Thyroid disorders in obese patients. Does insulin resistance make a difference?

Area of Science:

• Endocrinology
• Metabolic Health
• Thyroidology

Background:

• Obesity is a global health concern associated with various metabolic and endocrine dysfunctions.
• Insulin resistance is a key feature of obesity, contributing to conditions like type 2 diabetes.
• Thyroid disorders are also prevalent in obese populations, but their relationship with insulin resistance requires further elucidation.

Purpose of the Study:

• To investigate the association between insulin resistance and thyroid pathology in obese patients.
• To compare thyroid parameters between insulin-resistant and non-insulin-resistant obese individuals.

Main Methods:

• The study included 82 obese, non-diabetic patients aged 18-70 years.
• Evaluated parameters included fasting glucose, insulin, HOMA-IR, TSH, FT4, thyroid antibodies (TPO-Ab, Tg-Ab), and thyroid ultrasound.
• Statistical analyses, including multivariate regression, were used to assess correlations and differences.

Main Results:

• Thyroid nodules (35.4%) and Hashimoto's thyroiditis (32.9%) were the most common thyroid conditions.
• A positive correlation was found between homeostasis model assessment of insulin resistance index (HOMA-IR) and thyroid-stimulating hormone (TSH) levels (r = 0.24, p = 0.028).
• This correlation persisted after adjusting for multiple confounding factors, and TSH levels were significantly higher in insulin-resistant patients (HOMA-IR ≥ 2.5).

Conclusions:

• Thyroid nodules and hypothyroidism are common in obese patients presenting for endocrinology evaluation.
• Elevated TSH levels are associated with insulin resistance in obese individuals.
• These findings suggest a link between metabolic dysfunction (insulin resistance) and thyroid regulation in obesity.