title: Fatty liver largely explains associations of subclinical hypothyroidism with insulin resistance, metabolic syndrome, and subclinical coronary atherosclerosis.
abstract: BACKGROUND
  The association of subclinical hypothyroidism (SCH) with insulin resistance, metabolic syndrome (MS), and coronary atherosclerosis is uncertain.
  
  
  OBJECTIVE
  To investigate the role of increased intrahepatic fat in the association of SCH with insulin resistance, MS, and coronary atherosclerosis.
  
  
  METHODS
  We conducted a cross-sectional study in a sample of 753 subjects (46% males) aged 35-70 years with no history of diabetes, renal, hepatic, thyroid, or coronary heart disease, and were participants of the Genetics of Atherosclerotic Disease study. SCH was defined as a high serum TSH level with normal free thyroxine concentration. Fatty liver (FL), coronary artery calcification (CAC), and abdominal visceral adipose tissue were assessed by computed tomography. Cross-sectional associations of SCH with and without FL, with MS, insulin resistance, and subclinical atherosclerosis defined as a CAC score >0, were examined in logistic regression models.
  
  
  RESULTS
  SCH was observed in 17.7% of the population studied. The prevalence of FL was similar in both euthyroid and SCH subjects (31.8 vs 27.8%, P=0.371). SCH plus FL subjects were heavier and had more metabolic abnormalities compared with SCH plus normal liver subjects. In multivariate-adjusted logistic regression analyses, SCH plus FL was associated with MS (odds ratio (OR): 2.73, 95% CI: 1.26-5.92), insulin resistance (OR: 4.91, 95% CI: 1.63-14.75), and CAC score >0 (OR: 3.05, 95% CI: 1.20-7.76). SCH without FL showed no associations.
  
  
  CONCLUSIONS
  SCH with FL is associated with increased odds of MS, insulin resistance, and CAC, independent of potential confounders.
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico cposadasr@yahoo.com.
authors: Carlos
authors: C
authors: Posadas-Romero
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Esteban
authors: E
authors: Jorge-Galarza
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Rosalinda
authors: R
authors: Posadas-Sánchez
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Jorge
authors: J
authors: Acuña-Valerio
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Juan G
authors: JG
authors: Juárez-Rojas
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Eric
authors: E
authors: Kimura-Hayama
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Aida
authors: A
authors: Medina-Urrutia
authors: Endocrinology DepartmentInterventional Cardiology DepartmentComputed Tomography DepartmentInstituto Nacional de Cardiología 'Ignacio Chávez', Juan Badiano 1, Col. Sección XVI, C.P. 14080 Tlalpan, México D.F., Mexico.
authors: Guillermo C
authors: GC
authors: Cardoso-Saldaña
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged