Fatty liver largely explains associations of subclinical hypothyroidism with insulin resistance, metabolic syndrome, and subclinical coronary atherosclerosis

Abstract

Background: The association of subclinical hypothyroidism (SCH) with insulin resistance, metabolic syndrome (MS), and coronary atherosclerosis is uncertain. Objective: To investigate the role of increased intrahepatic fat in the association of SCH with insulin resistance, MS, and coronary atherosclerosis. Design, patients, and methods: We conducted a cross-sectional study in a sample of 753 subjects (46% males) aged 35-70 years with no history of diabetes, renal, hepatic, thyroid, or coronary heart disease, and were participants of the Genetics of Atherosclerotic Disease study. SCH was defined as a high serum TSH level with normal free thyroxine concentration. Fatty liver (FL), coronary artery calcification (CAC), and abdominal visceral adipose tissue were assessed by computed tomography. Cross-sectional associations of SCH with and without FL, with MS, insulin resistance, and subclinical atherosclerosis defined as a CAC score O0, were examined in logistic regression models. Results: SCH was observed in 17.7% of the population studied. The prevalence of FL was similar in both euthyroid and SCH subjects (31.8 vs 27.8%, PZ0.371). SCH plus FL subjects were heavier and had more metabolic abnormalities compared with SCH plus normal liver subjects. In multivariate-adjusted logistic regression analyses, SCH plus FL was associated with MS (odds ratio (OR): 2.73, 95% CI: 1.26-5.92), insulin resistance (OR: 4.91, 95% CI: 1.63-14.75), and CAC score O0 (OR: 3.05, 95% CI: 1.20-7.76). SCH without FL showed no associations. Conclusion: SCH with FL is associated with increased odds of MS, insulin resistance, and CAC, independent of potential confounders.

Subclinical Hypothyroidism is Associated with Atherogenic Lipid Profile in Postmenopausal Women

“…Posadas-Romero et al (24) found that patients with subclinical hypothyroidism have significantly higher triglyceride levels and decreased HDL-C. Similar results were observed by Siemiński et al (25), who found elevated serum concentrations of cholesterol and triglycerides, while HDL-C was lower in women with subclinical hypothyroidism compared to the euthyroid postmenopausal women.…”

Deficiencia de vitamina D y su asociación con enfermedad arterial coronaria en población mexicana: estudio Genético de la Enfermedad Aterosclerosa

“…El grupo control se formó con voluntarios de la población abierta, sin manifestaciones clínicas de EAC y sin antecedentes familiares de EAC prematura, que acudieron por invitación a través de medios escritos. De ambos grupos se excluyeron los pacientes con enfermedad renal, hepática o tiroidea, con enfermedades malignas o bien que tuvieran tratamiento con corticosteroides 16 . El proyecto fue aprobado por el Comité de Ética del Instituto Nacional de Cardiología Ignacio Chávez y realizado de acuerdo con los lineamientos de la Declaración de Helsinki.…”

Improving cardiovascular health in Spanish seafarers

“…We decided to include in this work the measurement of following parameters in a selected group: glycated haemoglobin (HbA1c) [4][5][6][7], high-sensitivity C-reactive protein (hs-CRP) [8][9][10], thyrotropin (TSH) [11][12][13][14], microalbuminuria [15][16][17], especially for their good cost-efficiency and easy accessibility.…”