High free triiodothyronine and free-triiodothyronine-to-free-thyroxine ratio levels are associated with metabolic syndrome in a euthyroid population

Urrunaga-Pastor, Diego; Guarnizo-Poma, Mirella; Moncada–Mapelli, Enrique; Aguirre, Luis G.; Lázaro-Alcántara, Herbert; Paico-Palacios, Socorro; Pantoja-Torres, Betzi; Benítes-Zapata, Vicente A.

doi:10.1016/j.dsx.2017.12.003

Cited by 20 publications

(13 citation statements)

References 34 publications

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“…28 Cross-sectional studies in Korea and Peru suggested increased FT3 and FT3/FT4 ratio are associated with metabolic syndrome and insulin resistance. [29][30][31] The difference in these results may be explained by the study population. All participants with thyroid autoimmunity were excluded from our analysis.…”

Section: Discussionmentioning

confidence: 81%

<p>Thyroid Hormone Changes in Euthyroid Patients with Diabetes</p>

Qin

Zhang

Qing

et al. 2020

DMSO

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Background: Thyroid dysfunction is associated with diabetes, but it is unclear if the thyroid hormone levels change in euthyroid adults with diabetes. Objective: To investigate the association between thyroid hormone levels and diabetes in euthyroid adults. Methods: Among the euthyroid adults who underwent health examination in West China Hospital of Sichuan University in 2016, patients with diabetes were identified according to the medical history, fasting blood glucose and HbA1c. Age and sex matched controls were identified from the population. The patients with diabetes group was further divided into two subgroups: patients with newly diagnosed diabetes (NDD) and with previously diagnosed diabetes (PDD). Independent t-test and multivariate logistic regression models were used to investigate the difference in the levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and the ratio of FT4/FT3 between groups. Results: We included 32,557 participants, 2,271 with diabetes. Compared to the adults without diabetes, the odds ratios (ORs) per one unit elevation of TSH, FT4, FT4/FT3 ratio and FT3 in patients with diabetes were 0.88 [95% confidence interval (CI): 0.82-0.95], 1.11 (95% CI: 1.08-1.14), 2.05 (95% CI: 1.81-2.32) and 0.85 (95% CI: 0.78-0.93), respectively. Compared to the NDD group, the ORs per one unit elevation of TSH, FT4, FT4/FT3 ratio and FT3 of the PDD group were 0.81 (95% CI: 0.71-0.92), 1.08 (95% CI: 1.04-1.12), 1.76 (95% CI: 1.49-2.08) and 1.01 (95% CI: 0.92-1.12), respectively. Conclusion: In euthyroid adults, diabetes was associated with increased FT4/FT3 ratio, which is linked to the peripheral turnover of the thyroid hormones.

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Section: Discussionmentioning

confidence: 81%

<p>Thyroid Hormone Changes in Euthyroid Patients with Diabetes</p>

Qin

Zhang

Qing

et al. 2020

DMSO

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“…It could explain that FT3, but not FT4, was correlated with the atherosclerosis prevalence in this study. Unlike euthyroid T2D patients, FT3 levels were increased but not decreased in euthyroid and nondiabetic adults [ 25 ]. The possible reason could be that, in adults with insulin resistance, T3 was elevated to directly stimulate the uptake of glucose.…”

Section: Discussionmentioning

confidence: 99%

Clinical Associations of Thyroid Hormone Levels with the Risk of Atherosclerosis in Euthyroid Type 2 Diabetic Patients in Central China

Wang

Chen

Yu³

et al. 2020

International Journal of Endocrinology

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Background. Thyroid function is associated with the etiology and pathogenesis of type 2 diabetes (T2D) and potentially contributes to the development of the complications of T2D. The association of thyroid hormones with atherosclerosis in euthyroid T2D patients is not clear. Purpose. To investigate the association of thyroid hormone levels with the risk of developing atherosclerosis in euthyroid T2D patients in Central China. Methods. This cross-sectional study recruited 910 euthyroid T2D patients from Henan Provincial People’s Hospital, China. Association among hemoglobin A1c (HbA1c), thyroid hormones, and the prevalence of atherosclerosis was assessed by multivariable Cox models after adjusting for covariates including age, BMI, duration of T2D, smoking status, SBP, TC, family history of T2D, and medications on hyperlipidemia. Results. Among all 910 subjects, 373 were diagnosed with atherosclerosis. There were 523 females and 387 males included in this study. The mean age was 51.9 years. The average BMI was 25.3 kg/m2. Low-normal serum-free triiodothyronine (FT3) levels (3.50–4.17 pmol/L) were associated with a high prevalence of atherosclerosis. Comparing with low-normal FT3, the prevalence ratio in patients with mid- (4.17–4.83 pmol/L) and high-normal FT3 level (4.83–6.50 pmol/L) is 0.74 (95% CI 0.56 to 0.97, p=0.029) and 0.63 (95% CI 0.46 to 0.87, p=0.005) after adjusting for covariates. High level of free thyroxine (FT4) also had decreased risk for atherosclerosis. Thyroid-stimulating hormone (TSH) and FT3 to FT4 ratio did not show significant association with the development of atherosclerosis. Conclusion. T2D patients with low but clinically normal FT3 level are more likely to develop macrovascular complications comparing with those with mid- and high-normal FT3 level.

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“…Elevated levels of the FT3/FT4 ratio were associated with metabolic syndrome and some of its components such as obesity, elevated triglycerides, fasting blood glucose levels, and lower high-density lipoprotein cholesterol levels in euthyroid subjects [19,20]. Based on regression analysis in a sample of 132,346 adults, Park et al confirmed the FT3/FT4 ratio to have a better predictive power for metabolic syndrome than TSH [21].…”

Section: The Most Common Cause Of Hypothyroidism In Iodine-sufficientmentioning

confidence: 99%

Free triiodothyronine/free thyroxine (FT3/FT4) ratio is strongly associated with insulin resistance in euthyroid and hypothyroid adults: a cross-sectional study

Štěpánek

Horáková

Štěpánek

et al. 2021

Endokrynologia Polska

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High free triiodothyronine and free-triiodothyronine-to-free-thyroxine ratio levels are associated with metabolic syndrome in a euthyroid population

Cited by 20 publications

References 34 publications

<p>Thyroid Hormone Changes in Euthyroid Patients with Diabetes</p>

<p>Thyroid Hormone Changes in Euthyroid Patients with Diabetes</p>

Clinical Associations of Thyroid Hormone Levels with the Risk of Atherosclerosis in Euthyroid Type 2 Diabetic Patients in Central China

Free triiodothyronine/free thyroxine (FT3/FT4) ratio is strongly associated with insulin resistance in euthyroid and hypothyroid adults: a cross-sectional study

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