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Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals

¹ Endocrine Unit, Department of Endocrinology and Metabolism, ‘Evgenidion’ Hospital, Athens University School of Medicine, 18, Papadiamantopoulou, 11528 Athens, Greece² Endocrine Unit, Department of Medical Therapeutics, Alexandra Hospital, Athens University School of Medicine, 80 Vass Sofias Avenue, 11528 Athens, Greece³ Vascular Laboratory, Department of Medical Therapeutics, Alexandra Hospital, Athens University School of Medicine, 80 Vass Sofias Avenue, 11528 Athens, Greece

(Correspondence should be addressed to M Alevizaki; Email: mani{at}otenet.gr)

Objective: Thyroid function parameters have been associated with obesity, but associations with the type of adiposity have not been examined. We used ultrasound (US) to assess regional adiposity and investigated associations of thyroid function with parameters of central obesity.

Design: Cross-sectional study.

Methods: A total of 303 apparently healthy individuals (age 42.9±8.8, body mass index (BMI) 19.0–43.3, median 26.2 kg/m², 181 women) were examined for indices of the metabolic syndrome. BMI, waist and hip circumference, abdominal subcutaneous fat (SF), and preperitoneal fat (PF) layer was estimated. TSH, free thyroxine (fT₄), triiodothyronine (T₃), thyroid autoantibodies, insulin, glucose, and lipid levels were measured. Subjects receiving T₄ (9.2%) were excluded.

Results: SF and SF/PF ratio were inversely correlated with fT₄ levels (r=–0.169, P=0.023, r=–0.193, P=0.009 respectively). In multivariate analysis, fT₄ was a predictor of SF and SF/PF, independently of age, sex, and smoking. SF correlated with TSH levels (r=0.149, P=0.037). PF and SF were positively associated with T₃ levels (r=0.245, P=0.004 and r=0.189, P=0.019 respectively). T₃ levels were positively associated with BMI (r=0.257, P=0.0004), waist perimeter (r=0.324, P<0.0001), and waist-to-hip ratio (WHR; r=0.363, P<0.0001). The T₃/fT₄ ratio was positively correlated with SF (r=0.182, P=0.028), WHR (r=0.267, P=0.0003), and BMI (r=0.146, P=0.043).

Conclusions: Increasing SF accumulation as assessed by US is associated with lower fT₄ and higher TSH levels among euthyroid slightly overweight individuals. These associations indicate that subtle variation in thyroid function may participate in regional adiposity.