TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects
Abstract
Objective: To examine the association between thyroid function and the components of the metabolic syndrome and insulin resistance in an Hispanic population. Design: Cross-sectional study. Methods: Subjects with no history of thyroid disease or diabetes were included. Thyroid function was stratified as euthyroid or subclinical hypothyroidism (SCH) status and subsequently by free thyroxine (FT 4) and TSH tertiles. The association of the metabolic syndrome components (defined by 2004 Adult Treatment Panel III criteria) and insulin resistance with thyroid status, TSH, and FT 4 were examined. Results: A total of 3148 subjects were analyzed. The prevalence of SCH was 8.3%. The prevalence of the metabolic syndrome was similar in euthyroid and SCH patients (31.6 vs 32.06%, P=0.89). Total cholesterol was higher in patients with SCH (5.51±1.19 vs 5.34±1.05 mmol/l, P<0.032). Serum TSH values showed a positive correlation (adjusted for age and sex) with total cholesterol, triglycerides, and waist circumference. In contrast, FT 4 showed a positive correlation with high-density lipoprotein cholesterol, and an inverse correlation with waist circumference, insulin, and HOMA-IR. Conclusion: SCH is not associated with an increased risk for the metabolic syndrome (as conceived as a diagnostic category defined by the National Cholesterol, Education Program, Adult Treatment Panel III criteria). Despite this, low thyroid function (even in the euthyroid state) predisposes to higher cholesterol, glucose, insulin, and HOMA-IR levels. The combined use of TSH and FT 4, compared with the assessment based on only FT 4, is a more convenient approach to evaluate the association between thyroid function and metabolic variables.
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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 [6]
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- Authors
- Garduño-Garcia, J. D. J., Alvirde-Garcia, U., López-Carrasco, G., Padilla Mendoza, M. E., Mehta, R., Arellano-Campos, O., Choza, R., Sauque, L., Garay-Sevilla, M. E., Malacara, J. M., Gomez-Perez, F. J., & Aguilar-Salinas, C. A.
- Affiliations
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX)
- Universidad de Guanajuato (MX)
- Corresponding author
- Aguilar-Salinas, Carlos A
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-08
- Volume
- 163
- Issue
- 2
- Pages
- 273-278
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2113371850
- Cited by
- 268
- References
- 23
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 8 · 2023: 13 · 2022: 17 · 2021: 25 · 2020: 15 · 2019: 22 · 2018: 14 · 2017: 21 · 2016: 22 · 2015: 29 · 2014: 24 · 2013: 18 · 2012: 12
- FWCI
- 9.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- 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 › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- subclinical hypothyroidism, thyroid-stimulating hormone, free thyroxine, metabolic syndrome, insulin resistance, HOMA-IR, cholesterol, triglycerides, waist circumference, Hispanic population, euthyroid subjects
- MeSH terms
- Blood Glucose, Cross-Sectional Studies, Female, Hispanic or Latino, Humans, Hypothyroidism, Insulin, Insulin Resistance, Cholesterol, HDL, Male, Mexico, Risk Factors, Severity of Illness Index, Thyroid Function Tests, Thyroid Gland, Thyrotropin, Thyroxine, Triiodothyronine, Biomarkers, Prevalence, Statistics, Nonparametric, Metabolic Syndrome, Waist Circumference
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