Journal Article

Relationship of TSH Levels with Cardiometabolic Risk Factors in US Youth and Reference Percentiles for Thyroid Function

Sena, Cecilia, Thaker, Vidhu V, Chen, Xinlei, Zhou, Chuhan, Deng, Shuliang

2021

Overview

Abstract Context Thyroid hormones play an important role in metabolic homeostasis, and higher levels have been associated with cardiometabolic risk. Objective To examine the association of cardiometabolic risk factors with TSH levels in US youth. Methods 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. Results 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). Conclusion 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.

• Publisher: Oxford University Press,Copyright Oxford University Press
• Subject: Adolescent / Adolescent Health / Blood pressure / Blood sugar / Body weight / Cardiometabolic Risk Factors / Child / Children / Cholesterol / Clinical s / Cohort Studies / Cross-Sectional Studies / Diabetes mellitus / Female / Health aspects / Health surveys / High density lipoprotein / Homeostasis / Humans / Hyperglycemia / Hypertriglyceridemia / Hypothyroidism / Insulin resistance / Male / Medical research / Medicine, Experimental / Nutrition Surveys / Obesity / Obesity in adolescence / Overweight / Reference Values / Risk factors / Surveys / Teenagers / Thyroid Diseases - blood / Thyroid Diseases - epidemiology / Thyroid Diseases - physiopathology / Thyroid Function Tests - standards / Thyroid gland / Thyroid Gland - physiology / Thyroid hormones / Thyroid-stimulating hormone / Thyrotropin / Thyrotropin - blood / Triglycerides / United States - epidemiology / Youth