Thyroid hormones and the metabolic syndrome

Abstract

Background: Clustering of various metabolic parameters including abdominal obesity, hyperglycaemia, low high-density lipoprotein cholesterol, elevated triglycerides and hypertension have been used worldwide as metabolic syndrome to predict cardiometabolic risk. Thyroid dysfunction impacts on various levels of these components.

Objectives: The purpose of the present review is to summarize available data on thyroid hormone-dependent action on components of the metabolic syndrome.

Methods: A PubMed search for any combination of hyperthyroidism, thyrotoxicosis or hypothyroidism and metabolic syndrome, blood pressure, hypertension, hyperlipidaemia, cholesterol, high-density lipoprotein cholesterol, glucose, diabetes mellitus, body weight or visceral fat was performed. We included papers and reviews published between 2000 and today but accepted also frequently cited papers before 2000.

Results: There is convincing evidence for a major impact of thyroid function on all components of the metabolic syndrome, reflecting profound alterations of energy homeostasis at many levels.

Conclusion: Even though the interactions shown in animal models and man are complex, it is evident that insulin sensitivity is highest and adverse thyroid effects on the metabolic system are lowest in euthyroid conditions.

Keywords: Arterial hypertension; Dyslipoproteinaemia; Energy homeostasis; Insulin resistance; Metabolic syndrome; Mitochondria; Obesity; Thyroid function.

Fig. 1

Schematic hypothalamic control of peripheral target organs of the metabolic syndrome through TH (red = inhibition, green = stimulation). The major THR subtypes active in target tissues are indicated.