Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study

ObjectiveThyroid hormones (THs) play a pivotal role in regulating metabolism, and their sensitivity may influence the risk of metabolic syndrome (MetS). This study aimed to investigate the association of impaired sensitivity to THs with MetS and MetS severity score (MetSSS) in Chinese euthyroid adul...

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Main Authors: Xiong Zhou, Ye Zhang, Zengyao Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1552484/full
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author Xiong Zhou
Ye Zhang
Zengyao Li
author_facet Xiong Zhou
Ye Zhang
Zengyao Li
author_sort Xiong Zhou
collection DOAJ
description ObjectiveThyroid hormones (THs) play a pivotal role in regulating metabolism, and their sensitivity may influence the risk of metabolic syndrome (MetS). This study aimed to investigate the association of impaired sensitivity to THs with MetS and MetS severity score (MetSSS) in Chinese euthyroid adults.MethodsA cross-sectional analysis was conducted involving 17,272 health check-up participants. THs sensitivity indices, including Thyroid Feedback Quantile-Based Index (TFQI), Parametric Thyroid Feedback Quantile-Based Index (PTFQI), TSH Index (TSHI), Thyrotropin Thyroxine Resistance Index (TT4RI), and free triiodothyronine/free thyroxine (FT3/FT4) ratio were assessed. Multivariable regression and restricted spline cubic analyses were conducted to explore the association between THs sensitivity indices and MetS and MetSSS. Subgroup analysis was also performed to examine this association stratified by sex and age.ResultsMultivariable logistic regression analysis indicated that MetS risk was positively associated with all impaired THs sensitivity indices (per SD increase) (TFQI: OR=1.20, 95%CI: 1.15-1.25); PTFQI: OR=1.28, 95%CI: 1.23-1.33; TSHI: OR=1.35, 95%CI: 1.29-1.42; TT4RI: OR=1.57, 95%CI: 1.47-1.67; FT3/FT4: OR=1.17, 95%CI: 1.12-1.23)(all P-value<0.001). After adjusting for confounders, compared with the lowest group of MetSSS, individuals in the highest group of MetSSS were positively associated with all impaired THs sensitivity indices (per SD increase) (TFQI: OR=1.16, 95%CI: 1.07-1.21 PTFQI: OR=1.12, 95%CI: 1.06-1.17; TSHI: OR=1.13, 95%CI: 1.06-1.19; TT4RI: OR=1.25, 95%CI: 1.15-1.35; FT3/FT4: OR=1.82, 95%CI: 1.72-1.93). Nonlinear associations were found between THs sensitivity indicators and MetS (P for non-linear<0.001). Subgroup analysis indicated that all thyroid hormones sensitivity indices were positively associated with MetS by gender (male/female) and age (<60 years/≥60 years).ConclusionImpaired sensitivity to THs is associated with an increased risk of MetS and MetSSS in Chinese euthyroid adults. Future research should consider thyroid hormones sensitivity indices in the assessment of MetS risk.
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spelling doaj-art-d18e4355678f4f0eb23cf68875e711dd2025-08-20T01:49:58ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15524841552484Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional studyXiong ZhouYe ZhangZengyao LiObjectiveThyroid hormones (THs) play a pivotal role in regulating metabolism, and their sensitivity may influence the risk of metabolic syndrome (MetS). This study aimed to investigate the association of impaired sensitivity to THs with MetS and MetS severity score (MetSSS) in Chinese euthyroid adults.MethodsA cross-sectional analysis was conducted involving 17,272 health check-up participants. THs sensitivity indices, including Thyroid Feedback Quantile-Based Index (TFQI), Parametric Thyroid Feedback Quantile-Based Index (PTFQI), TSH Index (TSHI), Thyrotropin Thyroxine Resistance Index (TT4RI), and free triiodothyronine/free thyroxine (FT3/FT4) ratio were assessed. Multivariable regression and restricted spline cubic analyses were conducted to explore the association between THs sensitivity indices and MetS and MetSSS. Subgroup analysis was also performed to examine this association stratified by sex and age.ResultsMultivariable logistic regression analysis indicated that MetS risk was positively associated with all impaired THs sensitivity indices (per SD increase) (TFQI: OR=1.20, 95%CI: 1.15-1.25); PTFQI: OR=1.28, 95%CI: 1.23-1.33; TSHI: OR=1.35, 95%CI: 1.29-1.42; TT4RI: OR=1.57, 95%CI: 1.47-1.67; FT3/FT4: OR=1.17, 95%CI: 1.12-1.23)(all P-value<0.001). After adjusting for confounders, compared with the lowest group of MetSSS, individuals in the highest group of MetSSS were positively associated with all impaired THs sensitivity indices (per SD increase) (TFQI: OR=1.16, 95%CI: 1.07-1.21 PTFQI: OR=1.12, 95%CI: 1.06-1.17; TSHI: OR=1.13, 95%CI: 1.06-1.19; TT4RI: OR=1.25, 95%CI: 1.15-1.35; FT3/FT4: OR=1.82, 95%CI: 1.72-1.93). Nonlinear associations were found between THs sensitivity indicators and MetS (P for non-linear<0.001). Subgroup analysis indicated that all thyroid hormones sensitivity indices were positively associated with MetS by gender (male/female) and age (<60 years/≥60 years).ConclusionImpaired sensitivity to THs is associated with an increased risk of MetS and MetSSS in Chinese euthyroid adults. Future research should consider thyroid hormones sensitivity indices in the assessment of MetS risk.https://www.frontiersin.org/articles/10.3389/fendo.2025.1552484/fullthyroid hormones sensitivitymetabolic syndromeseverityeuthyroidChinese adults
spellingShingle Xiong Zhou
Ye Zhang
Zengyao Li
Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study
Frontiers in Endocrinology
thyroid hormones sensitivity
metabolic syndrome
severity
euthyroid
Chinese adults
title Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study
title_full Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study
title_fullStr Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study
title_full_unstemmed Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study
title_short Impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid Chinese adults as revealed by a cross-sectional study
title_sort impaired sensitivity to thyroid hormones is positively associated to metabolic syndrome severity in euthyroid chinese adults as revealed by a cross sectional study
topic thyroid hormones sensitivity
metabolic syndrome
severity
euthyroid
Chinese adults
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1552484/full
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AT yezhang impairedsensitivitytothyroidhormonesispositivelyassociatedtometabolicsyndromeseverityineuthyroidchineseadultsasrevealedbyacrosssectionalstudy
AT zengyaoli impairedsensitivitytothyroidhormonesispositivelyassociatedtometabolicsyndromeseverityineuthyroidchineseadultsasrevealedbyacrosssectionalstudy