Independent associations of thyroid-related hormones with hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults

Abstract

Purpose The aim of the study is to explore the independent association of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance. Methods A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)], hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China. Results Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4 ± 44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1–3, respectively, p = 0.007) and fatty liver index (FLI) score (47.7 (33.9–60.8), 61.5 (45.1–88.9) and 90.5 (84.5–94.8), respectively, p < 0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (β (95%CI): 0.024 (0.004–0.043), p = 0.020), HOMA-IR (β (95%CI): 0.091 (0.007–0.174), p = 0.034), CAP (β (95%CI): 25.45 (2.59–48.31), p = 0.030) and FLI (β (95%CI): 0.121 (0.049–0.194), p = 0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis. Conclusions Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults. Trial registration Registration is not applicable for our study.

Correlation between thyroid function, sensitivity to thyroid hormones and metabolic dysfunction-associated fatty liver disease in euthyroid subjects with newly diagnosed type 2 diabetes

“…But unlike the consistent ndings regarding thyroid dysfunction and NAFLD, discrepancies were shown in studies based on euthyroid subjects. For FT3, we found that high-normal FT3 was associated with increased risk of MAFLD, which is in line with a series of studies [12,[38][39][40][41]. As shown by Gu et al, high-normal FT3 was independently associated with a higher incidence of NAFLD in middle-aged and older euthyroid subjects [38].…”

“…A large cross-sectional study in euthyroid subjects demonstrated a positive association between FT3 and the risk of NAFLD [40]. Also, in euthyroid overweight/obese adults, increased FT3 was indicated to be independently associated with higher risk of hepatic steatosis [39]. Contradictory results were indicated in a few studies.…”

Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes

“…53 Another study in euthyroid overweight/obese individuals indicated that increased FT3 was independently associated with higher risks of insulin resistance. 54 FT3 and FT4 positively and negatively correlated with HOMA-IR and atherogenic lipid profiles, respectively, in a euthyroid population with obesity. 55 In euthyroid subjects, serum FT4 was negatively associated with and TSH was positively associated with insulin resistance.…”

Relationship Between Thyroid Hormone and Liver Steatosis Analysis Parameter in Obese Participants: A Case-Control Study

“… 33 In the study by Ma et al, the mean (±SD) of age was 30.0±7.2 years old. 35 Thirdly, the disease characteristics of the study population were different among studies. In the studies by Tao et al, 37 Xu et al, 36 Ma et al 35 and van den Berg et al 32 euthyroid participants were selected.…”

“… 35 Thirdly, the disease characteristics of the study population were different among studies. In the studies by Tao et al, 37 Xu et al, 36 Ma et al 35 and van den Berg et al 32 euthyroid participants were selected. In the study by Ding et al 34 patients with hepatitis B virus were enrolled.…”