (2006) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2006.02433.x · Cited by 167 · see citing works
Duntas, L. H., & Biondi, B. (2012) · Thyroid · doi:10.1089/thy.2011.0499 · Cited by 162 · see citing works
“In a cross-sectional study (the Dan Thyr Study) that included 4082 subjects, FT4 levels were negatively associated with BMI, whereas serum TSH levels were positively, and independently of hypothyroidism, associated with BMI (70).”
Subclinical hypothyroidism, lipid metabolism and cardiovascular disease
Delitala, A., Fanciulli, G., Maioli, M., & Delitala, G. (2016) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2016.12.015 · Cited by 165 · see citing works
Fernández‐Real, J. M., López‐Bermejo, A., Castro, A., Casamitjana, R., & Ricart, W. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0841 · Cited by 162 · see citing works
The relationship between serum thyrotropin and components of metabolic syndrome
Lai, Y., Wang, J., Jiang, F., Wang, B., Chen, Y., Li, M., Liu, H., Li, C., Xue, H., Li, N., et al. (2010) · Endocrine Journal · doi:10.1507/endocrj.k10e-272 · Cited by 157 · see citing works
“Recent studies showed that subclinical thyroid dysfunction [13], even TSH within normal range [14] may be related to metabolic syndrome and its components.”
BackgroundResultBody Fatness and Markers of Thyroid Function among U.S. Men and Women
Kitahara, C. M., Platz, E. A., Ladenson, P. W., Mondul, A. M., Menke, A., & de González, A. B. (2012) · PLoS ONE · doi:10.1371/journal.pone.0034979 · Cited by 150 · see citing works
“Several cross-sectional studies have shown associations of body fat with higher serum TSH [9–16] and T3 [17] and lower T4 [15,16,18,19] among euthyroid individuals, though there have been some inconsistencies [12–14,17–20].”
BackgroundAssociation of Serum TSH with High Body Mass Differs between Smokers and Never-Smokers
Åsvold, B. O., Bjøro, T., & Vatten, L. J. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1180 · Cited by 149 · see citing works
Influence of obesity and surgical weight loss on thyroid hormone levels
Chikunguwo, S. M., Brethauer, S. A., Nirujogi, V., Pitt, T., Udomsawaengsup, S., Chand, B., & Schauer, P. R. (2007) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2007.07.011 · Cited by 150 · see citing works
“Recent findings egarding the pathophysiologic association between obesity nd thyroid hormones have renewed research interest in this rea [1–4].”
BackgroundInferring relevant cell types for complex traits by using single-cell gene expression
Calderon, D., Bhaskar, A., Knowles, D. A., Golan, D., Raj, T., Fu, A. Q., & Pritchard, J. K. (2017) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2017.09.009 · Cited by 127 · see citing works
Homeostatic control of the thyroid-pituitary axis: perspectives for diagnosis and treatment
Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2015) · Frontiers in Endocrinology · doi:10.3389/fendo.2015.00177 · Cited by 143 · see citing works
Johnson, P. I., Koustas, E., Vesterinen, H., Sutton, P. M., Atchley, D. S., Kim, A., Campbell, M. A., Donald, J. M., Sen, Ś., Bero, L., et al. (2016) · Environment International · doi:10.1016/j.envint.2016.03.009 · Cited by 130 · see citing works
“…are associated with triclosan exposure and with thyroid hormone concentrations (Calafat et al., 2008; Chen et al., 2013; Lankester et al., 2013; Knudsen et al., 2005; Hollowell et al., n.d.), we assigned studies “low risk” of bias under the confounding domain if they accounted for potential…”
BackgroundThyroid Function in Human Obesity: Underlying Mechanisms
Fontenelle, L. F., Feitosa, M. F., Severo, J. S., Freitas, T., Morais, J. B. S., Torres‐Leal, F. L., Henriques, G. S., & Marreiro, D. D. N. (2016) · Hormone and Metabolic Research · doi:10.1055/s-0042-121421 · Cited by 138 · see citing works
Wang, H., Zhou, Y., Tang, C., Wu, J., Chen, Y., & Jiang, Q. (2012) · Environmental Health · doi:10.1186/1476-069x-11-79 · Cited by 138 · see citing works
“A large cross-sectional study from Denmark found that thyroid function,was associated with BMI [45].”
BackgroundEffects of serum TSH and FT4 levels and the TSHR‐Asp727Glu polymorphism on bone: the Rotterdam Study
van der Deure, W. M., Uitterlinden, A. G., Albert Hofman, D., Rivadeneira, F., Pols, H. A. P., Peeters, R. P., & Visser, T. J. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.03016.x · Cited by 132 · see citing works
Plowden, T. C., Schisterman, E. F., Sjaarda, L. A., Zarek, S. M., Perkins, N. J., Silver, R. M., Galai, N., DeCherney, A. H., & Mumford, S. L. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-1049 · Cited by 128 · see citing works
Thyrotropin Levels and Risk of Fatal Coronary Heart Disease: The HUNT Study
Åsvold, B. O., Bjøro, T., Nilsen, T. I. L., Gunnell, D., & Vatten, L. J. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.8.855 · Cited by 125 · see citing works
Association between serum TSH concentration within the normal range and adiposity
Souza, A. D. M., & Sichieri, R. (2011) · European Journal of Endocrinology · doi:10.1530/eje-11-0261 · Cited by 125 · see citing works
Thyroid function in the nutritionally obese child and adolescent
Reinehr, T. (2011) · Current Opinion in Pediatrics · doi:10.1097/mop.0b013e328344c393 · Cited by 127 · see citing works
Gu, Y., Li, H., Bao, X., Zhang, Q., Liu, L., Meng, G., Wu, H., Du, H., Shi, H., Xia, Y., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2965 · Cited by 122 · see citing works
“Because studies have shown that serum TH and TSH levels are related to age (20) and BMI (21),”
BackgroundInfluentialSamuels, M. H., Schuff, K. G., Carlson, N. E., Carello, P., & Janowsky, J. S. (2007) · Thyroid · doi:10.1089/thy.2006.0252 · Cited by 124 · see citing works
Mazziotti, G., Porcelli, T., Patelli, I., Vescovi, P. P., & Giustina, A. (2010) · Bone · doi:10.1016/j.bone.2009.10.031 · Cited by 113 · see citing works
“Epidemiological studies suggested the existence of a positive correlation between serum TSH and BMI, with lower TSH values occurring in subjects with low body weight [25].”
BackgroundThyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women
Park, H. T., Cho, G. J., Ahn, K. H., Shin, J., Hong, S., Kim, T., Hur, J. Y., Kim, Y. T., Lee, K. W., & Kim, S. H. (2009) · Maturitas · doi:10.1016/j.maturitas.2009.01.007 · Cited by 121 · see citing works
Subclinical thyroid dysfunction and blood pressure: a community‐based study
Walsh, J. P., Bremner, A. P., Bulsara, M. K., O’Leary, P., Leedman, P. J., Feddema, P., & Michelangeli, V. (2006) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2006.02619.x · Cited by 117 · see citing works
Thyroid and Obesity: Not a One-Way Interaction
Rotondi, M., Magri, F., & Chiovato, L. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2515 · Cited by 117 · see citing works
“These data suggested that thyroid function (even within the normal range) could be one of several factors contributing to determining body weight in the general population (5).”
BackgroundInfluentialKim, H. J., Kim, N. K., Choi, J. H., Sohn, S. Y., Kim, S. W., Jin, S., Jang, H. W., Suh, S., Min, Y., Chung, J. H., et al. (2012) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2012.04506.x · Cited by 116 · see citing works
Svare, A., Nilsen, T. I. L., Bjøro, T., Åsvold, B. O., & Langhammer, A. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04009.x · Cited by 113 · see citing works
Roef, G. L., Lapauw, B., Goemaere, S., Zmierczak, H., Toye, K. R. C., Kaufman, J., & Taes, Y. (2012) · European Journal of Endocrinology · doi:10.1530/eje-12-0447 · Cited by 111 · see citing works
Longhi, S., & Radetti, G. (2012) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.856 · Cited by 112 · see citing works
“Moreover, it has also been reported that there is an inverse correlation between free thyroxine (fT4) values and body mass index (BMI), even when fT4 values remain in the normal range (15).”
BackgroundRatziu, V., Scanlan, T. S., & Bruinstroop, E. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.10.018 · Cited by 117 · see citing works
Kim, B., Kim, T. Y., Koh, J., Kim, H. K., Park, J., Lee, K., Shong, Y. K., & Kim, W. B. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03304.x · Cited by 111 · see citing works
Park, Y. J., Lee, E., Lee, Y. J., Choi, S. H., Park, J. H., Lee, S. B., Lim, S. K., Lee, W., Jang, H. C., Cho, B. Y., et al. (2009) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2009.05.015 · Cited by 110 · see citing works
Peeters, R. P., van der Deure, W. M., & Visser, T. J. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02279 · Cited by 107 · see citing works
Subclinical Hypothyroidism in Patients with Obesity and Metabolic Syndrome: A Narrative Review
Biondi, B. (2023) · Nutrients · doi:10.3390/nu16010087 · Cited by 122 · see citing works
“Numerous investigations have demonstrated a negative correlation between FT4 and BMI and a positive relationship between TSH and BMI [25–28 , 31– 34 ].”
BackgroundIttermann, T., Haring, R., Wallaschofski, H., Baumeister, S. E., Nauck, M. A., Dörr, M., Lerch, M. M., zu Schwabedissen, H. E. M., Rosskopf, D., & Völzke, H. (2012) · Thyroid · doi:10.1089/thy.2011.0279 · Cited by 107 · see citing works
“This seems to be biologically plausible, as overt hypothyroidism is associated with visceral obesity (13,14), metabolic syndrome (15), insulin resistance (16), and lipid peroxidation (17), all of which are closely related to hepatic steatosis.”
Subclinical hypothyroidism: a historical view and shifting prevalence
Hennessey, J. V., & Espaillat, R. (2015) · International Journal of Clinical Practice · doi:10.1111/ijcp.12619 · Cited by 109 · see citing works
Xu, C., Xu, L., Yu, C., Miao, M., & Li, Y. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04016.x · Cited by 106 · see citing works
Marcello, M. A., Cunha, L. L., Batista, F. D. A., & Ward, L. S. (2014) · Endocrine Related Cancer · doi:10.1530/erc-14-0070 · Cited by 106 · see citing works
“A negative association between BMI and serum free thyroxine (T4) levels was reported (Knudsen et al. 2005), with lower T4 levels being associated with fat accumulation (Knudsen et al. 2005, Alevizaki et al. 2009).”
BackgroundWen, L., Lin, L., Su, T., Chen, P., & Lin, C. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1282 · Cited by 103 · see citing works
“Hypoand hyperthyroidism can affect blood pressure (25, 26) and thyroid function may influence body mass index and glucose homeostasis (27).”
BackgroundKarmisholt, J., Andersen, S., & Laurberg, P. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1521 · Cited by 103 · see citing works
Self-citationThyroid hormone regulation by stress and behavioral differences in adult male rats
Helmreich, D. L., & Tylee, D. S. (2011) · Hormones and Behavior · doi:10.1016/j.yhbeh.2011.06.003 · Cited by 103 · see citing works
“Furthermore, recent evidence also suggests that relativelymildhypothyroidism, suchas that observed in the current experiments, may have significant effects on an individual (Joffe and Sokolov, 1994; Sait Gonen et al., 2004; Knudsen et al., 2005; Gulseren et al., 2006; Davis and Tremont, 2007).”
Current paradigms in the etiology of obesity
Kadouh, H. C., & Acosta, A. J. (2016) · Techniques in Gastrointestinal Endoscopy · doi:10.1016/j.tgie.2016.12.001 · Cited by 100 · see citing works
Thyroid function in childhood obesity and metabolic comorbidity
Pacifico, L., Anania, C., Ferraro, F., Andreoli, G. M., & Chiesa, C. (2011) · Clinica Chimica Acta · doi:10.1016/j.cca.2011.11.013 · Cited by 99 · see citing works
“Based on the notion that triiodothyronine (T3) controls metabolic and energy homeostasis and influences body weight, thermogenesis, lipolysis, and metabolism of cholesterol [3], and that thyroid-stimulating hormone (TSH), via its receptors in fat tissue, induces differentiation of preadipocytes into adipocytes and exp…”
BackgroundReference intervals in the diagnosis of thyroid dysfunction: treating patients not numbers
Jonklaas, J., & Razvi, S. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(18)30371-1 · Cited by 100 · see citing works
MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome
Gaberšček, S., Zaletel, K., Theiler‐Schwetz, V., Pieber, T. R., Obermayer-Pietsch, B. M., & Lerchbaum, E. (2014) · European Journal of Endocrinology · doi:10.1530/eje-14-0295 · Cited by 101 · see citing works
Ying, H., Tang, Y., Bao, Y., Su, X., Cai, X., Li, Y., & Wang, D. (2016) · Endocrine · doi:10.1007/s12020-016-1022-6 · Cited by 97 · see citing works
“Thirdly, TSH level is associated with BMI, even within the normal population reference range [35, 36].”
BackgroundVillagelin, D., Romaldini, J. H., dos Santos, R. B., Milkos, A. B. B. P., & Ward, L. S. (2015) · Thyroid · doi:10.1089/thy.2015.0195 · Cited by 98 · see citing works
Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals
Alevizaki, M. K., Saltiki, K., Voidonikola, P. T., Mantzou, A., Papamichael, C. M., & Stamatelopoulos, K. S. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0441 · Cited by 95 · see citing works
Agnihothri, R. V., Courville, A. B., Linderman, J. D., Smith, S., Brychta, R., Remaley, A., Chen, K. Y., Simchowitz, L., & Celi, F. S. (2014) · Thyroid · doi:10.1089/thy.2013.0055 · Cited by 94 · see citing works
“Our cross-sectional data support this hypothesis, since T3 and TSH correlate positively with adiposity (32–34), but it is worth noting that these findings have not been consistently replicated (35).”
BackgroundResultHigh‐normal tsh values in obesity: Is it insulin resistance or adipose tissue's guilt?
Muscogiuri, G., Sorice, G. P., Mezza, T., Prioletta, A., Lassandro, A. P., Pirronti, T., Casa, S. D., Pontecorvi, A., & Giaccari, A. (2013) · Obesity · doi:10.1002/oby.20240 · Cited by 93 · see citing works
“In agreement with earlier studies (2,3), our data showed a significant”
ResultMakepeace, A., Bremner, A., O'Leary, P. C., Leedman, P. J., Feddema, P., Michelangeli, V. P., & Walsh, J. P. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03239.x · Cited by 90 · see citing works
Grün, F. (2010) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e32833ddea0 · Cited by 91 · see citing works
Vejbjerg, P., Knudsen, N. J., Perrild, H., Laurberg, P., Pedersen, I. B., Rasmussen, L. B., Ovesen, L., & Jørgensen, T. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02255 · Cited by 89 · see citing works
“Subclinical thyroid dysfunction may also be harmful in itself, for example, persons with subclinical thyroid dysfunction may have a higher risk of developing cardiac disease (18, 19) and have been found to have a higher mean body mass index and a higher occurrence of obesity ( 20 ) .I n addition to hypoechogenicity, w…”
BackgroundSelf-citationLower Free Thyroxin Associates with a Less Favorable Metabolic Phenotype in Healthy Pregnant Women
Bassols, J., Prats‐Puig, A., Soriano‐Rodríguez, P., García-González, M. M., Reid, J., Martínez-Pascual, M., Mateos-Comerón, F., de Zegher, F., Ibáñez, L., & López‐Bermejo, A. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1784 · Cited by 89 · see citing works
Varshavsky, J., Morello-Frosch, R. A., Woodruff, T. J., & Zota, A. R. (2018) · Environment International · doi:10.1016/j.envint.2018.02.029 · Cited by 90 · see citing works
Samuels, M. H., Kolobova, I., Smeraglio, A., Peters, D., Purnell, J. Q., & Schuff, K. G. (2016) · Thyroid · doi:10.1089/thy.2015.0345 · Cited by 87 · see citing works
Tosovic, A., Bondeson, A., Bondeson, L., Ericsson, U., Malm, J., & Manjer, J. (2010) · Breast Cancer Research · doi:10.1186/bcr2587 · Cited by 85 · see citing works
“Furthermore, both thyroid conditions and breast cancer have been associated with BMI [21,22].”
InfluentialFlock, M. R., Green, M. H., & Kris-Etherton, P. M. (2011) · Advances in Nutrition · doi:10.3945/an.111.000422 · Cited by 82 · see citing works
Fitzgerald, S. P., Bean, N. G., Falhammar, H., & Tuke, J. (2020) · Thyroid® · doi:10.1089/thy.2019.0535 · Cited by 86 · see citing works
“, obesity having associations with high thyroid function), or associations of thyroid hormones in the same direction as associations with TSH, as indicators of reverse causation (Supplementary Table S1) (19).”
BackgroundResultInfluentialLiu, G., Liang, L., Bray, G. A., Qi, L., Hu, F. B., Rood, J., Sacks, F. M., & Sun, Q. (2017) · International Journal of Obesity · doi:10.1038/ijo.2017.28 · Cited by 85 · see citing works
Hoermann, R., Midgley, J. E. M., Giacobino, A., Eckl, W. A., Wahl, H. G., Dietrich, J. W., & Larisch, R. (2014) · Clinical Endocrinology · doi:10.1111/cen.12527 · Cited by 82 · see citing works
- Authors
- Knudsen, N., Laurberg, P., Rasmussen, L. B., Bülow, I., Perrild, H., Ovesen, L., & Jørgensen, T.
- Affiliations
- Bispebjerg Hospital (DK)
- Aalborg University Hospital (DK)
- Corresponding author
- Knudsen, Nils
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-07
- Volume
- 90
- Issue
- 7
- Pages
- 4019-4024
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2133682334
- Semantic Scholar
- 20e3a19b8599c2b8587d25dfab6ed083b7ff3e0f
- Cited by
- 753
- References
- 39
- Citations by year
- 2026: 15 · 2025: 28 · 2024: 35 · 2023: 33 · 2022: 41 · 2021: 38 · 2020: 50 · 2019: 49 · 2018: 38 · 2017: 43 · 2016: 46 · 2015: 47 · 2014: 56 · 2013: 47 · 2012: 41
- FWCI
- 10.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Technical University of Denmark, DTU Orbit (Technical University of Denmark, DTU) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- thyroid function, body mass index, obesity, serum TSH, free thyroxine, free triiodothyronine, weight gain, subclinical thyroid dysfunction, healthy population
- MeSH terms
- Adolescent, Adult, Aged, Cross-Sectional Studies, Humans, Middle Aged, Obesity, Thyroid Hormones, Thyrotropin, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
