Lifestyle is associated with thyroid function in subclinical hypothyroidism: a cross-sectional study

Abstract

Background: Few studies have focused on the association between lifestyle and subclinical hypothyroidism (SCH). The purpose of this study was to investigate the association between lifestyle and thyroid function in SCH.

Methods: This study was a part of a community-based and cross-sectional study, the Epidemiological Survey of Thyroid Diseases in Fujian Province, China. A total of 159 participants with SCH (81 males and 78 females) and 159 euthyroid (87 males and 72 females) participants without any missing data were included in the analysis. General information and lifestyle information including sleep, exercise, diet and smoking habits of the participants was collected by questionnaire and Pittsburgh sleep quality index scale (PSQI) was collected. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urine iodine concentration (UIC) were tested. Thyroid homeostasis parameter thyroid' s secretory capacity (SPINA-GT), Jostel's TSH index (TSHI), thyrotroph T4 sensitivity index (TTSI) were calculated. Logistic regression and multiple linear regression were performed to assess associations.

Results: Compared with euthyroid subjects, patients with SCH were more likely to have poor overall sleep quality (15.1 vs.25.8 %, P = 0.018) and l less likely to stay up late on weekdays (54.7 vs. 23.9 % P < 0.001). In SCH group, exercise was the influencing factor of TSH (β= -0.224, P = 0.004), thyroid secretory capacity (β = 0.244, P = 0.006) and thyrotropin resistance (β = 0.206, P = 0.009). Iodine excess was the influencing factor of thyroid secretory capacity (β = 0.209, P = 0.001) and pituitary thyroid stimulating function (β = 0.167, P = 0.034). Smoking was the influencing factor of pituitary thyroid stimulating function (β = 0.161, P = 0.040). Staying up late on weekends was the influencing factor of thyroid secretory capacity (β = 0.151, P = 0.047). After adjusting for possible confounders, logistic regression showed that those with poor overall sleep quality assessed by PSQI and iodine excess had an increased risk of SCH (OR 2.159, 95 %CI 1.186-3.928, P = 0.012 and OR 2.119, 95 %CI 1.008-4.456, P = 0.048, respectively).

Conclusions: Lifestyle including sleep, smoking, diet and exercise was closely related to thyroid function especially thyroid homeostasis in SCH.

Keywords: Cross-sectional study; Lifestyle; Subclinical hypothyroidism; Thyroid function.

Fig. 1

Score of seven dimensions of the Pittsburg sleep quality index scale (PSQI). A, subjective sleep quality; B, sleep latency; C, sleep duration; D, habitual sleep efficiency; E, sleep disturbances; F, use of sleeping medications; G, daytime dysfunction

Fig. 2

The risk factor and protection factor of SCH adjusted by possible confounding factors. Model 1 adjusted age, sex, BMI, SBP, TgAb. Model 2 adjusted age, sex, BMI, SBP, TgAb. TC, UA, HbA1c. The risk of SCH in subjects with poor overall sleep quality was higher than that with good overall sleep quality. The risk of SCH in subjects with iodine excess was higher than that without iodine excess. And the risk of SCH in those who stayed up late on weekdays was lower than who slept early on weekdays (P < 0.05)