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- Title
Relationship of TSH Levels with Cardiometabolic Risk Factors in US Youth and Reference Percentiles for Thyroid Function.
- Authors
Xinlei Chen; Shuliang Deng; Sena, Cecilia; Chuhan Zhou; Thaker, Vidhu V.; Chen, Xinlei; Deng, Shuliang; Zhou, Chuhan
- Abstract
<bold>Context: </bold>Thyroid hormones play an important role in metabolic homeostasis, and higher levels have been associated with cardiometabolic risk.<bold>Objective: </bold>To examine the association of cardiometabolic risk factors with TSH levels in US youth.<bold>Methods: </bold>Cross-sectional study of youth aged 12 to 18 years without known thyroid abnormalities from 5 National Health and Nutrition Examination Survey cycles (n = 2818) representing 15.4 million US children. Subclinical hypothyroidism (SH) was defined as thyrotropin (TSH) levels of 4.5 to 10 mIU/L. Assessed cardiometabolic risk factors include abdominal obesity (waist circumference >90th percentile), hypertriglyceridemia (triglyceride ≥130 mg/dL), low high-density lipoprotein cholesterol (<40 mg/dL), elevated blood pressure (systolic and diastolic blood pressure ≥90th percentile), hyperglycemia (fasting blood glucose ≥100 mg/dL, or known diabetes), insulin resistance (homeostatic model for insulin resistance > 3.16), and elevated alanine transferase (≥ 50 for boys and ≥44 U/L for girls). Age and sex- specific percentiles for thyroid parameters were calculated.<bold>Results: </bold>In this cohort of youth (51.3% male), 31.2% had overweight/obesity. The prevalence of SH was 2.0% (95% CI 1.2-3.1). The median TSH levels were higher in youth with overweight/obesity (P < 0.001). Adjusting for age, sex, race/ethnicity, and obesity, youth with TSH in the fourth quantile had higher odds of abdominal obesity (OR 2.53 [1.43-4.46], P = .002), insulin resistance (OR 2.82 [1.42-5.57], P = .003), and ≥2 cardiometabolic risk factors (CMRF) (OR 2.20 [1.23-3.95], P = .009).<bold>Conclusion: </bold>The prevalence of SH is low in US youth. The higher odds of insulin resistance and cardiometabolic risk factors in youth with TSH levels >75th percentile requires further study.
- Subjects
THYROID hormone regulation; THYROTROPIN; CHOLESTEROL metabolism; THYROID gland; SKELETAL muscle
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 3, pe1221
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa900