J Korean Med Sci.  2011 Apr;26(4):540-545. 10.3346/jkms.2011.26.4.540.

The Relation of Thyroid Function to Components of the Metabolic Syndrome in Korean Men and Women

• Park SB
• Choi HC
• Joo NS

• KMID: 1777885
• DOI: http://doi.org/10.3346/jkms.2011.26.4.540

Abstract

This study was to assess the relation of thyroid dysfunction to metabolic syndrome (MetS) at an earlier stage in Korean population. Metabolic parameters such as body composition, blood pressure (BP), fasting glucose, total cholesterol, triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), thyroid-stimulating hormone (TSH) and free thyroxine 4 (fT4) were measured. During a mean follow-up of 3 yr, 5,998 Koreans ages over 18 yr were assessed. There were 694 cases of MetS at follow-up. The mean age of the subjects was 45.6 +/- 9.5 yr. Mean level of TSH was 2.02 +/- 1.50 mIU/L, mean level of fT4 was 1.23 +/- 0.20 rhoM/L. At baseline, TSH levels and fT4 levels were associated to waist circumference, BP, glucose and lipids in the subjects. Increase in systolic blood pressure, diastolic blood pressure (DBP), total cholesterol and TG were significantly associated with changes in TSH levels after adjustment. Changes in DBP, TG, HDL-C and fasting glucose were significantly associated with changes in fT4 levels after adjustment. Increase in TSH levels even after further controlling for baseline TSH level predicted the MetS over the study period. In conclusion, there is a relationship between thyroid function and cardiovascular risk factors, such as BP, total cholesterol, TG, HDL-C and fasting glucose. Also, higher levels of TSH may predict the MetS in Korean.

Keyword

Thyroid Function; Cardiovascular Risk Factors; Metabolic Syndrome; Insulin Resistance

MeSH Terms

Adult
Asian Continental Ancestry Group
Blood Glucose/analysis
Blood Pressure
Cholesterol, HDL/blood
Cholesterol, LDL/blood
Female
Follow-Up Studies
Humans
Logistic Models
Male
Metabolic Syndrome X/*physiopathology
Middle Aged
Predictive Value of Tests
Republic of Korea
Risk Factors
Thyroid Gland/*physiopathology
Thyrotropin/blood
Thyroxine/blood
Triglycerides/blood
Waist Circumference

Reference

1. Chrousos GP. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuro-endocrine and target tissue-related causes. Int J Obes Relat Metab Disord. 2000. 24:Suppl 2. S50–S55.

2. Tsigos C, Chrousos GP. Differential diagnosis and management of Cushing's syndrome. Annu Rev Med. 1996. 47:443–461.

3. Friedman TC, Mastorakos G, Newman TD, Mullen NM, Horton EG, Costello R, Papadopoulos NM, Chrousos GP. Carbohydrate and lipid metabolism in endogenous hypercortisolism: shared features with metabolic syndrome X and NIDDM. Endocr J. 1996. 43:645–655.

4. Chrousos GP. The hypothalamic - pituitary - adrenal axis and immune-mediated inflammation. N Engl J Med. 1995. 332:1351–1362.

5. Chrousos GP, Detera-Wadleigh S, Karl M. Syndromes of glucocorticoid resistance. Ann Intern Med. 1993. 119:1113–1124.

6. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab. 2003. 88:2438–2444.

7. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med. 2000. 132:270–278.

8. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001. 344:501–509.

9. Duntas LH. Thyroid disease and lipids. Thyroid. 2002. 12:287–293.

10. Fommei E, Iervasi G. The role of thyroid hormone in blood pressure homeostasis: evidence from short-term hypothyroidism in humans. J Clin Endocrinol Metab. 2002. 87:1996–2000.

11. Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004. 24:1–13.

12. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000. 160:526–534.

13. Bakker SJ, ter Maaten JC, Popp-Snijders C, Slaets JP, Heine RJ, Gans RO. The relationship between thyrotropin and low density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab. 2001. 86:1206–1211.

14. Chubb SA, Davis WA, Davis TM. Interactions among thyroid function, insulin sensitivity, and serum lipid concentrations: the Fremantle diabetes study. J Clin Endocrinol Metab. 2005. 90:5317–5320.

15. Roos A, Bakker SJ, Links TP, Gans RO, Wolffenbuttel BH. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab. 2007. 92:491–496.

16. National Institutes of Health. Clinical Guidelines on the Identification, evaluation, and treatment of overweight and obesity in adults - the evidence report. National Institutes of Health. Obes Res. 1998. 6:Suppl 2. 51S–209S.

17. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract. 2007. 75:72–80.

18. Park HT, Cho GJ, Ahn KH, Shin JH, Hong SC, Kim T, Hur JY, Kim YT, Lee KW, Kim SH. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas. 2009. 62:301–305.

19. Jameson JL. DeGroot LJ, Jameson JL, editors. Mechanisms of thyroid hormone action. Endocrinology. 2001. Vol 2:4th ed. Philadelphia: WB Saunders;1327–1344.

20. Tulloch BR, Lewis B, Fraser TR. Triglyceride metabolism in thyroid disease. Lancet. 1973. 1:391–394.

21. Ito M, Takamatsu J, Matsuo T, Kameoka K, Kubota S, Fukata S, Tamai H, Miyauchi A, Kuma K, Hanafusa T. Serum concentrations of remnant-like particles in hypothyroid patients before and after thyroxine replacement. Clin Endocrinol (Oxf). 2003. 58:621–626.

22. Moore R, Mehrishi JN, Howard AN, Mills IH. Lymphocyte thyroid hormone receptors in obesity. Int J Obes. 1982. 6:541–548.

23. Burman KD, Latham KR, Djuh YY, Smallridge RC, Tseng YC, Lukes YG, Maunder R, Wartofsky L. Solubilized nuclear thyroid hormone receptors in circulating human mononuclear cells. J Clin Endocrinol Metab. 1980. 51:106–116.

24. Biondi B. Cardiovascular effects of mild hypothyroidism. Thyroid. 2007. 17:625–630.

25. Rosenbaum M, Hirsch J, Murphy E, Leibel RL. Effects of changes in body weight on carbohydrate metabolism, catecholamine excretion, and thyroid function. Am J Clin Nutr. 2000. 71:1421–1432.

26. Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part II: causal mechanisms and treatment. Circulation. 2002. 105:1503–1508.

27. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation. 2006. 113:657–663.

28. Liu YY, Schultz JJ, Brent GA. A thyroid hormone receptor alpha gene mutation (P398H) is associated with visceral adiposity and impaired catecholamine-stimulated lipolysis in mice. J Biol Chem. 2003. 278:38913–38920.

29. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, Grimley Evans J, Rodgers H, Tunbridge F, Young ET. The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community. Thyroid. 1996. 6:155–160.

30. Cappola AR, Fried LP, Arnold AM, Danese MD, Kuller LH, Burke GL, Tracy RP, Ladenson PW. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006. 295:1033–1041.