Korean J Fam Pract. 2018; 8(5): 764-770  https://doi.org/10.21215/kjfp.2018.8.5.764
A Cross-Sectional Study of the Association between Thyroid Hormones and Thyroid-Stimulating Hormone with Parameters of the Metabolic Syndrome in Korean Men and Women
Hye Jin Oh, Mun Hee Kim, Yu Ri Kwon, Hye Won Kim, Moon Jong Kim*, Young Sang Kim
Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
Moon Jong Kim
Tel: +82-31-780-5360, Fax: +82-31-780-5944
E-mail: mjkimfm@cha.ac.kr
ORCID: http://orcid.org/0000-0002-7961-4616
Received: July 27, 2017; Revised: September 20, 2017; Accepted: October 13, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The relationship between subclinical hypothyroidism and metabolic syndrome (MetS) is not clear. This study aimed to investigate the association between thyroid hormones and thyroid stimulating hormone with parameters of MetS in euthyroid and subclinical hypothyroid Korean individuals.
Methods: This cross-sectional study included 139 men and 127 women who participated in the medical examination program. Using multiple linear regression analysis, we evaluated the associations between thyroid hormones and thyroid stimulating hormone (TSH) with the parameters of MetS, respectively in men and women.
Results: Even after adjustment for age, body mass index, smoking, drinking, and exercise, we found no significant association between TSH and all parameters of MetS in both sexes. However, the association between not only free thyroxine (FT4) and total cholesterol but also free triiodothyronine (FT3) and diastolic BP in men was unaffected by adjustments made to age, body mass index, and lifestyle factors. In contrast, the FT4 level in women was not associated with MetS parameter while FT3 level was negatively associated with high-density lipoprotein (HDL)-cholesterol in women.
Conclusion: FT4 showed significant positive correlation with total cholesterol in men, and FT3 presented significant negative correlation with HDL-cholesterol in women. The findings suggest that when FT4 and FT3 levels are abnormal, it may be beneficial to check MetS parameters in Korean individuals.
Keywords: Metabolic Syndrome; Thyroid Hormones; Thyroid Stimulating Hormone; Total Cholesterol; High-Density Lipoprotein Cholesterol
References
  1. Leroith D. Pathophysiology of the metabolic syndrome: implications for the cardiometabolic risks associated with type 2 diabetes. Am J Med Sci 2012;343: 13-6.
    Pubmed CrossRef
  2. Yang JJ, Yoon HS, Lee SA, Choi JY, Song M, Han S, et al. Metabolic syndrome and sex-specific socio-economic disparities in childhood and adulthood:the Korea national health and nutrition examination surveys. Diabet Med 2014; 31: 1399-409.
    Pubmed CrossRef
  3. Gallagher EJ, Leroith D, Karnieli E. Insulin resistance in obesity as the underlying cause for the metabolic syndrome. Mt Sinai J Med 2010; 77: 51123.
    Pubmed CrossRef
  4. Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism. Int J Obes Relat Metab Disord 2000; 24 Suppl 2: S109-12.
    Pubmed CrossRef
  5. Klieverik LP, Janssen SF, van Riel A, Foppen E, Bisschop PH, Serlie MJ, et al. Thyroid hormone modulates glucose production via a sympathetic pathway from the hypothalamic paraventricular nucleus to the liver. Proc Natl Acad Sci U S A 2009; 106: 5966-71.
    Pubmed KoreaMed CrossRef
  6. Peppa M, Betsi G, Dimitriadis G. Lipid abnormalities and cardiometabolic risk in patients with overt and subclinical thyroid disease. J Lipids 2011;2011: 575840.
    Pubmed KoreaMed CrossRef
  7. Lai Y, Wang J, Jiang F, Wang B, Chen Y, Li M, et al. The relationship between serum thyrotropin and components of metabolic syndrome. Endocr J 2011;58: 23-30.
    Pubmed CrossRef
  8. Liu C, Scherbaum WA, Schott M, Schinner S. Subclinical hypothyroidism and the prevalence of the metabolic syndrome. Horm Metab Res 2011; 43:417-21.
    Pubmed CrossRef
  9. Rotondi M, Magri F, Chiovato L. Risk of coronary heart disease and mortality for adults with subclinical hypothyroidism. JAMA 2010; 304: 2481; author reply 2482.
    Pubmed CrossRef
  10. Cho B, Lee H, Go C, Kim S, Park H, Kim W, et al. A study on the urinary iodine excretion in normal subjects and patients with thyroid disease. J Korean Soc Endocrinol 1995; 10: 386-94.
  11. Oh MK, Cheon KS, Jung SM, Ryu DS, Park MS, Cheong SS, et al. Prevalence of thyroid diseases among adult for health check-up in a Youngdong area of Kwangwon province. J Korean Acad Fam Med 2001; 22: 1363-74.
  12. Strich D, Karavani G, Edri S, Gillis D. TSH enhancement of FT4 to FT3 conversion is age dependent. Eur J Endocrinol 2016; 175: 49-54.
    Pubmed CrossRef
  13. Ojamaa K, Klemperer JD, Klein I. Acute effects of thyroid hormone on vascular smooth muscle. Thyroid 1996; 6: 505-12.
    Pubmed CrossRef
  14. Roef G, Lapauw B, Goemaere S, Zmierczak HG, Toye K, Kaufman JM, et al. Body composition and metabolic parameters are associated with variation in thyroid hormone levels among euthyroid young men. Eur J Endocrinol 2012; 167: 719-26.
    Pubmed CrossRef
  15. Kitahara CM, Platz EA, Ladenson PW, Mondul AM, Menke A, Berrington de González A. Body fatness and markers of thyroid function among US men and women. PLoS One 2012; 7: e34979.
    Pubmed KoreaMed CrossRef
  16. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol 2010; 316:165-71.
    Pubmed CrossRef
  17. De Pergola G, Ciampolillo A, Paolotti S, Trerotoli P, Giorgino R. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrinol (Oxf) 2007; 67: 265-9.
    Pubmed CrossRef
  18. Vierhapper H, Nardi A, Grösser P, Raber W, Gessl A. Low-density lipoprotein cholesterol in subclinical hypothyroidism. Thyroid 2000; 10: 981-4.
    Pubmed CrossRef
  19. Kanaya AM, Harris F, Volpato S, Pérez-Stable EJ, Harris T, Bauer DC. Association between thyroid dysfunction and total cholesterol level in an older biracial population: the health, aging and body composition study. Arch Intern Med 2002; 162: 773-9.
    Pubmed CrossRef
  20. Tehrani FR, Tohidi M, Dovom MR, Azizi F, Tohidi M. A population based study on the association of thyroid status with components of the metabolic syndrome. J Diabetes Metab 2011; 2: 156-62.
    CrossRef
  21. Kim BJ, Kim TY, Koh JM, Kim HK, Park JY, Lee KU, et al. Relationship between serum free T4 (FT4) levels and metabolic syndrome (MS) and its components in healthy euthyroid subjects. Clin Endocrinol (Oxf) 2009; 70:152-60.
    Pubmed CrossRef
  22. Garduño-Garcia Jde J, Alvirde-Garcia U, López-Carrasco G, Padilla Mendoza ME, Mehta R, Arellano-Campos O, et al. TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects. Eur J Endocrinol 2010; 163: 273-8.
    Pubmed CrossRef
  23. Schindler A. Thyroid function and postmenopause. Gynecol Endocrinol 2003; 17: 79-85.
    Pubmed CrossRef
  24. Zuckerman SH, Evans GF, Schelm JA, Eacho PI, Sandusky G. Estrogen-mediated increases in LDL cholesterol and foam cell-containing lesions in human ApoB100×CETP transgenic mice. Arterioscler Thromb Vasc Biol 1999; 19: 1476-83.
    Pubmed CrossRef
  25. Kweon SS, Shin MH, Nam HS, Jeong SK, Park KS, Choi JS, et al. Sex differences in the associations of testosterone and sex hormone-binding globulin with metabolic syndrome in middle-aged and elderly Koreans: Namwon study. Circ J 2013; 77: 734-40.
    Pubmed CrossRef
  26. Rawal R, Teumer A, Völzke H, Wallaschofski H, Ittermann T, Åsvold BO, et al. Meta-analysis of two genome-wide association studies identifies four genetic loci associated with thyroid function. Hum Mol Genet 2012; 21: 327582.
    Pubmed CrossRef
  27. Carr MC, Hokanson JE, Zambon A, Deeb SS, Barrett PH, Purnell JQ, et al. The contribution of intraabdominal fat to gender differences in hepatic lipase activity and low/high density lipoprotein heterogeneity. J Clin Endocrinol Metab 2001; 86: 2831-7.
    CrossRef
  28. Koutsari C, Basu R, Rizza RA, Nair KS, Khosla S, Jensen MD. Nonoxidative free fatty acid disposal is greater in young women than men. J Clin Endocrinol Metab 2011; 96: 541-7.
    Pubmed KoreaMed CrossRef

This Article


Author ORCID Information

Services
Social Network Service

e-submission

Archives