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. 2023 Jul 27;28(1):259.
doi: 10.1186/s40001-023-01214-3.

The association between the thyroid feedback quantile-based index and serum uric acid in U.S. adults

Haitao Xie  1   2   3 , Ning Li  3 , Guowei Zhou  3 , Zhiyuan He  1   2   3 , Xiaoqing Xu  1   2   3 , Qian Liu  1   2   3 , Haiyan Wang  1   2   3 , Jie Han  1   2 , Le Shen  1   2 , Peng Yu  1   2 , Jiandong Chen  1   2 , Xiaohu Chen  4   5
Affiliations

The association between the thyroid feedback quantile-based index and serum uric acid in U.S. adults

Haitao Xie et al. Eur J Med Res. .

Abstract

Objectives: Previous studies have shown that there may be a positive correlation between serum uric acid levels and hyperthyroidism. However, the relationship between thyroid function and serum uric acid in healthy people is unclear. This study analyzed the relationship between impaired thyroid hormone sensitivity and serum uric acid levels, and presented them in quantitative form.

Research design and methods: This is a cross-sectional study of 4460 adults (male: 2300; female: 2160) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2010. Parameters representing central sensitivity to thyroid hormones were calculated as: thyroid feedback quantile-based index (TFQIFT4), thyroid stimulating hormone index (TSHI), and total thyroxine (T4) resistance index (TT4RI); Peripheral sensitivity to thyroid hormone was evaluated by FT3/FT4 ratio. In addition, we have innovated total triiodothyronine (T3) resistance index (TT3RI) and TFQIFT3 indexes based on FT3 and TSH. Multiple linear regression models were used to evaluate the correlation between thyroid resistance index and serum uric acid, and the results were presented graphically as smooth curve fittings.

Results: Higher levels of serum uric acid were associated with decreased sensitivity to thyroid hormones in euthyroid individuals. In conjunction with an increase in the thyroid hormone sensitivity index value, uric acid levels gradually increased as well. Furthermore, we found a segmented relationship between TT3RI and serum uric acid changes. The saturation and threshold analyses indicated that 18.85 was the turning point (logarithmic likelihood ratio test = 0.036). When TT3RI < 18.85, the relationship between serum uric acid and TT3RI was not significant [β(95% CI) 0.47 (- 0.05, 1.00), P = 0.077], but when TT3RI > 18.85, there was a significant rise in serum uric acid with an increase in TT3RI [β(95% CI) 3.94 (0.94, 6.95), P = 0.010]. A further finding of the interaction test was that impaired thyroid hormone sensitivity and uric acid changes vary among different age groups and BMI levels.

Conclusions: Decreased sensitivity to thyroid hormones was associated with high levels of serum uric acid in people with normal thyroid function. The interaction test shows that different age groups and BMI groups impact the association between impaired thyroid hormone sensitivity and serum uric acid. Furthermore, smooth curve fitting revealed a segmental relationship between TT3RI and serum uric acid levels.

Keywords: Impaired thyroid hormone sensitivity; Serum uric acid; Thyroid feedback quantile-based index; Thyroid function.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study design and exclusion information flowchart
Fig. 2
Fig. 2
Relationship of thyroid hormone sensitivity index with serum uric acid
Fig. 3
Fig. 3
Relationship of thyroid hormone sensitivity indexes with serum uric acid by gender
Fig. 4
Fig. 4
Relationship of thyroid hormone sensitivity indexes with serum uric acid by age
Fig. 5
Fig. 5
Relationship of thyroid hormone sensitivity indexes with serum uric acid by BMI
See this image and copyright information in PMC

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