Erişkinlerde obezite ve tiroid fonksiyonu arasındaki ilişki

Yıl 2018, Cilt: 31 Sayı: 2, 76 - 80, 05.06.2018

Ferhat Ekinci Demet Merder-coşkun Bilge Tuncel Dinçer Atila Hüseyin Yıldız Arzu Uzuner

https://doi.org/10.5472/marumj.430795

Cited By: 2

Öz

Amaç: Obezite, pek çok komorbid hastalığın seyrini olumsuz

etkilemektedir. Bu çalışmanın amacı obezite ve tiroid fonksiyonu

arasındaki ilişkiyi ortaya koymaktır.

Gereç ve Yöntem: Bu çalışma kesitsel bir çalışmadır. 2011

Aralık ve 2012 Aralık yılları arasında Marmara Universite

Hastahane’si Aile hekimliği ve Dahiliye polikliniklerine başvuran

erişkin yaş hastalar bu çalışmaya dahil edilmiştir. Hastaların

boy ve kiloları ölçülmüş, vücut kitle indeksi (VKİ) değerleri

hesaplanmıştır. Kanları alınmış ve tiroid stimulant hormonu

(TSH), serbest tşiroksin (fT4), total kolesterol, düşük dansitesli

lipoprotein (LDL), yüksek dansiteli lipoprotein (HDL), trigliserid

ve glukoz değerlerini ölçen tahliller yapılmıştır. Katılımcılar,

VKİ değerlerine göre üç gruba ayrılmış ve grupların verileri

karşılaştırılmıştır.

Bulgular: Çalışmaya 618 hasta dahil edilmiştir (%53 kadın/

%47 erkek). Ortalama yaş 43±15 ti. Normal kilolu grupta 175

(%28.3), fazla kilolu grupta 242 (%39.2) ve obez grupta 201

(%32.5) kişi yer almaktaydı. Gruplar arasında TSH ve fT4

değerleri açısından istatistiksel olarak anlamlı bir fark bulunmadı.

Gruplar arasında lipid profili açısından istatistiksel olarak anlamlı

fark bulundu.Fazla kilolu ve obez grubun aterojenik lipid değerleri

(total kolesterol, LDL ve trigliserid) ve glukoz değerleri normal

kilolu gruba kıyasla yüksek, HDL değerleri ise düşük bulundu

(P<0.05), fazla kilolu ve obez grup arasında lipid değerleri ve

glukoz değeri açısından istatistiksel olarak anlamlı bir fark

bulunmamıştır (P>0.05).

Sonuç: Bu çalışma, obezite ve tiroid fonksiyonu arasında

ilişki olmadığını gösteren literatürdeki ender çalışmalardan biridir.

Anahtar Kelimeler

Obezite, Erişkin, Tiroid Fonksiyon Testleri

Relationship between obesity and thyroid function in adults

Öz

Objectives: Obesity affects prognosis of many comorbid diseases

negatively. This study was conducted to investigate the relationship

between obesity and thyroid function.

Materials and Methods: This cross-sectional study was conducted

between December 2011 and December 2012. Consecutively selected

adults who applied to the outpatient clinics of Family Medicine and

Internal Medicine, at Marmara University Hospital were recruited in

the study. Height and weight were measured and body mass index

(BMI) was calculated. Thyroid-stimulating hormone (TSH), free

thyroxine (fT4), total cholesterol, low-density lipoprotein (LDL),

high-density lipoprotein (HDL), triglyceride and glucose levels were

measured for every participant. According to their BMI, participants

were divided into three groups as normal weight (<25), overweight (25-

30) and obese (≥30).

Results: Data of 618 participants (53% female/47% male)

was analyzed. Mean age was 43±15. There were 175 (28.3%)

participants in normal weight, 242 (39.2%) in overweight and 201

(32.5%) in obese groups. No statistically significant difference

was found between groups in terms of TSH or fT4. Statistically

significant difference was found in terms of lipid profiles and

blood glucose between groups. Atherogenic lipid levels (total

cholesterol, LDL and triglyceride) and blood glucose were

higher and HLD levels were lower in overweight or obese groups (P<0.05) but there were no statistically significant differences

between overweight and obese groups (P>0.05).

Conclusion: This study is one of the few studies in the

literature showing that there is no relationship between obesity and

thyroid function.

Anahtar Kelimeler

Obesity, Adults, Thyroid function tests

Kaynakça

• World Health Organization. Obesity and overweight. WHO Fact Sheet No. 311. Geneva: WHO; 2015. (http://www.wpro.who.int/mediacentre/factsheets/obesity/en/ Access date: 05/01/18)
• OECD (2014). OECD Health statistics 2014, forthcoming. (http://www.oecd.org/els/health-systems/oecd-healthstatistics- 2014-frequently-requested-data.htm Access date: 07/01/18)
• Adeboye B, Bermano G, Rolland C. Obesity and its health impact in Africa: a systematic review. Cardiovasc J Afr 2012;23: 512-1. doi:10.5830/CVJA-2012-040.
• Torun E, Cakir E, Özgüç F, Özgen IT. The effect of obesity degree on childhood pulmonary function tests. Balkan Med J 2014;31:235-8. doi:10.5152/balkanmedj.2014.13101.
• Bjoro T, Holmen J, Krüger O, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT). Europ J Endocrinol 2000;143.5: 639-47. doi: 10.1530/eje.0.1430639
• Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol 2010; 316.2: 165-71. doi: 10.1016/j.mce.2009.06.005.
• Garnerone L, Iorio L, Zelaschi R, et al. Thyroid function and obesity. Minerva Medica 2010; 101: 363-70.
• Manji N, Boelaert K, Sheppard MC, et al. Lack of association between serum TSH or free T4 and body mass index in euthyroid subjects. Clin Endocrinol 2006;64: 125-8. doi:10.1111/j.1365-2265.2006.02433.x
• Fossati P, Fontaine P. Endocrine and metabolic consequences of massive obesity. Rev Praticien 1993;43: 1935-9.
• Buscemi, S, Verga S, Maneri R, et al. Influences of obesity and weight loss on thyroid hormones. A 3–3.5-year follow-up study on obese subjects with surgical bilio-pancreatic bypass. J Endocrinol Invest 1997;20: 276-81. doi: 10.1007/ BF03350300
• Altunoğlu E, Ülgen E, Müderrisoğlu C, Erdenen F, Boz M. Obezite ve tiroid fonksiyonları. İstanbul Tıp Dergisi 2009;1: 24-5.
• Shinkov A, Borissova AM, Kovatcheva R, et al. The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects. Arq Bras Endocrinol Metabol 2014;58: 926-32. doi: 10.1590/0004-2730000003538.
• Alkac C, Akbas F, Alkac B, Atmaca HU. Obezitede tiroid fonksiyonları. JAREM. 2014; 2: 74-6. doi: 10.5152/ jarem.2014.466
• Biondi B. Thyroid and obesity: an intriguing relationship. J Clin Endocrinol Metab 2010;95: 3614-7. doi: 10.1210/ jc.2010-1245
• Iacobellis G, Ribaudo MC, Zappaterreno A, et al. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol 2005;62: 487-91. . doi: 10.1111/j.1365- 2265.2005.02247.x
• Knudsen N, Laurberg P, Rasmussen LB, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab 2005; 90: 4019-24. doi: 10.1210/ jc.2004-2225
• Bastemir M, Akin F, Alkis E, Kaptanoglu B. Obesity is associated with increased serum TSH level, independent of thyroid function. Swiss Medical Weekly 2007; 137: 431-4. doi: 2007/29/smw-11774
• De Pergola G, Ciampolillo A, Paolotti S, Trerotoli P, Giorgino R. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrinol 2007; 67: 265-9. doi: 10.1111/j.1365-2265.2007.02874.x
• Makepeace AE, Bremner AP, O’Leary P, et al. Significant inverse relationship between serum free T4 concentration and body mass index in euthyroid subjects: differences between smokers and nonsmokers. Clin Endocrinol 2008;69: 648-52. doi: 10.1111/j.1365-2265.2008.03239.x.
• Muscogiuri G, Sorice GP, Mezza T, et al. High‐normal tsh values in obesity: Is it insulin resistance or adipose tissue’s guilt? Obesity 2013;21: 101-106. doi: 10.1002/oby.20240.
• Mamtani M, Kulkarni H, Dyer TD, et al. Increased waist circumference is independently associated with hypothyroidism in Mexican Americans: replicative evidence from two large, population-based studies. BMC Endocrine Disorders 2014;14:46. doi:10.1186/1472-6823-14-46.
• Rahbar AR, Kalantarhormozi M, Izadi F, et al. Relationship between Body Mass Index, waist-to-hip ratio, and serum lipid concentrations and thyroid-stimulating hormone in the euthyroid adult population. Iran J Med Sci 2017;42:301-5.
• Wang Y, Yin Q, Xu M, Ni Q, Wang W, Wang Q. BMI modulates the effect of thyroid hormone on lipid profile in euthyroid adults. Int J Endocrinol 2017;2017:8591986. doi:10.1155/2017/8591986.
• Ozsenel EB, Gurler MY, Karatemiz G, et al. Comparison of body mass index and lipid levels between obese and normal weighted hypothyroid patients. Şişli Etfal Hastanesi Tip Bülteni. 2015;49: 131-4. . doi: 10.5350/ SEMB.20140808021149
• Tagliaferri M, Berselli ME, Calo G, et al. Subclinical hypothyroidism in obese patients: relation to resting energy expenditure, serum leptin, body composition, and lipid profile. Obesity 2001;9: 196-201. doi: 10.1038/oby.2001.21