Relationship of thyroid function with body mass index and insulin-resistance in euthyroid obese subjects
Relationship of thyroid function with body mass index and insulin-resistance in euthyroid obese subjects
复制标题
DOI：
10.1007/bf03346663
复制
发表时间：
2010-10-01
影响因子：
5.4
通讯作者：
Orsi, E.
中科院分区：
文献类型：
--
作者：
Ambrosi, B.;Masserini, B.;Orsi, E.
本研究旨在进一步探讨肥胖与甲状腺功能的关系以及胰岛素抵抗对下丘脑-垂体-甲状腺轴的可能作用。方法与结果对581例肥胖患者的血清TSH和游离T-4(FT4)水平进行了人体测量和代谢参数的测定，TSH值随肥胖程度的加重而递增，并与体重指数(p=0.001r=0.13)和腰围(p=0.02)呈正相关。胰岛素抵抗患者TSH升高(1 8+/-1 0vs 1 6+/-0 9mU/L，P=0 0 3)，FT4水平降低(13 8+/-2 3vs 15 0+/-2 2pmol/L，p<)；FT4与空腹胰岛素(p<；0.0 0 1，r=-0.2 87)、HOMA IR(p<；0.0 0 1，r=-0.2 95)呈负相关，与胰岛素敏感性检查指数(Quick！，p<；0.0 0 1r=-0.148)呈负相关。结论甲状腺功能与超重/肥胖之间的关系似乎存在，主要受胰岛素抵抗的影响，TSH和/或甲状腺激素在正常范围内的变化是否会影响体重，或者肥胖本身是否会改变甲状腺功能目前还不能说明。还需要进一步的研究，通过不仅考虑甲状腺激素的变化，还考虑体脂分布、肥胖持续时间和低级别炎症来评估甲状腺功能和体重之间的联系(J Endocrinol Invest 33 640 643 2010)(C)2010 Editrice Kurtis
Background and aims It is recognized that overt thyroid dysfunction is associated with weight changes, but the influence of a minor alteration of thyroid function remains unclear This study aimed to further investigate the relation ship between obesity and thyroid function and to examine the possible role of insulin resistance on the hypothalamic pituitary thyroid axis Methods and results Serum TSH and free T-4 (FT4) levels anthropometric and metabolic parameters were evaluated in 581 obese patients In all patients TSH values progressively increased according to the severity of obesity and were positively correlated with body mass index (p=0 001 r=0 13) and waist circumference (p=0 02, r=0 11) Patients with insulin resistance showed higher TSH (1 8 +/- 1 0 vs 1 6 +/- 0 9 mu Ul/l, p=0 03) and lower FT4 levels (13 8 +/- 2 3 vs 15 0 +/- 2 2 pmol/l, p < 0 001) as compared with patients with normal insulin sensitivity Moreover TSH was positively cor related with fasting insulin (p < 0 001 r=0 152) and home stasis model assessment of insulin resistance (HOMA IR p < 0 001 r=0 148), and negatively correlated with Quantitative Insulin Sensitivity Check Index (QUICK!, p < 0 001 r=-0 148) FT4 was negatively associated with fasting insulin (p < 0 001, r=-0 287) and HOMA IR (p < 0 001, r=-0 295), and positively associated with QUICKI (p < 0 001 r=0 295) Conclusions A relationship between thyroid function and over weight/obesity condition seems to exist, mainly influenced by insulin resistance Whether variations in TSH and/or thyroid hormones, within a normal range, can influence body weight or whether obesity per se can alter thyroid function cannot be stated so far Further studies are needed to assess the link between thyroid function and body weight by considering not only changes in thyroid hormones but also body fat distribution obesity duration and low grade inflammation (J Endocrinol Invest 33 640 643 2010) (c) 2010 Editrice Kurtis