Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals

Liu, C; Hua, Lin; Liu, K; Zhong, Xin

doi:10.1007/s40618-023-02035-1

Cited by 12 publications

(11 citation statements)

References 33 publications

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“…In another study, the authors also showed a significant negative relationship between TFQI and lumbar BMD in male participants. 21 Liu et al 22 showed that impaired sensitivity to thyroid hormone correlated to OP and fractures in euthyroid individuals.…”

Section: Discussionmentioning

confidence: 99%

“… 21 Liu et al . 22 showed that impaired sensitivity to thyroid hormone correlated to OP and fractures in euthyroid individuals.…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 19 Notably, reduced sensitivity to thyroid hormones was associated with T2DM and OP independently. 18 , 20 – 22 However, to our knowledge, the relationship between sensitivity to thyroid hormone indices and the risk of OP in patients with T2DM has not been reported, which highlights an important research gap. Therefore, we conducted a population-based study to gain new insights into the association between thyroid hormone sensitivity and OP risk in euthyroid men and women (in the postmenopausal stage) with T2DM.…”

Section: Introductionmentioning

confidence: 96%

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Association between sensitivity to thyroid hormone indices and osteoporosis in euthyroid patients with type 2 diabetes mellitus

Zhai

Chang

et al. 2023

Therapeutic Advances in Chronic Disease

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Background: Thyroid hormones are known to regulate bone metabolism and may influence bone mineral density (BMD), as well as the risk of osteoporosis (OP) and fractures in patients with type 2 diabetes mellitus (T2DM). Recently, sensitivity to thyroid hormone indices has been linked with T2DM and OP independently. However, the relationship between thyroid hormone sensitivity and OP in euthyroid T2DM patients has yet to be investigated. Objectives: The aim of this study was to determine the association between sensitivity to thyroid hormone indices and the risk of OP in euthyroid patients with T2DM. Design: This study employed a retrospective, cross-sectional design and utilized data acquired from the Cangzhou Central Hospital in China between 2019 and 2020. Methods: We retrospectively analyzed the data of 433 patients with T2DM for anthropometric measurements, clinical laboratory test results, and BMD. The thyroid-stimulating hormone index, thyrotroph thyroxine resistance index, and thyroid feedback quantile-based index (TFQI) were calculated to determine thyroid hormone sensitivity. Finally, multivariable logistic regression, generalized additive models, and subgroup analysis were performed to detect the association between sensitivity to thyroid hormone indices and the risk of OP in these patients. Results: We did not observe a statistically significant linear relationship between sensitivity to thyroid hormones indices and OP after covariate adjustment. However, a nonlinear relationship existed between TFQI and the prevalence of OP. The inflection point of the TFQI was at −0.29. The effect sizes (odds ratio) on the left and right of the inflection point were 0.07 [95% confidence interval (CI): 0.01–0.71; p = 0.024] and 2.78 (95% CI: 1.02–7.58; p = 0.046), respectively. This trend was consistent in older female patients with higher body mass index (BMI; 25–30 kg/m2). Conclusion: An approximate U-shaped relationship was observed between sensitivity to thyroid hormone indices and OP risk in euthyroid patients with T2DM with variations in sex, age, and BMI. These findings provide a new perspective to elucidate the role of thyroid hormones in OP, specifically in patients with T2DM.

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Section: Discussionmentioning

confidence: 99%

“… 21 Liu et al . 22 showed that impaired sensitivity to thyroid hormone correlated to OP and fractures in euthyroid individuals.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Association between sensitivity to thyroid hormone indices and osteoporosis in euthyroid patients with type 2 diabetes mellitus

Zhai

Chang

et al. 2023

Therapeutic Advances in Chronic Disease

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“…The process by which FT4 is converted to active FT3 can be assessed by the FT3/FT4 ratio, i.e., FT3 (pmol/L)/FT4 (pmol/L) ( 16 ). Central indices of thyroid hormone sensitivity were computed using the formulas presented below: TFQI was derived by applying the population empirical cumulative distribution function (cdf) to hormone concentration ( 5 ), representing the thyroid feedback quantile-based index; TFQI FT4 was determined as cdf FT4 − (1 − cdf TSH); TFQI FT3 was calculated as cdf FT3 − (1 − cdf TSH); the TFQI values range between −1 and 1, where negative and positive values denote good and poor sensitivity to FT4 or FT3, respectively ( 17 ); TT4RI was calculated as FT4 (pmol/L) * TSH (mIU/L) ( 4 ); TT3RI was calculated as FT3 (pmol/L) * TSH (mIU/L); TSHI was calculated as ln TSH (mIU/L) + 0.1345 * FT4 (pmol/L) ( 3 ). Higher values of TSHI, TT4RI, and TT3RI indicated reduced central sensitivity to thyroid hormones ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

Thyroid function and thyroid homeostasis parameters are associated with increased urinary albumin excretion in euthyroid individuals over 60 years old from NHANES

Liu,

Li,

Chai

et al. 2024

Front. Endocrinol.

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IntroductionThe relationship between thyroid function/homeostasis parameters and renal function has been extensively studied. However, the relationship between thyroid function and thyroid homeostasis parameters with albuminuria among elderly individuals remains unclear.MethodsThe population was divided into an albuminuria group and a non-albuminuria group for baseline characteristic difference analysis. Multivariable logistic regression was used to test the association between thyroid function, and thyroid homeostasis parameters and albuminuria. The nonlinear relationship was explored with restricted cubic splines. Meanwhile, we investigated whether the relationship also existed in the diabetes and hypertension subgroups. Receiver operating characteristic (ROC) curves were used to assess the effectiveness of the indices.ResultsFT4 and TFQIFT4 were positively correlated with albuminuria (OR = 1.12; 95% CI = 1.02–1.23, p = 0.02; OR = 1.79; 95% CI = 1.08–2.99, p = 0.03), and FT3/FT4 was negatively correlated with albuminuria (OR = 0.03; 95% CI = 0.00–0.26, p = 0.003). Additionally, the nonlinear relationship between FT3/FT4 as well as TSHI and albuminuria was approximately U-shaped. Similar results were observed in the hypertension subgroup but not in the diabetes subgroup. There was a U-shaped nonlinear relationship between FT3 and albuminuria in the diabetes group. In addition, FT3/FT4 performed better than TFQI, TT4RI, and TSHI in ROC analyses for albuminuria prediction.ConclusionFT4, TFQIFT4, and a low FT3/FT4 ratio were risk factors for albuminuria in euthyroid individuals over 60 years old. However, FT3 was more associated with albuminuria in the diabetes subgroup. TSH was not associated with albuminuria in any analysis. In our study, we attempted to provide more reasonable thyroid parameters and basis for evaluating patients with underlying albuminuria. FT3/FT4 may be used as a helpful indicator to predict albuminuria and provide novel ideas for the evaluation and treatment of albuminuria.

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“…Central resistance phenomena affect the feedback loop set point within the central nervous system, while peripheral resistance phenomena diminish the metabolic effects of hormones ( 20 ). Impaired thyroid sensitivity was associated with metabolic disorders, including osteoporosis ( 22 ), carotid plaque ( 23 ), and metabolic dysfunction-associated fatty liver disease ( 24 ). A study has indicated that elevated levels of resistance to thyroid hormone indices are associated with diabetes-related mortality in the general population of the United States ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Association of sensitivity to thyroid hormones with all-cause mortality in euthyroid US adults: a nationwide cohort study

Yu,

Liu,

Song

et al. 2024

European Thyroid Journal

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Background This study aimed to examine the associations of thyroid hormone sensitivity indices, including free triiodothyronine to free thyroxine (FT3/FT4) ratio, thyroid feedback quantile-based index by FT4 (TFQIFT4), thyroid-stimulating hormone index (TSHI), and thyrotrophic thyroxine resistance index (TT4RI) with all-cause mortality in euthyroid adults. Methods The study included 6243 euthyroid adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2012. FT3/FT4 ratio, TFQIFT4, TSHI, and TT4RI were calculated. The multivariable Cox proportional hazard regression, restricted cubic spline (RCS), and subgroup analysis were conducted. Results Individuals in quartile 4th (Q4) had lower all-cause mortality than those in quartile 1st (Q1) of FT3/FT4 ratio (OR 0.70, 95% CI (0.51, 0.94)). Regarding TFQIFT4, individuals in Q4 of TFQIFT4 had a 43% higher all-cause mortality than those in Q1 (OR 1.43, 95% CI (1.05, 1.96)) (P <0.05, all). Compared with participants in Q1, no associations of TSHI and TT4RI with mortality were found. TFQIFT4 was linearly and positively associated with mortality. However, the FT3/FT4 ratio showed a U-shaped association with mortality. Conclusions Increased risk for all-cause mortality was positively associated with TFQIFT4, suggesting that increased risk for all-cause mortality was associated with decreased central sensitivity to thyroid hormones. Furthermore, the FT3/FT4 ratio showed a U-shaped association with mortality, with an inflection point at 0.5. However, more cohort studies are needed to validate the conclusions.

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Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals

Cited by 12 publications

References 33 publications

Association between sensitivity to thyroid hormone indices and osteoporosis in euthyroid patients with type 2 diabetes mellitus

Association between sensitivity to thyroid hormone indices and osteoporosis in euthyroid patients with type 2 diabetes mellitus

Thyroid function and thyroid homeostasis parameters are associated with increased urinary albumin excretion in euthyroid individuals over 60 years old from NHANES

Association of sensitivity to thyroid hormones with all-cause mortality in euthyroid US adults: a nationwide cohort study

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