Association between thyroid hormone levels, body composition and insulin resistance in euthyroid subjects with normal thyroid ultrasound: The Kangbuk Samsung Health Study

Summary Objective Thyroid hormones play crucial roles in the control of energy homoeostasis and can influence body composition. In contrast, the changes in body composition might influence thyroid hormone levels. We evaluated associations between thyroid hormone levels, body composition and insulin resistance in euthyroid subjects with normal thyroid ultrasound (US) findings. Design and Patients This retrospective cross‐sectional study included 36 655 euthyroid subjects who joined the medical health check‐up programme at our institution. Serum thyroid hormone levels were analysed in association with body fat percentage (BFP), skeletal muscle mass index (SMI) and homoeostatic model assessment of insulin resistance (HOMA‐IR). Linear regression analyses were performed to evaluate relationships between thyroid hormone levels and anthropometric parameters. Results Mean age was 36.4 years, and 49% of subjects were female. In multiple linear regression analysis, serum‐free triiodothyronine (FT3) levels exhibited positive associations with waist circumference (WC) and HOMA‐IR and a negative association with body weight, body mass index (BMI) and SMI among both men and women. The association between serum‐free thyroxine (FT4) levels and anthropometric markers showed inconsistent results in men and women. Serum thyroid‐stimulating hormone (TSH) levels showed a positive association with HOMA‐IR in both men and women. Conclusions Lower SMI was significantly associated with higher serum FT3 levels, the active form of thyroid hormone, in both men and women. Higher insulin resistance was positively associated with serum FT3 levels and inversely associated with serum TSH levels in euthyroid subjects with normal thyroid US findings.