title: High Thyroid-stimulating Hormone Levels Increase Proinflammatory and Cardiovascular Markers in Patients with Extreme Obesity.
abstract: OBJECTIVE
  Obesity is an important health problem worldwide and many studies have suggested a relationship between obesity and thyroid function, with controversial results. Interestingly, high TSH levels have been involved with the presence of inflammatory state and risk for developing cardiovascular diseases in hypothyroid and obese patients. The aim in this work was to determine the prevalence of hypothyroidism in patients with extreme obesity and to determine whether their TSH levels were related to increased serum levels of inflammatory and cardiovascular markers.
  
  
  METHODS
  A cross-sectional study in 101 patients with extreme obesity (BMI ≥40) was performed. Anthropometric (weight, height and waist circumference) and biochemical (fasting glucose, glycosylated hemoglobin, triglycerides, total cholesterol, LDL-C, HDL-C and insulin) parameters were measured. TSH and FT4 levels as well as clinical exploration for diagnosis of hypothyroidism were carried out. Serum concentration of IL-10, IL-6, adiponectin, resistin, leptin, ICAM-1, VCAM-1 and E-selectin were determined.
  
  
  RESULTS
  A high prevalence for diabetes (37.6%), prediabetes (50.5%), dyslipidemia (74.3%), hypertension (61.4%) and hypothyroidism (48.5%) was observed in patients with extreme obesity. The presence of hypothyroidism increased serum concentration of proinflammatory cytokines IL-6 and leptin and decreased the antiinflammatory cytokine adiponectin. In addition, serum TSH levels showed a correlation for waist circumference, weight, BMI, A1c, insulin, IL-6, leptin, ICAM-1 and E-selectin.
  
  
  CONCLUSIONS
  There is a high prevalence for hypothyroidism in patients with extreme obesity. High levels of TSH contribute to elevate proinflammatory and cardiovascular risk markers, increasing the risk for development of cardiovascular diseases.
authors.affiliation: Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Jaime Héctor
authors.initials: JH
authors.lastname: Gómez-Zamudio
authors.affiliation: Clínica de Obesidad, Servicio de Endocrinología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Victoria
authors.initials: V
authors.lastname: Mendoza-Zubieta
authors.affiliation: Clínica de Obesidad, Servicio de Endocrinología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Aldo
authors.initials: A
authors.lastname: Ferreira-Hermosillo
authors.affiliation: Clínica de Obesidad, Servicio de Endocrinología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Marío Antonio
authors.initials: MA
authors.lastname: Molina-Ayala
authors.affiliation: Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Adán
authors.initials: A
authors.lastname: Valladares-Sálgado
authors.affiliation: Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Fernando
authors.initials: F
authors.lastname: Suárez-Sánchez
authors.affiliation: Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México.
authors.forename: Jose
authors.initials: J
authors.lastname: de Jesús Peralta-Romero
authors.affiliation: Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México. Electronic address: mcruzl@yahoo.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cruz
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood*; D003430:Cross-Sectional Studies; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications / Q000453:epidemiology; D007249:Inflammation / Q000097:blood; D007328:Insulin / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications; D015995:Prevalence; D052243:Resistin; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood*; D014280:Triglycerides / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D055105:Waist Circumference
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D019040:E-Selectin; C508609:IL10 protein, human; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; C499624:RETN protein, human; D052243:Resistin; C546936:SELE protein, human; D014280:Triglycerides; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D016753:Interleukin-10; D013972:Thyrotropin
keywords: Cardiovascular markers; Extreme obesity; Hypothyroidism; TSH