scholarly journals The relationship between serum thyroid-stimulating hormone, insulin resistance, and cardiovascular risk factors in obese patients with subclinical hypothyroidism

2021 ◽  
Vol 16 (8) ◽  
pp. 630-635
Author(s):  
N.V. Pasiechko ◽  
Yu.V. Yevstratieva
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Obese Patients ◽  
Obese People ◽  
The Relationship ◽  
Tsh Levels

Background. The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. The putative relationships between thyroid hormones, body weight, and adipose tissue homeostasis have been the focus of several studies in recent years, but the causal relationships between these parameters have not been well established. The purpose of the study: to investigate the relationship between serum thyroid-stimulating hormone (TSH), insulin resistance (IR), and cardiovascular risk factors in a sample of obese people with subclinical hypothyroidism. Materials and methods. A retrospective, longitudinal analysis of 145 obese patients was performed. The TSH and free thyroxine (fT4) levels, anthropometric measurements, and laboratory test results were analyzed. Results. Twenty-three individuals presented with TSH levels above the normal level (subclinical hypothyroidism). Their waist circumference (WC) was significantly higher than that of euthyroid individuals. Serum TSH positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides, and high-density lipoprotein cholesterol (HDL-C). Using TSH and body mass index as independent variables, TSH levels were shown to be independently related to HOMA-IR (p = 0.002) and triglycerides (p = 0.006). Among euthyroid subjects, individuals with TSH values < 2.5 mIU/ml exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values. Conclusions. Subclinical hypothyroidism in overweight and obese people appears to be associated with excess weight, especially visceral weight. In the present sample of obese patients, TSH levels appear to be associated with insulin resistance.

scholarly journals Obese patients with higher TSH levels had an obvious metabolic improvement after bariatric surgery

2021 ◽  
Vol 10 (10) ◽  
pp. 1326-1336
Author(s):  
Nannan Bian ◽  
Xiaomeng Sun ◽  
Biao Zhou ◽  
Lin Zhang ◽  
Qiu Wang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Thyroid Function ◽  
Fasting Blood Glucose ◽  
Thyroid Stimulating Hormone ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Free Triiodothyronine ◽  
The Relationship ◽  
Tsh Levels

Objective Bariatric surgery has become the most effective treatment for morbid obesity. Increasing evidence showed that bariatric surgery can alleviate insulin resistance and influence thyroid function. This study aimed to investigate the relationship between changes in thyroid function and adipose tissue insulin resistance (adipo-IR) after bariatric surgery. Methods A total of 287 non-diabetic participants with regular thyroid function were recruited and divided into the lean, overweight and obese groups. Among them, 50 morbidly obese patients submitted to bariatric surgery. Results The obese group had a higher level of adipo-IR, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), FT3/free thyroxine (FT4) and metabolism disorders than the lean and overweight groups. BMI was correlated with TSH, FT3, FT3/FT4 and adipo-IR (r = 0.309, 0.315, 0.322 and 0.651, respectively, all P < 0.001). Adipo-IR was significantly correlated with TSH (r = 0.402, P < 0.001), FT3 (r = 0.309, P < 0.001), and FT3/FT4 (r = 0.228, P < 0.05). Bariatric surgery resulted in a sharp decline in BMI, adipo-IR, TSH, FT3 and FT3/FT4 levels, meanwhile, metabolic disorders improved. The decrease in BMI after bariatric surgery was significantly correlated with reductions in adipo-IR (r = 0.577, P < 0.001) and TSH (r = 0.401, P = 0.005). Interestingly, the fasting blood glucose, fasting insulin, adipo-IR and TSH in the higher TSH group decreased more remarkably than in the lower TSH group. Conclusion Obese individuals with higher TSH levels had an obvious metabolic improvement after bariatric surgery.

scholarly journals Subclinical Hypothyroidism and Cardiovascular Risk – An Overview of Current Understanding

2010 ◽  
Vol 7 (1) ◽  
pp. 53 ◽  
Author(s):  
Ulla Feldt Rasmussen ◽  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Large Scale ◽  
Thyroid Stimulating Hormone ◽  
Individual Variability ◽  
Overt Hypothyroidism ◽  
Therapeutic Trial ◽  
Treatment Benefit

Subclinical or mild hypothyroidism is often associated with adverse cardiovascular risk factors, such as high cholesterol, together with hypertension, endothelial dysfunction and other atherosclerotic cardiovascular risk factors. The ischaemic abnormalities are probably related to long-term consequences of a slowly progressing development of hypothyroidism. In recent years, it has become evident that a consensus on the exact limits for cut-off between normal and subclinically hypothyroid individuals is not currently possible. The main reasons for this are differences for measurement of serum thyroid-stimulating hormone (TSH), that reference populations are very different and that a person’s intra-individual variability is much narrower than any population-based interval. Finally, the prevalence of subclinical hypothyroidism varies from 4 to 17% in different normal populations. Available evidence indicates that patients with subclinical hypothyroidism have developed or are at risk of developing an adverse cardiovascular profile and subclinical hypothyroidism is most likely a mild variant of overt hypothyroidism. There is currently no evidence for a treatment benefit, but studies to demonstrate the expected minor improvements have not been performed on a sufficiently large scale. Patients should be informed about the disease and based on a combined clinical and laboratory judgement, should be offered a therapeutic trial in case of even vague symptoms.

Improvement of Insulin Resistance and Cardiovascular Risk Factors with Treatment of Subclinical Hypothyroidism in Patients with Autoimmune Thyroiditis

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1975-P
Author(s):  
CELESTINO NEVES ◽  
SOFIA C. OLIVEIRA ◽  
JOÃO SÉR NEVES ◽  
MIGUEL G. PEREIRA ◽  
OKSANA SOKHATSKA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Autoimmune Thyroiditis ◽  
Subclinical Hypothyroidism

scholarly journals Association Between Insulin-like Growth Factor 1 and Insulin Resistance in Obese Prepubertal Boys: A Cross-sectional Study

2020 ◽  
Author(s):  
Jiangying Kuang ◽  
Li Zhang ◽  
Yueqin Xu ◽  
Jiang Xue ◽  
Shuang Liang
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Growth Factor ◽  
Cardiovascular Risk Factors ◽  
Whole Body ◽  
Sensitivity Index ◽  
Insulin Like Growth Factor ◽  
Prepubertal Boys ◽  
The Relationship

Abstract Background: As one of the most common features of obesity, insulin resistance is central to the pathogenesis of the metabolic syndrome. Low insulin-like growth factor 1(IGF-1) levels have been proven to be associated with many traditional cardiovascular risk factors, but it still remains controversy with the relationship between IGF-1 and insulin resistance. Accordingly, the main purpose of this study is to investigate the relationship between IGF-1 and insulin resistance in obese prepubertal boys.Methods: We used whole body insulin sensitivity index (WBISI) to represent insulin resistance. 70 obese prepubertal boys were included in this study, and the obese subjects were divided into two groups by using 1.285 as a threshold value for WBISI. Clinical examination and laboratory examinations were assessed for all participants.Results: Among obese boys, the group of children with WBISI ≤1.285 had lower IGF-1 standard deviation scores (SDS) (p = 0.021) than WBISI >1.285 group. The results of multivariate stepwise regression analysis show that WBISI was positively correlated with IGF-1 SDS (β =1.726, p = 0.002) after adjusting for traditional cardiovascular risk factors.Conclusion: IGF-1 SDS was negatively associated with insulin resistance in obese prepubertal boys, independent of other traditional cardiovascular disease risk markers.

scholarly journals Association between insulin-like growth factor 1 and insulin resistance in obese prepubertal boys:a cross-sectional study

2020 ◽  
Author(s):  
Jiangying Kuang ◽  
Li Zhang ◽  
Yueqin Xu ◽  
Jiang Xue ◽  
Shuang Liang
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Growth Factor ◽  
Cardiovascular Risk Factors ◽  
Whole Body ◽  
Sensitivity Index ◽  
Insulin Like Growth Factor ◽  
Prepubertal Boys ◽  
The Relationship

Abstract Background As one of the most common features of obesity, insulin resistance is central to the pathogenesis of the metabolic syndrome. Low insulin-like growth factor 1(IGF-1) levels have been proven to be associated with many traditional cardiovascular risk factors, but it still remains controversy with the relationship between IGF-1 and insulin resistance. Accordingly, the main purpose of this study is to investigate the relationship between IGF-1 and insulin resistance in obese prepubertal boys.Methods We used whole body insulin sensitivity index (WBISI) to represent insulin resistance. 70 obese prepubertal boys were included in this study, and the obese subjects were divided into two groups by using 1.285 as a threshold value for WBISI. Clinical examination and laboratory examinations were assessed for all participants.Results Among obese boys, the group of children with WBISI ≤ 1.285 had lower IGF-1 standard deviation scores (SDS) (p = 0.021) than WBISI > 1.285 group. The results of multivariate stepwise regression analysis show that WBISI was positively correlated with IGF-1 SDS (β = 1.726, p = 0.002) after adjusting for traditional cardiovascular risk factors.Conclusion IGF-1 SDS was negatively associated with insulin resistance in obese prepubertal boys, independent of other traditional cardiovascular disease risk markers.

scholarly journals Specific impact of cardiovascular risk factors on coronary microcirculation in patients with subclinical hypothyroidism

2021 ◽  
Author(s):  
Mirjana Stojković ◽  
Biljana Nedeljković-Beleslin ◽  
Milorad Tesic ◽  
Zoran Bukumiric ◽  
Jasmina Ciric ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Thyroid Hormones ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Free Triiodothyronine ◽  
Flow Reserve ◽  
The Impact

Background: Although thyroid hormones have significant effect on cardiovascular system, the impact of subtle thyroid dysfunction such as subclinical hypothyroidism (SCH) remains to be determined. We investigated coronary flow reserve (CFR) in patients with subclinical hypothyroidism. Methods: Thirty-two subjects with SCH and eighteen control subjects with normal serum thyroid hormones and thyroid-stimulating hormone (TSH) levels were included in the study. TSH, free thyroxine, free triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and plasma levels of C-reactive protein were measured. Coronary diastolic peak flow velocities in left anterior descending coronary artery were measured at baseline and after adenosine infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity. Results: CFR values were not significantly different between the two groups (SCH 2.76 ± 0.35 vs controls 2.76 ± 0.42). There was a significant correlation of CFR with waist to hip ratio, hypertension, smoking habits, markers of glucose status (glucose level, HbA1c, insulin level, HOMA IR), cholesterol, LDL-cholesterol and triglyceride levels in SCH group, whereas only cholesterol level showed significant correlation with CFR in controls. There was no correlation between CFR and thyroid hormones. Conclusion: We concluded that there is a different impact of cardiovascular risk factors on CFR in SCH patients compared to healthy control and that these two groups behave differently in the same circumstances under the same risk factors. The basis for this difference could be that the altered thyroid axis “set point” changes the sensitivity of the microvasculature in patients with SCH to known risk factors.

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