Relationship between serum TSH level with obesity and NAFLD in euthyroid subjects

Abstract

To explore the relationship between serum thyroid stimulating hormone (TSH) level and obesity and nonalcoholic fatty liver disease (NAFLD) in euthyroid subjects, 1322 subjects were subjected to a questionnaire survey and physical examination. Fasting blood samples were collected to test serum TSH, plasma glucose and lipids. Fatty liver was diagnosed by type B ultrasonography. The relationship between serum TSH level and body mass index (BMI), percentage of body fat and NAFLD was analyzed. The results showed that serum TSH level was significantly higher in females than in males at the same group, and it was significantly higher in overweight group than in control group. Levels of body weight, BMI, waist circumference and percentage of body fat were increased in TSH >2.5 group compared to TSH ≤2.5 group in women. However, plasma lipids showed no significant differences. In males all the parameters showed no significant differences between two groups. Serum TSH was significantly correlated with body weight, BMI, waist circumference and percentage of body fat after adjustment for age in females. Multiple linear regression analysis revealed that percentage of body fat and BMI contributed significantly to the variance of TSH. Serum TSH level was significantly higher in nonalcoholic fatty liver group than in normal group in females. Multiple logistic regression analysis showed that TSH level was not the independent risk factor of NAFLD. Taken together the data suggest that serum TSH in normal range is significantly correlated with BMI and percentage of body fat in females. And the change of TSH level would not influence the prevalence of NAFLD.

Keywords

thyroid stimulating hormone / obesity / lipid / thyroid function / nonalcoholic fatty liver disease

References

[1] PucciE., ChiovatoL., PincheraA.. Thyroid and lipid metabolism. Int J Obes Relat Metab Disord, 2000, 24(s2): S109-112

[2] AlkemadeA.. Central and peripheral effects of thyroid hormone signaling in the control of energy metabolism. J Neuroendocrinol, 2010, 22(1): 56-63

[3] TeixeiraP.F., ReutersV.S., FerreiraM.M., et al.. Lipid profile in different degrees of hypothyroidism and effects of levothyroxine replacement in mild thyroid failure. Transl Res, 2008, 151(4): 224-231

[4] MilionisH.J., EfstathiadouZ., TselepisA.D., et al.. Lipoprotein (a) levels and apolipoprotein (a) isoform size in patients with subclinical hypothyroidism: effect of treatment with levothyroxine. Thyroid, 2003, 13(4): 365-369

[5] MansourianA.R.. A review on hyperthyroidism: thyrotoxicosis under surveillance. Pak J Biol Sci, 2010, 13(22): 1066-1076

[6] AmbrosiB., MasseriniB., IorioL., et al.. Relationship of thyroid function with body mass index and insulin-resistance in euthyroid obese subjects. J Endocrinol Invest, 2010, 33(9): 640-643

[7] ShonH.S., JungE.D., KimS.H., et al.. Free T4 is negatively correlated with body mass index in euthyroid women. Korean J Intern Med, 2008, 23(2): 53-57

[8] KhaderY.S., BatiehaA., JaddouH., et al.. Anthropometric cutoff values for detecting metabolic abnormalities in Jordanian adults. Diabetes Metab Syndr Obes, 2010, 18(3): 395-402

[9] Diagnostic criteria of nonalcoholic fatty liver disease. . Zhonghua Gan Zang Bing Za Zhi (Chinese), 2003, 11(2): 71

[10] KnudsenN., LaurbergP., RasmussenL.B., et al.. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab, 2005, 90(7): 4019-4024

[11] NyrnesA., JordeR., SundsfjordJ.. Serum TSH is positively associated with BMI. Int J Obes (Lond), 2006, 30(1): 100-105

[12] RuhlaS., WeickertM.O., ArafatA.M., et al.. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf), 2010, 72(5): 696-701

[13] BastemirM., AkinF., AlkisE., et al.. Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss Med Wkly, 2007, 137(29–30): 431-434

[14] SoriskyA., AntunesT.T., GagnonA.. The adipocyte as a novel TSH target. Mini Rev Med Chem, 2008, 8(1): 91-96

[15] KlieverikL.P., CoomansC.P., EndertE., et al.. Thyroid hormone effects on whole-body energy homeostasis and tissue-specific fatty acid uptake in vivo. Endocrinology, 2009, 150(12): 5639-5648

[16] SartorioA., FerreroS., TrecateL., et al.. Thyroid function is more strongly associated with body impedance than anthropometry in healthy subjects. J Endocrinol Invest, 2002, 25(7): 620-623

[17] VanderpumpM.P.. How should we manage patients with mildly increased serum thyrotrophin concentrations. Clin Endocrinol (Oxf), 2010, 72(4): 436-440

[18] NevesC., AlvesM., MedinaJ.L., et al.. Thyroid diseases, dyslipidemia and cardiovascular pathology. Rev Port Cardiol, 2008, 27(10): 1211-1236

[19] RoosA., BakkerS.J., LinksT.P., et al.. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab, 2007, 92(2): 491-496

[20] ParkY.J., LeeE.J., LeeY.J., et al.. Subclinical hypothyroidism (SCH) is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life (QoL) in elderly subjects. Arch Gerontol Geriatr, 2010, 50(3): e68-73

[21] ZhuX., ChengS.Y.. New insights into regulation of lipid metabolism by thyroid hormone. Curr Opin Endocrinol Diabetes Obes, 2010, 17(5): 408-413

[22] LiangpunsakulS., ChalasaniN.. Is hypothyroidism a risk factor for non-alcoholic steatohepatitis. J Clin Gastroenterol, 2003, 37(4): 340-343

[23] KalaitzakisE.. Fatigue in non-alcoholic fatty liver disease: is there a role for hypothyroidism. Gut, 2009, 58(1): 149-150

[24] GardnerC.J., RichardsonP., WongC., et al.. Hypothyroidism in a patient with non-alcoholic fatty liver disease. BMJ, 2011, 342: c7199

[25] GalofreJ.C., PujanteP., AbreuC., et al.. Relationship between thyroid-stimulating hormone and insulin in euthyroid obese men. Ann Nutr Metab, 2008, 53(3–4): 188-194

[26] AsvoldB.O., BjoroT., NilsenT.I., et al.. Association between blood pressure and serum thyroid-stimulating hormone concentration within the reference range: a population-based study. J Clin Endocrinol Metab, 2007, 92(3): 841-845

[27] MurphyE., GluerC.C., ReidD.M., et al.. Thyroid function within the upper normal range is associated with reduced bone mineral density and an increased risk of nonvertebral fractures in healthy euthyroid postmenopausal women. J Clin Endocrinol Metab, 2010, 95(7): 3173-3181

[28] FreyA., LampertA., DietzK., et al.. Thyrotropin serum concentrations in healthy volunteers are associated with depression-related personality traits. Neuropsychobiology, 2007, 56(2–3): 123-126

[29] LaurbergP., AndersenS., CarleA., et al.. The TSH upper reference limit: where are we at. Nat Rev Endocrinol, 2011, 7(4): 232-239

[30] TengW., ShanZ., TengX., et al.. Effect of iodine intake on thyroid diseases in China. N Engl J Med, 2006, 354(26): 2783-2793