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3 "Phenotype"
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Obesity and Metabolic Syndrome
The Relationship between Thyroid Function and Different Obesity Phenotypes in Korean Euthyroid Adults
Jeong Mi Kim, Bo Hyun Kim, Hyungi Lee, Eun Heui Kim, Mijin Kim, Jong Ho Kim, Yun Kyung Jeon, Sang Soo Kim, In Joo Kim, Yong Ki Kim
Diabetes Metab J. 2019;43(6):867-878.   Published online April 3, 2019
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  • 17 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   

Thyroid disease and metabolic syndrome are both associated with cardiovascular disease. The aim of this study was to investigate the correlation between thyroid hormones and obesity sub-phenotypes using nationwide data from Korea, a country known to be iodine replete.


This study was based on data obtained from the sixth Korea National Health and Nutrition Examination Survey, administered from 2013 to 2015. A total of 13,873 participants aged ≥19 years were included, and classified into four groups: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO) by body fat on the basis of body mass index and metabolic health.


At baseline, serum free thyroxine (fT4) values were significantly higher in the MHNO phenotype (MHNO, 1.27±0.01 ng/dL; MHO, 1.25±0.01 ng/dL; MUNO, 1.24±0.01 ng/dL; MUO, 1.24±0.01 ng/dL, P<0.001) in total study population. However, this significant association no longer remained after adjustment for age, urine iodine concentration, and smoking (P=0.085). After adjustment for confounders, statistically significant association was observed between lower thyroid stimulating hormone (TSH) and MHNO phenotype (P=0.044). In men participants (not women), higher fT4 values were significantly associated with MHNO phenotype (P<0.001). However, no significant association was observed between thyroid function (TSH or fT4) and obesity phenotypes in groups classified by age (cutoff age of 55 years).


Although there was a difference by age and sex, we found that the decrease of TSH and the increase of fT4 values were associated with MHNO.


Citations to this article as recorded by  
  • Causal association between obesity and hypothyroidism: a two-sample bidirectional Mendelian randomization study
    Yingkun Qiu, Qinyu Liu, Yinghua Luo, Jiadi Chen, Qingzhu Zheng, Yuping Xie, Yingping Cao
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Association between thyroid function and obesity phenotypes in healthy euthyroid individuals: an investigation based on Tehran Thyroid Study
    Behnaz Abiri, Amirhossein Ramezani Ahmadi, Maryam Mahdavi, Atieh Amouzegar, Majid Valizadeh
    European Journal of Medical Research.2023;[Epub]     CrossRef
  • Characteristics of the metabolically unhealthy phenotype in menopausal resistance training practitioners
    Ana Carla Leocadio de Magalhaes, Vilma Fernandes Carvalho, Sabrina Pereira da Cruz, Andréa Ramalho
    Nutrición Hospitalaria.2023;[Epub]     CrossRef
  • A systematic review and meta-analysis investigating the relationship between metabolic syndrome and the incidence of thyroid diseases
    Heba Alwan, Valerie Aponte Ribero, Orestis Efthimiou, Cinzia Del Giovane, Nicolas Rodondi, Leonidas Duntas
    Endocrine.2023; 84(2): 320.     CrossRef
  • Higher Sensitivity to Thyroid Hormones May Be Linked to Maintaining the Healthy Metabolic Condition in People with Obesity: New Insight from NHANES
    Ying-shan Liu, Xiao-cong Liu, Jian Kuang, Hai-xia Guan
    Obesity Facts.2023; 16(5): 497.     CrossRef
  • Is there a link between obesity phenotype and thyroid diseases? A mini-review of current concepts
    Ewa Malwina Milewska-Kobos, Ewelina Szczepanek-Parulska, Marek Ruchala
    Postępy Higieny i Medycyny Doświadczalnej.2023; 77(1): 107.     CrossRef
  • Sex-specific Association of Subclinical Hypothyroidism With Incident Metabolic Syndrome: A Population-based Cohort Study
    Zhiyuan Wu, Yue Jiang, Di Zhou, Shuo Chen, Yu Zhao, Haiping Zhang, Yue Liu, Xia Li, Wei Wang, Jingbo Zhang, Xiaoping Kang, Lixin Tao, Bo Gao, Xiuhua Guo
    The Journal of Clinical Endocrinology & Metabolism.2022; 107(6): e2365.     CrossRef
  • Determination of age and sex specific TSH and FT4 reference limits in overweight and obese individuals in an iodine-replete region: Tehran Thyroid Study (TTS)
    Hengameh Abdi, Bita Faam, Safoora Gharibzadeh, Ladan Mehran, Maryam Tohidi, Fereidoun Azizi, Atieh Amouzegar
    Endocrine Research.2021; 46(1): 37.     CrossRef
  • Association of Metabolic Obesity Phenotypes and Total Testosterone in Chinese Male Population
    Luna Liu, Shuang Liu, Qianmei Song, Dandan Luo, Yu Su, Xiangyu Qi, Qian Wang, Jing Ning, Youyuan Lv, Qingbo Guan
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 399.     CrossRef
  • Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors
    Nijole Kazukauskiene, Aurelija Podlipskyte, Giedrius Varoneckas, Narseta Mickuviene
    International Journal of Environmental Research and Public Health.2021; 18(7): 3388.     CrossRef
  • Association between different obesity phenotypes and hypothyroidism: a study based on a longitudinal health management cohort
    Yupeng Wang, Haiyan Lin, Qihang Li, Liying Guan, Meng Zhao, Fang Zhong, Jing Liu, Zhongshang Yuan, Honglin Guo, Yongfeng Song, Ling Gao, Jiajun Zhao
    Endocrine.2021; 72(3): 688.     CrossRef
  • Causal Association Between Serum Thyrotropin and Obesity: A Bidirectional, Mendelian Randomization Study
    Xichang Wang, Xiaotong Gao, Yutong Han, Fan Zhang, Zheyu Lin, Hong Wang, Weiping Teng, Zhongyan Shan
    The Journal of Clinical Endocrinology & Metabolism.2021; 106(10): e4251.     CrossRef
  • Effect of body mass index on peak growth hormone level after growth hormone stimulation test in children with short stature
    Na Yeong Lee, Sung Eun Kim, Seulki Kim, Moon Bae Ahn, Shin Hee Kim, Won Kyoung Cho, Kyoung Soon Cho, Min Ho Jung, Byung-Kyu Suh
    Annals of Pediatric Endocrinology & Metabolism.2021; 26(3): 192.     CrossRef
  • Interaction effect of obesity and thyroid autoimmunity on the prevalence of hyperthyrotropinaemia
    Xiaoyong Guo, Zhao He, Shanshan Shao, Yilin Fu, Dongmei Zheng, Lu Liu, Ling Gao, Liying Guan, Meng Zhao, Jiajun Zhao
    Endocrine.2020; 68(3): 573.     CrossRef
  • The role of thyroid hormone in metabolism and metabolic syndrome
    Patrícia de Fátima dos Santos Teixeira, Patrícia Borges dos Santos, Carmen Cabanelas Pazos-Moura
    Therapeutic Advances in Endocrinology and Metabolism.2020; 11: 204201882091786.     CrossRef
  • Characteristics of Serum Thyroid Hormones in Different Metabolic Phenotypes of Obesity
    Xiaomin Nie, Xiaojing Ma, Yiting Xu, Yun Shen, Yufei Wang, Yuqian Bao
    Frontiers in Endocrinology.2020;[Epub]     CrossRef
Fetal Protein Deficiency Causes Long Term Changes in Mitochondrial DNA Content of Liver and Muscle in Female Sprague-Dawley Rats.
Suk Kyeong Kim, Min Seon Kim, Youn Young Kim, Do Joon Park, Kyong Soo Park, Ki Up Lee, Hong Kyu Lee
Korean Diabetes J. 2003;27(2):115-122.   Published online April 1, 2003
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AbstractAbstract PDF
Epidemiological data suggest a strong association between low birth weight and the increased risk of metabolic syndrome, including type 2 diabetes, hypertension and cardiovascular disease, in adult life. However, the underlying mechanisms are largely unknown. In our previous study, the mitochondrial DNA (mtDNA) copy number in peripheral blood leukocytes was decreased in patients with type 2 diabetes and insulin resistance. To test the hypothesis that mitochondrial changes may serve as a link between fetal under nutrition and insulin resistance in later life, the effects of fetal protein malnutrition on the mitochondria of the liver and skeletal muscle, the main sites of insulin action in adulthood, were investigated. METHODS: Eight-week old female rats were divided into 2 groups and fed on either a control diet (casein 180 g/kg diet) (n=5) or a low protein diet (casein 80 g/kg diet) (n=7) for 15 days prior to mating. They were mated with 10 week-old male Sprague Dawley rats that had been fed on the control diet. The female offspring, born to the mothers fed the low protein diet, were randomly divided into 2 groups 4 weeks after birth, and weaned on either the low protein (low protein group, n=48) or control diet (resuscitated group, n=48). As a control group, the offspring born to the mothers fed the control diet were weaned on the control diet (n=48). The animals in each group were again randomly divided into 4 groups, and sacrificed at 5, 10, 15 and 20 weeks of age, respectively (n=12 per group). The body weight, liver and muscle mtDNA content were measured at weeks 5, 10, 15 and 20. RESULTS: The mtDNA contents of the liver and skeletal muscle were reduced in fetal malnourished adult rats, and were not restored to normal levels even when proper nutrition was supplied after weaning. CONCLUSION: Our findings indicate that under nutrition in early life causes long lasting changes in the mitochondria DNA content of the liver and muscles, which may contribute to the development of insulin resistance in later life.
The Relationship between Apolipoprotein E Phenotypes, Serum Lipid Metabolism, and Oxidative Stress in Korean Type 2 Diabetic Patients.
Soo Bong Choi, Sun Min Park
Korean Diabetes J. 1999;23(2):182-192.   Published online January 1, 2001
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AbstractAbstract PDF
The cause of type 2 diabetes mellitus (DM) is not known, but one of the causes may be the reduction of insulin secretion through the fibrosis formed with amyloid deposits in pancreatic beta cells. Amyloidogenesis in hippocampus is a characteristic feature in Alzheimers disease. Possession of the Apolipoprotein (Apo) E 4 allele (E4/2, FA/3 or E4/4) is a risk factor for the development of Alzheimers disease. However, it is controversial that Apo E polymophsim is associated with the etiopathology of type 2 DM. Both Alzheimers disease and type 2 DM has increased oxidative stress, which may be related to the formation of fibrosis. The purpose of this study was to investigate the distribution of Apo E phenotypes in type 2 diabetic subjects and healthy subjects, and to determine whether Apo E phenotypes influenced serum lipid profiles and glutathione peroxidase and superoxide dismutase activities of red blood cells in type 2 DM and healthy subjects. METHODS: Overnight fasting blood was collected from 84 type 2 diabetic patients and 85 healthy subjects. Apo E phenotypes was determined by the isoelectrofocusing method. Serum lipid profiles and supetoxide dismutase and glutathione peroxidase activ'ities of red blood cells (RBC) were measured. RESULTS: The frequency of Apo E 4 in the type 2 DM was higher than that in the control group (p<0,05). The serum total cholesterol and triglyceride levels of the type 2 DM were overall higher than in healthy subjects. Serum lipid profiles were not affected by Apo E phenotypes in healthy subjects. However, semm total cholesterol levels of type 2 diab diabetic patients with Apo E3/3 were signifcantly lower than those with Apo FA/3 (p<0.05), but serum HDL, cholesterol levels had an opposite tendency. Serum triglyceride levels of type 2 diabetic patients with Apo E3/2 were higher than those with Apo E4/3 (p<0.05), RBC superoxide dismutase and gluta,thione peroxidase activities in type 2 diabetic patients tended to be lower than those in the control group. These enzyme activities of type 2 diabetic patieints with Apo E3 were lowest among the Apo E phenotype groups (p<0.05). CONCLUSION: This result suggests that type 2 diabctic patients had more Apo E 4 allele than in healthy people. Antioxidant enzyme activities decrqased in type 2 diabetic patients with Apo E 4 allele. Serum lipid profiles of type 2 diabetic patients with Apo E 4 allele was an increased risk factor for cardiovascular disease.

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