Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population

Zhiyuan Wu; Yue Jiang; Pingan Li; Yutao Wang; Haiping Zhang; Zhiwei Li; Xia Li; Lixin Tao; Bo Gao; Xiuhua Guo

doi:10.1186/s12967-023-04276-3

Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population

J Transl Med. 2023 Jul 5;21(1):436. doi: 10.1186/s12967-023-04276-3.

Authors

Zhiyuan Wu^#^{1

2}, Yue Jiang^#¹, Pingan Li¹, Yutao Wang³, Haiping Zhang¹, Zhiwei Li¹, Xia Li⁴, Lixin Tao^{5

6}, Bo Gao^{7

8}, Xiuhua Guo^{9

10}

Affiliations

¹ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China.
² Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
³ Shanghai Fufan Information Technology Co., Ltd, No.323 Guoding Road, Yangpu District, Shanghai, 200433, China.
⁴ Department of Mathematics and Statistics, La Trobe University, Melbourne, 3086, Australia.
⁵ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. taolixin@ccmu.edu.cn.
⁶ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. taolixin@ccmu.edu.cn.
⁷ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. gaobo@ccmu.edu.cn.
⁸ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. gaobo@ccmu.edu.cn.
⁹ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. statguo@ccmu.edu.cn.
¹⁰ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing, 100069, China. statguo@ccmu.edu.cn.

^# Contributed equally.

Abstract

Background: Impaired sensitivity to thyroid hormones is a newly proposed clinical entity associated with hyperuricemia in the subclinical hypothyroid population. However, it is unknown whether the association exists in the euthyroid population. This study aimed to explore the association of impaired sensitivity to thyroid hormones (assessed by the thyroid feedback quantile-based index [TFQI], parametric thyroid feedback quantile-based index [PTFQI], thyrotrophic thyroxine resistance index [TT4RI] and thyroid-stimulating hormone index [TSHI]) with hyperuricemia and quantify the mediating effect of body mass index BMI in the euthyroid population.

Methods: This cross-sectional study enrolled Chinese adults aged ≥ 20 years who participated in the Beijing Health Management Cohort (2008-2019). Adjusted logistic regression models were used to explore the association between indices of sensitivity to thyroid hormones and hyperuricemia. Odds ratios [OR] and absolute risk differences [ARD] were calculated. Mediation analyses were performed to estimate direct and indirect effects through BMI.

Results: Of 30,857 participants, 19,031 (61.7%) were male; the mean (SD) age was 47.3 (13.3) years; and 6,515 (21.1%) had hyperuricemia. After adjusting for confounders, individuals in the highest group of thyroid hormone sensitivity indices were associated with an increased prevalence of hyperuricemia compared with the lowest group (TFQI: OR = 1.18, 95% CI 1.04-1.35; PTFQI: OR = 1.20, 95% CI 1.05-1.36; TT4RI: OR = 1.17, 95% CI 1.08-1.27; TSHI: OR = 1.12, 95% CI 1.04-1.21). BMI significantly mediated 32.35%, 32.29%, 39.63%, and 37.68% of the associations of TFQI, PTFQI, TT4RI and TSHI with hyperuricemia, respectively.

Conclusions: Our research revealed that BMI mediated the association between impaired sensitivity to thyroid hormones and hyperuricemia in the euthyroid population. These findings could provide useful evidence for understanding the interaction between impaired sensitivity to thyroid hormone and hyperuricemia in euthyroid individuals and suggest the clinical implications of weight control in terms of impaired thyroid hormones sensitivity.

Keywords: Body mass index (BMI); Hyperuricemia; Mediation analysis; Thyroid hormones sensitivity; Uric acid.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Female
Humans
Hyperuricemia* / complications
Male
Obesity / complications
Obesity / epidemiology
Thyroid Hormones
Thyrotropin
Thyroxine

Substances

Thyroid Hormones
Thyroxine
Thyrotropin