Thyroid hormones modulate uric acid metabolism in patients with recent onset subclinical hypothyroidism by improving insulin sensitivity

Desideri, Giovambattista; Bocale, Raffaella; D'Amore, Annamaria; Carnassale, Giulia; Necozione, Stefano; Barini, Angela; Barini, Angelina; Lombardi, Celestino Pio

doi:10.1007/s11739-019-02065-9

Cited by 19 publications

(20 citation statements)

References 23 publications

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“…An increase in hyperuricemia rates was observed in patients with hypothyroidism [10] and in patients with subclinical hypothyroidism [11] compared to the general individuals, but no relationship between hypothyroidism and hyperuricemia was found in these studies. Moreover, another research reported no relationship between SUA and thyroid hormones in patients with thyroid dysfunction [20]. However, the majority of previous studies are consistent with our ndings.…”

Section: Discussionsupporting

confidence: 91%

Association between Decreased Thyroid Stimulating Hormone and Hyperuricemia in Type 2 Diabetic Patients with Early-stage Diabetic Kidney Disease

Feng

Huang

Yan³

et al. 2020

Preprint

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Background Serum uric acid (SUA) is associated with the development of diabetic kidney disease (DKD). Thyroid hormones can regulate metabolism and insulin resistance. The relationship between SUA and thyroid function is still uncertain. Methods 254 type 2 diabetic patients with early-stage DKD were enrolled in current study and were further classified as high SUA group (SUA > 360 µmol/L, n = 126) and normal SUA group (SUA ≤ 360 µmol/L, n = 128). 85 control subjects were recruited as control group. The clinical characteristics were obtained via face-to-face surveys and medical records. Results Compared with normal SUA group and control group, high SUA group exhibited the increased SUA, free triiodothyronine and free thyroxine levels, and the decreased thyroid stimulating hormone (TSH) level (P < 0.017 for all), and no significant difference was detected in these parameters between normal SUA group and control group. Furthermore, the increased creatinine (β = 2.049, P < 0.001), triglycerides (β = 10.068, P < 0.001), urinary albumin-to-creatinine ratio (β = 0.262, P = 0.001), fasting blood glucose (β = 5.280, P = 0.003) and fasting insulin (β = 1.440, P = 0.034) levels, and the decreased TSH (β = -24.906, P < 0.001) level were independently correlated with higher SUA level in type 2 diabetic patients with early-stage DKD. Notably, decreased TSH retained a significant association (odds ratio = 1.654, P = 0.002) with hyperuricemia in type 2 diabetic patients with early-stage DKD. Conclusions TSH is negatively correlated with SUA, and decreased TSH is an independent risk factor for hyperuricemia in type 2 diabetic patients with early-stage DKD. These results indicate that thyroid hormones, TSH in particular, might participate in regulating uric acid metabolism in patients with early-stage DKD.

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Section: Discussionsupporting

confidence: 91%

Association between Decreased Thyroid Stimulating Hormone and Hyperuricemia in Type 2 Diabetic Patients with Early-stage Diabetic Kidney Disease

Feng

Huang

Yan³

et al. 2020

Preprint

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“…Currently, some studies have pointed out that the correlation between thyroid hormone and uric acid level, but this correlation is still controversial. A recent study suggests that thyroid hormone may regulate uric acid levels in patients with subclinical hypothyroidism by regulating insulin resistance [1]. In a study of hyperuricemia, hypothyroidism was found to be a risk factor for men more than women, leading the researchers to consider the effects of sex hormones [2].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of the Correlation between Uric Acid and Thyroid Hormone in People with Normal Thyroid Function

Chao

Zhu

Fang

2019

Journal of Diabetes Research

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Objective. This study adopts the method of retrospective analysis to collect general information and laboratory results of physical examination population, hoping to clarify the correlation between uric acid and thyroid hormone. Methods. The subjects of the study were healthy subjects who underwent physical examination at the Sir Run Run Shaw Hospital affiliated to the Medical College of Zhejiang University from January 2016 to December 2018. Demographic information and medical history of all subjects were recorded through an electronic health system. Serum uric acid (SUA) was grouped by quartiles. Statistical analyses were performed with R version 3.5.1. Results. A total of 48,526 subjects were included in the analysis. Gender ratio, age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, FBG, HbA1c, TG, HDL-C, ALT, AST, FT3, FT4, and TSH were significantly different among the uric acid groups. The regression coefficients of SUA in the TSH, FT3, and FT4 regression models were B=1.000 (95% CI 1.000-1.000, p=0.009), B=0.999 (95% CI 0.999-0.999, p<0.001), and B=1.001 (95% CI 1.001-1.001, p<0.001), respectively. There was a significant dose-dependent relationship between FT4, FT3, and SUA gradient. Conclusions. Under normal thyroid function, there were significant differences in TSH, FT3, and FT4 between groups with different uric acid levels. Uric acid levels were linearly correlated with FT3 and FT4, but not with TSH.

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“…Hyperuricemia. Monitoring of uric acid levels in TD may be needed as TH replacement therapy can improve insulin sensitivity in SHypo patients and modulate the uric acid levels[89].…”

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confidence: 99%

Thyroid Dysfunction and Dysmetabolic Syndrome: The Need for Enhanced Thyrovigilance Strategies

Kalra

Aggarwal²,

Khandelwal

2021

International Journal of Endocrinology

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Thyroid dysfunction (TD) is common in metabolic disorders such as diabetes mellitus (DM), cardiovascular disease (CVD), obesity, dyslipidemia, hyperuricemia, kidney and liver dysfunctions, and polycystic ovary syndrome (PCOS). Subclinical hypothyroidism (SHypo) worsens glycemic control in patients with DM, and these patients, especially those with Type-1DM, have higher prevalence of TD. Both TD and DM increase CVD risk. Even minor alteration in thyroid hormone (TH) levels can alter cardiovascular function. While hyperthyroidism increases systolic blood pressure and leads to high-output heart failure, hypothyroidism increases diastolic blood pressure and leads to low-output heart failure. Chronic subclinical hyperthyroidism (SHyper) and SHypo both increase the risk of hypertension, coronary artery disease (CAD) events, CAD deaths, and total deaths. SHyper alters cardiac morphology and function. SHypo causes dyslipidemia and endothelial dysfunction and increases the risk for weight gain and obesity. Overweight and obese patients often have hyperleptinemia, which increases the secretion of thyroid stimulating hormone (TSH) and induces TD. Dyslipidemia associated with TD can increase serum uric acid levels. Hyperuricemia promotes inflammation and may increase the risk for dyslipidemia, atherosclerosis, and CVD. TD increases the risk for developing chronic kidney disease. In nephrotic syndrome, proteinuria is associated with urinary loss of TH leading to TD. Some correlation between TD and severity of liver disease is also seen. TD and PCOS have common risk factors and pathophysiological abnormalities. Hypothyroidism must be excluded before diagnosing PCOS. Current guidelines do not strongly recommend thyroid screening in the presence of all metabolic disorders. However, pragmatic thyrovigilance is required. Clinicians must stay alert to signs and symptoms of TD, maintain high clinical suspicion, and investigate thoroughly. Drug-induced TD should be considered when TH levels do not match clinical findings or when patients are on medications that can alter thyroid function.

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Thyroid hormones modulate uric acid metabolism in patients with recent onset subclinical hypothyroidism by improving insulin sensitivity

Cited by 19 publications

References 23 publications

Association between Decreased Thyroid Stimulating Hormone and Hyperuricemia in Type 2 Diabetic Patients with Early-stage Diabetic Kidney Disease

Association between Decreased Thyroid Stimulating Hormone and Hyperuricemia in Type 2 Diabetic Patients with Early-stage Diabetic Kidney Disease

Retrospective Analysis of the Correlation between Uric Acid and Thyroid Hormone in People with Normal Thyroid Function

Thyroid Dysfunction and Dysmetabolic Syndrome: The Need for Enhanced Thyrovigilance Strategies

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