The Study Of The Relationship Between Thyroid Function And Components Of The Metabolic Syndrome

ObjectiveWe uesd the data from epidemiology to explore the hypothesis that thyroid hormone is associated with components of the metabolic syndrome,and provided evidence for mild thyroid dysfunction and normal thyroid function to prevent diabetes mellitus and cardiovascular disease.MethodsA total of 549 adult inhabitants were asked to fullfill the questionnaire in Shanghai Huashan Hospital,Subjects who were thyroid dysfunction and taking thyroid medication or medicine influencing the thyroid function were excluded.Finally, 496 subjects aged(19-94) years were enrolled and needed to fill the questionnaire in details,accepted physical examination,drawn vein blood.The sera were measured for thyrotropin(TSH),fasting plasma glucose(FPG),postprandial blood glucose(PBG),fasting insulin(FINS ),glycosylated hemoglobin (HBAlC),triglyceride(TG),HDL-cholesterol. Homeostasis model assessment for insulin resistance(HOMA-IR ) was cauculated.Body mass index(BMI) was cauculated as the ratio between weight and height squared(kg/m~2).The Metabolic Syndrome was defined according to Chinese Medical Association Diabetes Association(CDS) criteria.According to the criteria of thyroid disease,we put theses subjects into hypothyroidism, hyperthyroidism,normal thyroid function,and then according to the epidemiological data of shanghai foudings that TSH between 1.0-1.9 mlU/L was safe,we divided the group of normal thyroid function into low(0.35＜TSH＜1.0 mlU/L),moderate(1.0≤TSH≤1.9mlU/L),high(1.9＜TSH＜5.5mlU/L) subgroups.According to the CDS criteria put theses subjects into MS group and non-MS group. Results1.The relationship between TSH and the prevale-nce of MS and its components:the prevalence of hypertension was higher in the group of hypothyroidism than which in the group of normal thyroid function(P＜0.05,OR＝1.80.There was no differences among patients in groups of hypothyroidism,hyperthyroidism and normal thyroid function about MS and its other components(P＞0.05).2.Comparison the components of MS between different serum TSH hypothyroidism had significantly increased TG and decreased HDL-C when compared to those in the group of normal thyroid function(P=0.007,P=0.005 respectively).Other compinents of MS have no differences among patients of hypothyroidism, hyperthyroidism and normal thyroid function(P＞0.05).3.Comparison the serum TSH between groups of MS and non-MS:Serum TSH in the group of Metabolic Syndrome was higher than which in the group of non Metabolic Syndrome(2.242 vs 2.024,P=0.019).4.The relationship between serum TSH within the reference range and the prevalence of MS and its components:within the reference range of serum TSH,adjustment for gender,age and HOMA-IR,comparing TSH of 1.00-1.90 mlU/L(moderate tertile of the reference range) with TSH of 1.90-5.5 mlU/L(upper tertile of the reference range),the odds ratio for over weight/obesity was 1.126(95%CI 0.951-1.400).Adjustment for gender and age,the relationship between serum TSH within the reference range and dyslipidemia was significant(P＜0.05);but adjustment for HOMA-IR and BMI,this relationship was not significant (P=0.173).Adjustment for gender,age,HOMA-IR and BMI,the relationship between serum TSH within the reference range and the prevence of hypertension, elevated glucose and MS were not related(P＞0.05).5.The relationship between serum TSH within the reference range and the components of MS:in the linear regression model,serum TSH is positively related with BMI(β=0.921,P=0.022),but not related with SBP,DBP,TG, HDL-C,FBG,PBG(P＞0.05).In the multiple linear regression,adjustment for gender,age,HOMA-IR and BMI,the relationship between serum TSH and BMI bacame more significant(β＝1.316,P＝0.001),the relationship between serum TSH and TG became significant(P＝0.066,P＝0.016),but the relationship between serum TSH and DBP was not significant(P＞0.05).Further adjustment for BMI,the relationship between serum TSH and TG was not shown (P＞0.05).Adjustment for gender,age,HOMA-IR and BMI,there were no significant relationships between serum TSH and SBP,DBP,TG,HDL-C, FBG,PBG(P＞0.05).6.Serum TSH within the reference range and insulin resistence:Adjustment for gender,age and BMI,there were no significant relationship between serum TSH and HOMA-IR(P＞0.05).Serum TSH was related with FINS significantly(P＝0.057,P＝0.021).Adjustment for gender,age,the relationship was still existing (P＝0.059,P=0.016).7.Serum TSH within the reference range and waist circum ference:adjustment for gender,age and HOMA-IR,serum TSH was positively related with waist circumference.(P＝3.073,P＜0.05)Conclusions1.The prevalence of hypertension was higher in the group of hypothyroidism than which in the group of normal thyroid function;2.Hypothyroidism had significantly increased TG and decreased HDL-C when compared to those in the group of normal thyroid function;3.Serum TSH in the group of Metabolic Syndrome was higher than which in the group of non-Metabolic Syndrome;4.Within the reference range of TSH,the prevalence of overweight/obesity and BMI was positively related with the TSH.5.Slightly increased serum TSH maybe a risk factor of Metabolic Syndrome. ObjectiveTo investigate thyroid function in patients with dyslipdimia,and study the relationship between dyliPidemia and thyroidfunction.MethodsA total of 549 adult inhabitants were asked to fullfill the questionnaire in shan ghai huashan hospital,Subjects who were enrolled and needed to fill the quest ionnaire in details,accepted physical examination,drawn vein blood.The sera were measured for thyrotropin(TSH),fasting plasma glucose(FPG),Postpr andial blood glucose(PBG),fasting insulin(FINS),Glycosylated hemoglobin (HBAlC),triglyceride(TG),HDL-cholesterol.Body mass index(BMI) was cauculated as the ratio between weight and height squared(in kg/m~2).Dyslip idemia in patients with the diagnosis to be in line with the U.S.National Chol esterol Education Program Adult Treatment Group Third Gui de(ATPⅢ).E xclusion criteria:one of the following patients are excluded from the study:1. Have been suffering from diabetes or other en-docrine diseases;2.Is using t he drugs which may affect thyroid function and lipid levels;3.Recently suffe ring from acute diseases(such as myocardial infarction or pneumonia,etc.);4. malignancies,chronic infections,or serious heart diseases,liver,renal failure; 5.pregnant women,or one year after childbirth.Finally,428 adults into the grou p.According to the diagnostic criteria ofdyslipidemia,428 subjects were divid ed into dyslipidemiagroup and the control group.Testing thyroid function toc ompare the prevalence of thyroid dysfunction rate and other parameters. Results:1.the prevalence of thyroid dysfunction in the dyslipidemia group was higher than in the control group.The rate of thyroid dysfunction of women in the dyslipidemia group of was significantly higher than the proportion of women(P＝0.022),while the men the prevalence of thyroid dysfunction rate was no significant difference(p＝0.241).2.The prevalence rates of Dyslipidemia group hyperthyroidism,subclinical hyperthyroidism,hypothyroidism and subclinical hypothyroidism were 0.2%,2.7%, 0.8%and 13.6%.The prevalence of subclinical hypothyroidism was significantly higher(P＝0.06)3.In The dyslipidemia group,the prevalence rate of hyperthyroidism,subclinical hyperthyroidism in all ages there is no significant difference.However, hypothyroidism and subclinical hypothyroidism in the 50-year-old and above population the prevalence rate was significantly higher(P＝0.000).the prevalence of Hypothyroidism,subclinical hypothyroidism increases with age increased.4.The risk factors of throid dysfunction in the dyslipidemia group were femail and The high-density lipoprotein cholesterol reduce.Conclusions:The old women with dyslipidemia will have a higher rate of thyroid dysfunction. Screening for thyroid function is a work that can not be ignored.especially for the patients who are women and have lower HDL-C level.