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Clinical research of relationship between subclinical thyroid dysfunction and hyperuricemia

HUANG Rong, CAO Qin, GU Jing-li, MA Jia-hua, GU Wei-wei, FAN Zhu-ping   

  1. Department of Health Care Centre, Renji Hospital,  Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2013-10-28 Published:2013-10-31
  • Supported by:

    Shanghai Public Health Key Discipline Construction Plan, 12GWZX0903; Medical Research Cooperation Plan of Shanghai Medical Institute and Astrazeneca (China)

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Abstract:

Objective To investigate the relationship between subclinical thyroid dysfunction and hyperuricemia. Methods A total of 18 731 subjects undergoing medical examinations were selected. Serum thyroid stimulation hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured by chemiluminescence immunoassay, and serum uric acid was examined by uricase-peroxidase coupling method. According to the 95% confidence interval (95%CI) of serum TSH, the study population was divided into subclinical hyperthyroidism group (decreased TSH), normal group and subclinical hypothyroidism group (increased TSH), the detected parameters were compared among groups, and Logistic regression analysis was conducted between serum TSH and incidence of hyperuricemia. Results The mean serum TSH of the study population was (1.54±1.13) mIU/L, and the 95%CI was 0.69-3.67 mIU/L. The numbers of subjects in subclinical hyperthyroidism group (TSH≤0.69 mIU), normal group (0.69 mIU/L<TSH＜3.67 mIU/L) and subclinical hypothyroidism group (TSH≥3.67 mIU/L) were 172, 18 167 and 392 respectively. The incidence of subclinical thyroid dysfunction was 3.01% (564/1 8731). There was an ascending trend in body mass index (BMI) and serum uric acid with the elevation of serum TSH. Compared with normal group, the serum uric acid, total cholesterol and low density lipoprotein (LDL) were significantly lower, and the  high density lipoprotein (HDL) was significantly higher in subclinical hyperthyroidism group (P＜0.05).  Compared with normal group, the blood pressure, BMI, serum uric acid and serum triglyceride were significantly higher, and the HDL was significantly lower in subclinical hypothyroidism group (P＜0.05). Logistic regression analysis indicated that increased serum FSH was  independently associated with incidence of hyperuricemia (OR=2.834; 95%CI: 1.445-5.556) with the normal range of FT4 and FT3. Conclusion The reference range of serum TSH in subjects undergoing medical examinations is 0.69-3.67 mIU/L, and increased serum TSH is associated with metabolic disorders. Subclinical thyroid dysfunction is a risk factor for hyperuricemia.

Key words: thyroid stimulation hormone, subclinical hypothyroidism, hyperuricemia