Korean J Fam Pract 2019; 9(2): 154-160  https://doi.org/10.21215/kjfp.2019.9.2.154
The Association between Thyroid Function and Metabolic Syndrome in Euthyroid Korean Male Adults: Korean National Health and Nutrition Examination Survey VI
Soo Gyeong Park1, Do-Hoon Kim1,*, Joo-Hyun Park1, E Yeon Kim1, Moonyoung Choi1, Hyonchong Kim1, Da Eun Seul1, Hyunjin Kim1,
Kang Uk Lee1, Myung Ji Nam1, Kyungdo Han2, Da Hye Kim2
1Department of Family Medicine, Korea University Ansan Hospital, Ansan; 2Department of Biostatics, Catholic University College of Medicine, Seoul, Korea
Do-Hoon Kim, Tel: +82-31-412-4261, Fax: +82-31-412-5364, E-mail: kmcfm@hanmail.net, ORCID: http://orcid.org/0000-0001-7421-4501
Received: June 20, 2018; Revised: November 23, 2018; Accepted: February 18, 2019; Published online: April 20, 2019.
© 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: Thyroid hormones are one of the key factors involved in energy, lipid, and glucose metabolisms. Many studies have been conducted to establish the association between thyroid function and metabolic syndrome. This study aimed to identify the association between thyroid hormone and metabolic syndrome in euthyroid Korean male adults.
Methods: Using data from the sixth Korea National Health and Nutrition Examination Survey from 2013 to 2015, this cross-sectional study of 2,285 male adults was conducted. Subjects who had thyroid diseases and were not euthyroid were excluded. The included subjects were divided into four groups according to free thyroxine (fT4) and thyroid-stimulating hormone levels. We analyzed the prevalence and adjusted odds ratio of metabolic syndrome according to thyroid hormone levels.
Results: The prevalence of metabolic syndrome and its components decreased constantly from the lowest fT4 quartile to the highest fT4 quartile. Compared with that in the lowest fT4 quartile, the adjusted odds ratio of hypertriglyceridemia in the highest fT4 quartile was 0.651.
Conclusion: In euthyroid subjects, fT4 levels are associated with metabolic syndrome and all its components.
Keywords: Thyroid Function; Thyroxine; Metabolic Syndrome
References
  1. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37:1595-607.
    Pubmed CrossRef
  2. Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999; 16: 442-3.
    Pubmed CrossRef
  3. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.
    Pubmed CrossRef
  4. Einhorn D, Reaven GM, Cobin RH, Ford E, Ganda OP, Handelsman Y, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9: 237-52.
    Pubmed CrossRef
  5. Zimmet P, M M Alberti KG, Serrano Ríos M. [A new international diabetes federation worldwide definition of the metabolic syndrome: the rationale and the results]. Rev Esp Cardiol 2005; 58: 1371-6. Spanish.
    Pubmed CrossRef
  6. Lim S, Shin H, Song JH, Kwak SH, Kang SM, Yoon JW, et al. Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007. Diabetes Care 2011; 34:1323-8.
    Pubmed KoreaMed CrossRef
  7. Duntas LH. Thyroid disease and lipids. Thyroid 2002; 12: 287-93.
    Pubmed CrossRef
  8. Danzi S, Klein I. Thyroid hormone and blood pressure regulation. Curr Hypertens Rep 2003; 5: 513-20.
    Pubmed CrossRef
  9. Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007; 116: 1725-35.
    Pubmed CrossRef
  10. Danzi S, Klein I. Thyroid hormone and the cardiovascular system. Med Clin North Am 2012; 96: 257-68.
    Pubmed CrossRef
  11. Iwen KA, Schröder E, Brabant G. Thyroid hormones and the metabolic syndrome. Eur Thyroid J 2013; 2: 83-92.
    Pubmed KoreaMed CrossRef
  12. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
    Pubmed CrossRef
  13. Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, et al. Followup report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26:3160-7.
    Pubmed CrossRef
  14. World Health Organization, Regional Office for the Western Pacific. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney:Health Communications Australia; 2000. p. 15-8.
  15. Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ, Feddema P, et al. Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch Intern Med 2005; 165: 2467-72.
    Pubmed CrossRef
  16. Rodondi N, Bauer DC, Cappola AR, Cornuz J, Robbins J, Fried LP, et al. Subclinical thyroid dysfunction, cardiac function, and the risk of heart failure. The Cardiovascular Health study. J Am Coll Cardiol 2008; 52: 1152-9.
    Pubmed KoreaMed CrossRef
  17. Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 2010; 304: 1365-74.
    Pubmed KoreaMed CrossRef
  18. Cappola AR, Fried LP, Arnold AM, Danese MD, Kuller LH, Burke GL, et al. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 2006; 295: 1033-41.
    Pubmed KoreaMed CrossRef
  19. Biondi B, Palmieri EA, Fazio S, Cosco C, Nocera M, Saccà L, et al. Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J Clin Endocrinol Metab 2000; 85: 4701-5.
    Pubmed CrossRef
  20. Ochs N, Auer R, Bauer DC, Nanchen D, Gussekloo J, Cornuz J, et al. Metaanalysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med 2008; 148: 832-45.
    Pubmed CrossRef
  21. Mehran L, Amouzegar A, Tohidi M, Moayedi M, Azizi F. Serum free thyroxine concentration is associated with metabolic syndrome in euthyroid subjects. Thyroid 2014; 24: 1566-74.
    Pubmed CrossRef
  22. Lin SY, Wang YY, Liu PH, Lai WA, Sheu WH. Lower serum free thyroxine levels are associated with metabolic syndrome in a Chinese population. Metabolism 2005; 54: 1524-8.
    Pubmed CrossRef
  23. 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: 491-6.
    Pubmed CrossRef
  24. Shin HS, Kim JR, Seo JY, Shin KS, Yoo BW, Cho YJ, et al. Relationship between serum TSH level within the normal reference range and the metabolic syndrome. Korean J Clin Geri 2014; 15: 14-9.
    CrossRef
  25. Flamant F, Samarut J. Thyroid hormone receptors: lessons from knockout and knock-in mutant mice. Trends Endocrinol Metab 2003; 14: 85-90.
    Pubmed CrossRef
  26. Jansen J, Friesema EC, Milici C, Visser TJ. Thyroid hormone transporters in health and disease. Thyroid 2005; 15: 757-68.
    Pubmed CrossRef
  27. Park HT, Cho GJ, Ahn KH, Shin JH, Hong SC, Kim T, et al. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas 2009; 62: 301-5.
    Pubmed CrossRef

This Article


Services
Social Network Service

e-submission

Archives