The Relationship Between Metabolic Parameters, Age, and Thyroid Status: A Cross-Sectional
      Study-Based National Survey of Iodine Nutrition, Thyroid Disease

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Abstract

Aim

The relationship between thyroid status and metabolic factors was investigated as well as iodine nutrition in the general population and among the elderly population.

Methods

We performed a cross-sectional survey of 2483 subjects to assess the status of national iodine nutrition and incidence of thyroid disease. The general and elderly populations were divided into normal thyroid function (NTF) and subclinical hypothyroidism (SCH) groups. The anthropometric parameters and biochemical indicators were then analyzed.

Results

Overall, 327 participants were diagnosed with thyroid diseases, 73 (22.32%) of whom were 65 years or older. For the general population, compared with the NTF group, individuals in the SCH group were older, presented with higher systolic blood pressure, fasting blood glucose, serum cholesterol, and urinary iodine concentration (all p<0.05) but lower blood uric acid (UA) (p<0.05). Linear regression analysis further revealed that age and triglyceride (TG) serum levels positively correlated with serum thyroid-stimulating hormone (TSH) levels. Multiple regression analyses revealed that age, TG, waist circumference (WC), and body mass index were independent predictors for abnormal TSH serum levels. For the elderly population, compared with NTF group, individuals in the SCH group were substantially older (p<0.05) but presented with lower UA (p<0.05). Pearson linear regression analysis revealed a positive correlation between age (p=0.003) as well as TG levels (p<0.001) and serum TSH levels. In contrast, WC (p=0.003) was negatively related to TSH serum levels. Further multiple regression analysis revealed that age, TG, WC and heart rate were independent predictors of blood TSH.

Conclusion

The large-scale national study of iodine nutrition, thyroid disease has shown a vital relationship between metabolic indicators and serum TSH levels. Age and metabolic diseases increase the likelihood of developing thyroid diseases, both the general population and among the elderly.

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Most cited references 25

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Global epidemiology of hyperthyroidism and hypothyroidism

Peter N Taylor, Colin M. Dayan, Onyebuchi Okosieme … (2018)

Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology. In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. However, continued vigilance against iodine deficiency remains essential in developed countries, particularly in Europe. In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

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The Colorado Thyroid Disease Prevalence Study

Gay Canaris, Neil R. Manowitz, Gilbert Mayor … (2000)

The prevalence of abnormal thyroid function in the United States and the significance of thyroid dysfunction remain controversial. Systemic effects of abnormal thyroid function have not been fully delineated, particularly in cases of mild thyroid failure. Also, the relationship between traditional hypothyroid symptoms and biochemical thyroid function is unclear.

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Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism.

Martin Surks, J Hollowell (2007)

Measurements from all age groups defined the upper limit of the TSH reference range in National Health and Nutrition Examination Survey III. The TSH median, 97.5 centile and prevalence of subclinical hypothyroidism (SCH), normal serum T(4) and TSH greater than 4.5 mIU/liter, increased progressively with age. Age-adjusted reference ranges would include many people with TSH greater than 4.5 mIU/liter. We determined whether increasing 50 and 97.5 centiles with age resulted from more patients with SCH in populations with normal TSH distribution or whether age-specific population shifts to higher serum TSH might account for these findings. We analyzed TSH, antithyroid antibodies, and TSH frequency distribution curves for specific age deciles in populations without thyroid disease, with or without antithyroid antibodies. Without thyroid disease, 10.6% of 20- to 29-yr-olds had TSH greater than 2.5 mIU/liter, increasing to 40% in the 80+ group, 14.5% of whom had TSH greater than 4.5 mIU/liter. When TSH was greater than 4.5 mIU/liter, the percentage with antibodies was 67.4% (age 40-49 yr) and progressively decreased to 40.5% in the 80+ group. TSH frequency distribution curves of the 80+ group with or without antibodies was displaced to higher TSH, including TSH at peak frequency. The 97.5 centiles for the 20-29 and 80+ groups were 3.56 and 7.49 mIU/liter, respectively. Seventy percent of older patients with TSH greater than 4.5 mIU/liter were within their age-specific reference range. TSH distribution progressively shifts toward higher concentrations with age. The prevalence of SCH may be significantly overestimated unless an age-specific range for TSH is used.

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Author and article information

Journal

Journal ID (nlm-ta): Risk Manag Healthc Policy

Journal ID (iso-abbrev): Risk Manag Healthc Policy

Journal ID (publisher-id): rmhp

Journal ID (pmc): rmhp

Title: Risk Management and Healthcare Policy

Publisher: Dove

ISSN (Electronic): 1179-1594

Publication date (Electronic): 23 April 2021

Publication date Collection: 2021

Volume: 14

Pages: 1723-1730

Affiliations

[1 ]Department of Endocrinology, Chongqing University Central Hospital, Chongqing Emergency Medical Center , Chongqing, 400014, People’s Republic of China

[2 ]Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University , Luzhou, Sichuan, 646000, People’s Republic of China

Author notes

Correspondence: Xiaodong Duan Email duanxiaodong2032@sina.com

[*]

These authors contributed equally to this work

Article

Publisher ID: 306122

DOI: 10.2147/RMHP.S306122

PMC ID: 8079349

PubMed ID: 33935526

SO-VID: 078b2327-46bc-4890-acd9-59c4bc16aa76

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 13 February 2021

Date accepted : 31 March 2021

Page count

Figures: 2, Tables: 12, References: 25, Pages: 8

Funding

Funded by: Chongqing Science and Technology Bureau and Health Commission Foundation Medical Research Funding;

Funded by: Chongqing University for Fundamental Research Funds of Central Universities;

This work is funded by Chongqing Science and Technology Bureau and Health Commission Foundation Medical Research Funding (No.2020GDRC023 & No.2020FYYX122), Chongqing University for Fundamental Research Funds of Central Universities (2019CDYGYB020).

The Relationship Between Metabolic Parameters, Age, and Thyroid Status: A Cross-Sectional Study-Based National Survey of Iodine Nutrition, Thyroid Disease

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King Salman Center for Disability Research - Sponsored Research Output

Most cited references 25

Global epidemiology of hyperthyroidism and hypothyroidism

The Colorado Thyroid Disease Prevalence Study

Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism.

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