.: ORİJİNAL ARAŞTIRMA
Effects of Obesity on the Thyroid Hormone Levels: Retrospective Cross-Sectional Study
Obezitenin Tiroid Hormon Düzeyleri Üzerine Etkileri: Retrospektif Kesitsel Çalışma
Turkiye Klinikleri J Intern Med. 2023;8(1):1-7
doi: 10.5336/intermed.2021-87117
Makale Dili: EN
Tam Metin
Ücretsiz Erişim
ABSTRACT
Objective: The incidence of obesity is increasing. Thyroid dysfunction has been extensively studied in obesity. The aim of this study is to determine thyroid hormone levels in patients with obesity (Class I and II obesity) and morbid obesity, and to determine the correlation between body mass index (BMI) and thyroid hormones. Material and Methods: Data from one hundred fifty-seven patients with obesity, including 71 patients with a BMI of 30-39.9 kg/m2 (Group 1) and 86 patients with morbid obesity with a BMI≥40 kg/m2 (Group 2), and 60 control subjects with a BMI of 18.5-24.9 kg/m2 were retrospectively reviewed. Thyroid hormone levels were compared. Consent was obtained from the patients and, if necessary, their legal representatives. The study was a retrospective cross-sectional study. Ethics committee approval was obtained for our study. Results: The mean age of obese and normal-weight individuals was similar (p=0.94). Thyroidstimulating hormone (TSH) levels were higher in patients than in controls (3.7±1.8 μIU/mL and 2.5±1.7, respectively; p=0.01). The prevalence of subclinical hypothyroidism (SCH) was higher in patients than in controls (p=0.003). There was a positive correlation between TSH and BMI (r=0.44, p=0.001). In subgroup analysis, TSH level was similar in Group 1 and Group 2 (p=0.07). TSH was higher in Group 1 (p=0.03) and Group 2 (p=0.01) than in the control group. The frequency of SCH was similar in Group 1 and Group 2 (p=0.06). The frequency of SCH was higher in Group 1 (p=0.006) and Group 2 (p=0.002) than in the control group. Conclusion: TSH level was higher in patients with obesity than in healthy controls. There was a positive correlation between BMI and TSH. Thyroid hormone levels were similar in patients with a BMI of 30-39.9 kg/m2 and morbid obesity. We recommend thyroid hormone screening in obesity.
Keywords: Obesity; thyroid hormones; thyroid-stimulating hormone
Objective: The incidence of obesity is increasing. Thyroid dysfunction has been extensively studied in obesity. The aim of this study is to determine thyroid hormone levels in patients with obesity (Class I and II obesity) and morbid obesity, and to determine the correlation between body mass index (BMI) and thyroid hormones. Material and Methods: Data from one hundred fifty-seven patients with obesity, including 71 patients with a BMI of 30-39.9 kg/m2 (Group 1) and 86 patients with morbid obesity with a BMI≥40 kg/m2 (Group 2), and 60 control subjects with a BMI of 18.5-24.9 kg/m2 were retrospectively reviewed. Thyroid hormone levels were compared. Consent was obtained from the patients and, if necessary, their legal representatives. The study was a retrospective cross-sectional study. Ethics committee approval was obtained for our study. Results: The mean age of obese and normal-weight individuals was similar (p=0.94). Thyroidstimulating hormone (TSH) levels were higher in patients than in controls (3.7±1.8 μIU/mL and 2.5±1.7, respectively; p=0.01). The prevalence of subclinical hypothyroidism (SCH) was higher in patients than in controls (p=0.003). There was a positive correlation between TSH and BMI (r=0.44, p=0.001). In subgroup analysis, TSH level was similar in Group 1 and Group 2 (p=0.07). TSH was higher in Group 1 (p=0.03) and Group 2 (p=0.01) than in the control group. The frequency of SCH was similar in Group 1 and Group 2 (p=0.06). The frequency of SCH was higher in Group 1 (p=0.006) and Group 2 (p=0.002) than in the control group. Conclusion: TSH level was higher in patients with obesity than in healthy controls. There was a positive correlation between BMI and TSH. Thyroid hormone levels were similar in patients with a BMI of 30-39.9 kg/m2 and morbid obesity. We recommend thyroid hormone screening in obesity.
Keywords: Obesity; thyroid hormones; thyroid-stimulating hormone
ÖZET
Amaç: Obezite insidansı giderek artmaktadır. Obezitede tiroid disfonksiyonu kapsamlı bir şekilde çalışılmıştır. Bu çalışmanın amacı obez (Sınıf I ve II obezite) ve morbid obez hastalarda tiroid hormon düzeylerini belirlemek ve beden kitle indeksi (BKİ) ile tiroid hormonları arasındaki korelasyonu tanımlamaktır. Gereç ve Yöntemler: Obez 157 hastanın verisi, BKİ 30-39,9 kg/m2 olan 71 birey (Grup 1), BKİ≥40 kg/m2 olan 86 morbid obez birey (Grup 2) ve BKİ of 18,5-24,9 kg/m2 olan 60 kontrol birey retrospektif olarak tarandı. Tiroid hormon seviyeleri karşılaştırıldı. Hastalardan ve gereğinde yasal temsilcilerinden onam alındı. Çalışmamız retrospektif kesitsel çalışmadır. Çalışmamız için etik kurul onayı alınmıştır. Bulgular: Obez ve normal kilolu bireylerin yaş ortalamaları benzer bulundu (p=0,94). Obez hastalarda tiroid uyarıcı hormon (TSH) düzeyleri normal kilolu kontrol grubuna göre daha yüksekti (3,7±1,8 μIU/mL ve 2,5±1,7, sırasıyla; p=0,01). Obezite grubunda subklinik hipotiroidizm prevalansı normal kilolu kontrol grubuna göre daha yüksekti (p=0,003). Obez hastalarda TSH konsantrasyonları ve BKİ arasında pozitif korelasyon saptandı (r=0,44, p=0,001). Subgrup analizde Grup 1 ve Grup 2'nin TSH seviyesi benzerdi (p:0,07). TSH Grup 1 (p=0,03) ve Grup 2'de (p=0,01) kontrol grubuna göre daha yüksek saptandı. Subklinik hipotiroidi sıklığı Grup 1 ve Grup 2'de benzerdi (p=0,06). Subklinik hipotiroidi sıklığı Grup 1 (p=0,006) ve Grup 2'de (p=0,002) kontrol grubuna göre daha yüksekti. Sonuç: Obez hastalarda TSH düzeyi sağlıklı kontrol grubuna göre daha yüksek idi. BKİ ile TSH arasında pozitif bir korelasyon bulunmaktadır. BKİ 30-39,9 kg/m2 olan ve morbid obezitesi olan hastalarda tiroid hormon düzeyleri benzerdi. Biz obezitede TSH düzeylerinin taranmasını öneriyoruz.
Anahtar Kelimeler: Obezite; tiroid hormonları; tiroid uyarıcı hormon
Amaç: Obezite insidansı giderek artmaktadır. Obezitede tiroid disfonksiyonu kapsamlı bir şekilde çalışılmıştır. Bu çalışmanın amacı obez (Sınıf I ve II obezite) ve morbid obez hastalarda tiroid hormon düzeylerini belirlemek ve beden kitle indeksi (BKİ) ile tiroid hormonları arasındaki korelasyonu tanımlamaktır. Gereç ve Yöntemler: Obez 157 hastanın verisi, BKİ 30-39,9 kg/m2 olan 71 birey (Grup 1), BKİ≥40 kg/m2 olan 86 morbid obez birey (Grup 2) ve BKİ of 18,5-24,9 kg/m2 olan 60 kontrol birey retrospektif olarak tarandı. Tiroid hormon seviyeleri karşılaştırıldı. Hastalardan ve gereğinde yasal temsilcilerinden onam alındı. Çalışmamız retrospektif kesitsel çalışmadır. Çalışmamız için etik kurul onayı alınmıştır. Bulgular: Obez ve normal kilolu bireylerin yaş ortalamaları benzer bulundu (p=0,94). Obez hastalarda tiroid uyarıcı hormon (TSH) düzeyleri normal kilolu kontrol grubuna göre daha yüksekti (3,7±1,8 μIU/mL ve 2,5±1,7, sırasıyla; p=0,01). Obezite grubunda subklinik hipotiroidizm prevalansı normal kilolu kontrol grubuna göre daha yüksekti (p=0,003). Obez hastalarda TSH konsantrasyonları ve BKİ arasında pozitif korelasyon saptandı (r=0,44, p=0,001). Subgrup analizde Grup 1 ve Grup 2'nin TSH seviyesi benzerdi (p:0,07). TSH Grup 1 (p=0,03) ve Grup 2'de (p=0,01) kontrol grubuna göre daha yüksek saptandı. Subklinik hipotiroidi sıklığı Grup 1 ve Grup 2'de benzerdi (p=0,06). Subklinik hipotiroidi sıklığı Grup 1 (p=0,006) ve Grup 2'de (p=0,002) kontrol grubuna göre daha yüksekti. Sonuç: Obez hastalarda TSH düzeyi sağlıklı kontrol grubuna göre daha yüksek idi. BKİ ile TSH arasında pozitif bir korelasyon bulunmaktadır. BKİ 30-39,9 kg/m2 olan ve morbid obezitesi olan hastalarda tiroid hormon düzeyleri benzerdi. Biz obezitede TSH düzeylerinin taranmasını öneriyoruz.
Anahtar Kelimeler: Obezite; tiroid hormonları; tiroid uyarıcı hormon
REFERANSLAR:
- Sogabe M, Okahisa T, Kimura T, Okamoto K, Miyamoto H, Muguruma N, et al. Influence of metabolic syndrome on upper gastrointestinal disease. Clin J Gastroenterol. 2016;9(4):191-202. [Crossref] [PubMed]
- Sturm R. Increases in morbid obesity in the USA: 2000-2005. Public Health. 2007;121(7):492-6. [Crossref] [PubMed] [PMC]
- El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 2005;100(6):1243-50. [Crossref] [PubMed]
- Sakaguchi M, Oka H, Hashimoto T, Asakuma Y, Takao M, Gon G, et al. Obesity as a risk factor for GERD in Japan. J Gastroenterol. 2008;43(1):57-62. [Crossref] [PubMed]
- Pi-Sunyer X. The medical risks of obesity. Postgrad Med. 2009;121(6):21-33. [Crossref] [PubMed] [PMC]
- Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29(1):76-131. [Crossref] [PubMed]
- Salerno M, Capalbo D, Cerbone M, De Luca F. Subclinical hypothyroidism in childhood - current knowledge and open issues. Nat Rev Endocrinol. 2016;12(12):734-46. [Crossref] [PubMed]
- Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al; American Association Of Clinical Endocrinologists And American Thyroid Association Taskforce On Hypothyroidism In Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012;22(12):1200-35. Erratum in: Thyroid. 2013;23(2):251. Erratum in: Thyroid. 2013;23(1):129. [Crossref] [PubMed]
- Hennessey JV, Espaillat R. Diagnosis and management of subclinical hypothyroidism in elderly adults: a review of the literature. J Am Geriatr Soc. 2015;63(8):1663-73. [Crossref] [PubMed]
- Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014;13(4-5):391-7. [Crossref] [PubMed]
- Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian J Endocrinol Metab. 2016;20(4):554-7. [Crossref] [PubMed] [PMC]
- Sari R, Balci MK, Altunbas H, Karayalcin U. The effect of body weight and weight loss on thyroid volume and function in obese women. Clin Endocrinol (Oxf). 2003;59(2):258-62. [Crossref] [PubMed]
- Michalaki MA, Vagenakis AG, Leonardou AS, Argentou MN, Habeos IG, Makri MG, et al. Thyroid function in humans with morbid obesity. Thyroid. 2006;16(1):73-8. [Crossref] [PubMed]
- Bastemir M, Akin F, Alkis E, Kaptanoglu B. Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss Med Wkly. 2007;137(29-30):431-4. [Crossref] [PubMed]
- Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L, 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):4019-24. [Crossref] [PubMed]
- Duntas LH, Biondi B. The interconnections between obesity, thyroid function, and autoimmunity: the multifold role of leptin. Thyroid. 2013;23(6):646-53. [Crossref] [PubMed]
- García-Solís P, García OP, Hernández-Puga G, Sánchez-Tusie AA, Sáenz-Luna CE, Hernández-Montiel HL, et al. Thyroid hormones and obesity: a known but poorly understood relationship. Endokrynol Pol. 2018;69(3):292-303. [Crossref] [PubMed]
- Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol. 2010;316(2):165-71. [Crossref] [PubMed]
- Mehta S, Mathur D, Chaturvedi M, Devpura G, Jat VS. Thyroid hormone profile in obese subjects--a clinical study. J Indian Med Assoc. 2001;99(5):260-1, 272. [PubMed]
- Bhowmick SK, Dasari G, Levens KL, Rettig KR. The prevalence of elevated serum thyroid-stimulating hormone in childhood/adolescent obesity and of autoimmune thyroid diseases in a subgroup. J Natl Med Assoc. 2007;99(7):773-6. [PubMed] [PMC]
- Teixeira PFDS, Dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab. 2020;11:2042018820917869. [Crossref] [PubMed] [PMC]
- Juiz-Vali-a P, Outeiri-o-Blanco E, Pértega S, Varela-Rodriguez BM, García-Brao MJ, Mena E, et al. Effect of weight loss after bariatric surgery on thyroid-stimulating hormone levels in euthyroid patients with morbid obesity. Nutrients. 2019;11(5):1121. [Crossref] [PubMed] [PMC]
- Alkaç Ç, Akbaş F, Alkaç B, Usta Atmaca H. Obesity and thyroid functions. Journal of Academic Research in Medicine. 2014;4(2):74-6. [Crossref]
- Marzullo P, Minocci A, Tagliaferri MA, Guzzaloni G, Di Blasio A, De Medici C, et al. Investigations of thyroid hormones and antibodies in obesity: leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants. J Clin Endocrinol Metab. 2010;95(8):3965-72. [Crossref] [PubMed]
- Topaloğlu Ö, Sümer F, Çetin S, Yoloğlu S, Kayaalp C, Şahin İ. Alterations of thyroid functions in obesity: is there any impact of co-existence of type 2 diabetes mellitus? Turkish Journal of Diabetes and Obesity. 2018;2(1):23-7. [Link]
- Sosa-López JG, Alarcón-González P, Sánchez-Hernández VH, Cruz-Estrada A, Aguilar-Serralde CA, Velasco-Medina AA. Impact of obesity on the thyroid profile, long-term experience at the General Hospital of Mexico, "Dr. Eduardo Liceaga". Revista médica del Hospital General de México. 2021;84(1):4-10. [Crossref]
- Koritschoner NP, Alvarez-Dolado M, Kurz SM, Heikenwälder MF, Hacker C, Vogel F, et al. Thyroid hormone regulates the obesity gene tub. EMBO Rep. 2001;2(6):499-504. [Crossref] [PubMed] [PMC]
.: İşlem Listesi