Are Thyroid Autoimmune Diseases Associated with Cardiometabolic Risks in a Population with Normal Thyroid-Stimulating Hormone?
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Updated: Feb 2, 2026
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Published on: March 17, 2023
Yi Chen1, Chunfang Zhu1, Yingchao Chen1
1Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Insights
Thyroid autoimmunity is linked to increased cardiometabolic risks, particularly in women, even with normal thyroid-stimulating hormone (TSH) levels. These findings suggest thyroid autoimmune diseases (AITDs) may be potential risk factors for metabolic disorders.
Area of Science:
- Endocrinology
- Cardiology
- Metabolic Health
Background:
- The relationship between thyroid autoimmunity and cardiovascular risks remains complex and requires further investigation.
- Thyroid autoimmune diseases (AITDs) encompass conditions like Hashimoto's thyroiditis and Graves' disease.
- Cardiometabolic risk factors include obesity, hypertension, dyslipidemia, and insulin resistance.
Purpose of the Study:
- To evaluate the association between thyroid autoimmunity and cardiometabolic risks in a large population with normal thyroid-stimulating hormone (TSH) levels.
- To determine if thyroid autoimmunity is an independent risk factor for metabolic disorders.
- To investigate sex-specific differences in the association between thyroid autoimmunity and cardiometabolic parameters.
Main Methods:
- A cross-sectional study (SPECT-China) involving 9082 adults with normal TSH levels.
- Thyroid autoimmunity was assessed by anti-thyroid peroxidase antibodies (TPOAb), anti-thyroglobulin antibodies (TgAb), and thyroid ultrasonography (US).
- Cardiometabolic risk factors including BMI, waist circumference (WC), HbA1c, and HOMA-IR were analyzed.
Main Results:
- Thyroid autoimmunity (TPOAb and/or TgAb positivity) was associated with higher BMI, WC, and HbA1c in women.
- Both thyroid autoimmunity and US findings were positively associated with BMI and WC in both genders.
- Thyroid autoimmunity was linked to increased risks of central obesity, hyperlipidemia, and metabolic syndrome, predominantly in women.
Conclusions:
- Thyroid autoimmunity is positively associated with cardiometabolic risk factors like obesity, central obesity, hyperlipidemia, and metabolic syndrome, especially in women.
- These findings suggest that AITDs may represent potential risk factors for cardiometabolic disorders, irrespective of TSH levels.
- Further research is warranted to elucidate the mechanisms underlying this association and guide clinical management.
Background:
The interrelation between thyroid autoimmunity and cardiovascular risks is complex and has not been confirmed. This study aimed at evaluating whether there exists a relationship between thyroid autoimmune diseases (AITDs) and cardiometabolic risks in a large population with normal thyroid-stimulating hormone (TSH) levels.
Methods:
The data was obtained from a cross-sectional study (SPECT-China study). This study enrolled 9082 subjects (3948 males and 5134 females) above 18 years with normal TSH levels. AITD was defined according to the positivity of TPOAb and TgAb as well as thyroid ultrasonography (US) findings.
Results:
After full adjustment, TPOAb and/or TgAb positivity (TPO/TgAb (+)) was significantly associated with higher BMI, waist circumference (WC), and HbA1c only in women (P = 0.004, 0.026 and 0.032, respectively), while both TPO/TgAb positivity and US positivity (TPO/TgAb (+) and US (+)) were positively associated with BMI and WC in both genders (P = 0.002 and 0.020 in men; P < 0.001and <0.001 in women). TPO/TgAb (+) and US (+) were positively associated with HOMA-IR in women (P = 0.021) as well. Binary logistic analysis showed that AITDs had increased risks of central obesity, hyperlipidemia, and metabolic syndrome only in women (all P < 0.05). Moreover, TPO/TgAb (+) and US (+) were associated with an increased risk of obesity for both genders (P = 0.014 in men and P = 0.006 in women).
Conclusions:
Thyroid autoimmunity was positively associated with HbA1c, HOMA-IR, obesity, central obesity, hyperlipidemia, and metabolic syndrome, especially in women. This highlighted that AITDs may be potential risk factors for cardiometabolic disorders even if one's TSH was within the reference range.
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