Association between physical activity and thyroid function in American adults: a survey from the NHANES database.

OBJECTIVE: Physical activity (PA) is closely related to our lives, and the effects of PA on thyroid function have not been elucidated. METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2012, we included 5877 participants and analyzed the associations of thyroid function with weekly physical activity (PAM, expressed in metabolic equivalents of task) and physical activity time (PAT) in American adults. Univariate and multivariate logistic analyses were used to demonstrate the associations of PAM and PAT with the primary outcome. Linear regression analysis was performed to determine the associations between thyroid biochemical indicators/diseases and PAM/PAT. RESULTS: Our study revealed noticeable sex differences in daily PA among the participants. The odds ratio of the fourth versus the first quartile of PAM was 3.07 (confidence interval, CI [1.24, 7.58], p = 0.02) for overt hypothyroidism, 3.25 (CI [1.12, 9.45], p = 0.03) for subclinical hyperthyroidism in adult men. PAT in the range of 633-1520 min/week was found to be associated with the occurrence of subclinical hyperthyroidism [p < 0.001, OR (95% CI) = 5.89 (1.85, 18.80)], PAT of the range of > 1520 min/week was found to be associated with the occurrence of overt hypothyroidism [p < 0.001, OR (95% CI) = 8.70 (2.80, 27.07)] and autoimmune thyroiditis (AIT) [p = 0.03, OR (95% CI) = 1.42 (1.03, 1.97)] in adult men. When PAM < 5000 MET*minutes/week or PAT < 1000 min/week, RCS showed an L-shaped curve for TSH and an inverted U-shaped curve for FT4. The changes in FT3 and TT3 in men were linearly positively correlated with PAM and PAT, while TT4 is linearly negatively correlated. CONCLUSION: The amount of daily physical activity of American adults is strongly associated with changes in thyroid function, including thyroid hormone levels and thyroid diseases. Thyroid hormone levels were varied to a certain extent with changes in PAM and PAT.

Comprehensive assessment on the association of dietary vitamins with all-cause and cardiovascular mortality among individuals with prediabetes: evidence from NHANES 1999-2018.

Background: Prediabetes has become a global health issue, and currently, the relationship between vitamin levels and mortality in prediabetes remains unclear. This study aims to investigate the association between the levels of eleven vitamins and all-cause and cardiovascular disease (CVD) mortality in prediabetes patients. Methods: This cross-sectional study included 14 634 prediabetes patients from 10 cycles of the National Health and Nutrition Examination Survey between 1999 and 2018. Mortality and underlying causes of death were determined by linking records from the National Death Index until December 31, 2019. Multivariable Cox proportional hazards regression models were established to assess hazard ratios and 95% confidence intervals for all-cause, CVD, cancer, and other mortalities. Restricted cubic splines were used to visualize non-linear associations between various vitamins and mortality risk. Results: During the follow-up period, 2316/14 634 prediabetes patients died (12.55%), with 722 deaths (3.68%) attributed to CVD. After multivariable adjustment, vitamin B1, niacin, folate, vitamin C, vitamin E, and vitamin K levels exhibited non-linear associations with all-cause mortality (all p < 0.05). Vitamin B1, niacin, and vitamin E levels showed non-linear associations with CVD mortality (p < 0.05). Vitamin B6 exhibited a linear negative association with all-cause, CVD, and other mortalities (p > 0.05). However, vitamins A and B2 levels were not significantly associated with mortality rates (all p > 0.05). Consistent results were observed in the subgroup analyses after complete adjustment for variables. Conclusions: Higher levels of dietary vitamins B1, B6, niacin, folate, vitamin C, vitamin E, and vitamin K were significantly associated with lower risk of all-cause mortality and CVD mortality in patients with prediabetes. There was no association between vitamin A and B2 levels and all-cause and CVD mortality among individuals with prediabetes. These findings suggest the importance of correcting vitamin deficiencies to prevent mortality in prediabetes patients.

Association Between Long-Term Exposure to Environmental Fine Particulate Matter and the Prevalence of Thyroid Disorders: A National Cross-Sectional Study in China.

Background: Exposure to particles with an aerodynamic diameter of ≤2.5 µm (PM2.5) is associated with the occurrence of thyroid dysfunction among pregnant women and neonates, but it is not known if this association occurs in the general population. We aimed to determine the association of prolonged exposure to PM2.5 with the prevalence of thyroid disorders among adults in China. Methods: A nationally representative cross-sectional study of thyroid disorders, iodine status, and diabetes status was carried out in all 31 provinces across China from 2015 to 2017. In total, 73,900 adults aged 18 years and older were included. Serum concentrations of thyroid hormones, thyrotropin, and thyroid antibodies and the urine iodine concentration were measured. The environmental concentration of PM2.5 for each participant's residential address at a spatial resolution of 1 × 1 km was estimated. Results: The average long-term exposure to PM2.5 at residential addresses was 66.41 µg/m3, ranging from 17.58 µg/m3 to 120.40 µg/m3. Compared with that of individuals with lower exposure levels, the prevalence of thyroid diseases such as autoimmune thyroiditis and subclinical hypothyroidism was greater in those with PM2.5 concentrations within the third quartile range (60.18 to 73.78 µg/m3). Compared with those in the first quartile (17.58 to 46.38 µg/m3), participants in the highest PM2.5 quartile (73.78 to 120.40 µg/m3) presented an increased risk of overt hypothyroidism (OR 1.23 [CI 0.94-1.61]), subclinical hypothyroidism (1.10 [1.01-1.21]), autoimmune thyroiditis (1.09 [1.00-1.18]), and thyroglobulin antibody positivity (1.17 [1.07-1.29]). However, there was no association between PM2.5 exposure and overt hyperthyroidism, subclinical hyperthyroidism, Graves' disease, or thyroid peroxidase antibody positivity (p > 0.05). Each 10 µg/m³ increase in the PM2.5 concentration was associated with an increased risk of overt hypothyroidism (OR 1.05 [1.00-1.11]), subclinical hypothyroidism (1.02 [1.00-1.03]), and thyroglobulin antibody positivity (1.02 [1.00-1.04]). Furthermore, a nearly linear exposure-response relationship was observed between long-term PM2.5 exposure and thyroglobulin antibody positivity. Conclusions: PM2.5 exposure was associated with thyroid disorders among Chinese adults. A dose-response relationship between PM2.5 exposure and autoimmune thyroiditis, as well as thyroglobulin antibody positivity, was also observed.

Association between anthropometric indices and hyperuricemia: a nationwide study in China.

This article explored the relationship between anthropometric indices and hyperuricemia in Chinese adults. The ability of each anthropometric index to predict hyperuricemia was also compared in this article. This is a cross-sectional study containing 69,842 samples from 31 provinces and cities in China. Anthropometric indices included body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), waist circumference-triglyceride index (WTI), and weight-adjusted waist index (WWI). The survey data obtained were disaggregated and analyzed according to sex and age. BMI, WC, BRI, WHtR, LAP, VAI, TyG, WTI, and WWI were all significantly associated with hyperuricemia (P < 0.001). In the total population, WTI (AUC 0.7015, P < 0.001) had the highest predictive power, and WWI (AUC 0.5417, P < 0.001) had the lowest. In addition, after dividing the male and female populations, LAP (AUC 0.6571, P < 0.001 for men; AUC 0.7326, P < 0.001 for women) had the highest predictive power among both men and women. The ABSI (AUC 0.5189, P < 0.001 for men; AUC 0.5788, P < 0.001 for women) had the lowest predictive power among both men and women. BMI, WC, BRI, WHtR, LAP, VAI, TyG, and WTI were positively correlated with the risk of hyperuricemia and serum uric acid concentrations in both sexes. Among the general population, WTI had the highest predictive power. After dividing the population by sex, LAP had the highest predictive power in both men and women. Key Points • Anthropometric indices are highly correlated with hyperuricemia. Waist circumference-triglyceride index (WTI) is first found to be associated with hyperuricemia, and it has high predictive power. • The predictive power of anthropometric indices for hyperuricemia is more useful in women. • The restricted cubic splines visually shows the ratio of anthropometric indices to hyperuricemia ratio and the patient's serum uric acid concentration.

Vitamin E Intake and Prevalence Rates of Thyroid Dysfunction and Autoimmune Thyroiditis: A Cross-Sectional Analysis of NHANES Data.

Background: Thyroid disorders are associated with various dietary factors and nutritional elements. The aim of this study was to investigate the relationships between dietary vitamin E intake and the prevalence of thyroid dysfunction and thyroid antibody positivity using data from the National Health and Nutrition Examination Survey (NHANES) database. Methods: Data from the NHANES database collected between 2007 and 2012 were analyzed. A total of 7,773 nonpregnant adults without preexisting thyroid diseases and possessing complete thyroid and vitamin E data were included in the study. The participants were categorized into tertiles based on their dietary vitamin E intake: the lowest group (T1: ≤4.53 mg), the intermediate group (T2: 4.54-8.10 mg), and the highest group (T3: ≥8.11 mg). We used a complex multistage probability sampling design in conjunction with R software. We compared thyroid indices, the prevalence of overt and subclinical hyperthyroidism or hypothyroidism, and the occurrence of thyroid antibody positivity among the three groups based on vitamin E intake. Weighted multinomial logistic regression was used to assess the association between dietary vitamin E intake and thyroid disorders. Restricted cubic splines (RCSs) were used to explore potential nonlinear associations. Results: The prevalence rates of subclinical hypothyroidism (SCH) were 3.63%, 3.07%, and 1.85% in T1, T2, and T3, respectively, indicating a decreasing trend (P-trend = 0.013). In the general population, high vitamin E intake (T3) was significantly associated with a lower prevalence of SCH (OR = 0.28, CI = 0.15-0.54, p < 0.001). Subgroup analysis revealed a more pronounced protective effect in males, with both moderate (T2, OR = 0.45, CI = 0.23-0.87, p = 0.020) and high (T3, OR = 0.19, CI = 0.09-0.39, p < 0.001) dietary vitamin E intake being associated with a lower prevalence of SCH. In addition, moderate (T2, OR = 0.59, CI = 0.37-0.93, p = 0.024) and high (T3, OR = 0.52, CI = 0.36-0.75, p < 0.001) dietary vitamin E intake was associated with a lower prevalence of autoimmune thyroiditis (AIT) in males. However, no significant association was observed among females. Conclusion: The findings of this study suggest that a higher intake of vitamin E is associated with lower prevalence rates of SCH and autoimmune thyroiditis among males.

Association between different metabolic phenotypes of obesity and thyroid disorders among Chinese adults: a nationwide cross-sectional study.

Background: Increased body mass index (BMI) and metabolic abnormalities both have potential associations with thyroid disease. The aim of this study was to investigate the correlation between different metabolic phenotypes of obesity and thyroid disorders using nationwide data from China. Methods: Data were collected from a cross-sectional survey called the Thyroid Disorders, Iodine Status, and Diabetes Epidemiological Survey conducted between 2015 and 2017 in China. A total of 69007 subjects aged 18 years or older were defined and divided into six groups on the basis of BMI and metabolic health status: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUO). We estimated the odds ratios (ORs) and confidence intervals [CIs] for different thyroid disorders according to metabolic phenotypes using multivariate logistic regression models. Results: In our study, we found that the prevalence of subclinical hypothyroidism was almost as high in the MUNW group as in the MUO group, the prevalence of overt hyperthyroidism was highest in the MUNW group and Graves' disease was highest in the MHO group. Our results also suggested that the prevalence of goiter and thyroid nodules increased with increased BMI values and that the MUO group had the highest incidence. Multivariate logistic regression analysis indicated that subjects with unhealthy metabolic phenotypes (MUNW, MUOW, and MUO) all had an increased risk of subclinical hypothyroidism, regardless of their BMI. MUNW subjects had an approximately 1.6-fold higher risk of overt hyperthyroidism and a 1.8-fold higher risk of Graves' disease than their metabolically healthy counterparts (MHNW). The present study also demonstrated that the MUO group had the highest risk of goiter and thyroid nodules among the metabolic phenotypes of obesity. Conclusion: Based on our study, we found that metabolic abnormalities and obesity play different roles in various thyroid diseases. Metabolically unhealthy individuals, both with and without obesity, have a higher risk of thyroid disorders than metabolically healthy individuals without obesity.

Influencing Factors and New Reference Intervals of Adult Thyroid Volume in Iodine-Sufficient Areas of China.

The diagnosis of goiter is based on the thyroid volume measured by ultrasound in which iodine plays an important role. The purpose of this study was to evaluate the factors that affect thyroid volume and update the reference range of thyroid volume to provide a new basis for the diagnosis and treatment of goiter. A study population from mainland China was evaluated in the Thyroid disorders, Iodine status and Diabetes Epidemiological (TIDE) study. Thyroid size was measured by ultrasound, and thyroid volume was calculated. A quantile regression model was used to analyze the influence of related factors on the thyroid volume at each percentile. The median urinary iodine concentration (UIC) was 185.54 µg/l. The quantile regression model suggested that body surface area (BSA) and thyroid-stimulating hormone (TSH) were positive and negative factors for thyroid volume, respectively (p < 0.01). Excess iodine reduces the median and lower limits of thyroid volume. In iodine-sufficient areas, smoking is no longer a risk factor. The reference value range of thyroid volume stratified by sex was 3.92-19.06 ml for males and 3.1-16.17 ml for females. The maximum reference ranges for stratification by sex and BSA were 4.25-20.98 ml for men and 3.44-18.31 ml for women. The iodine nutrition level of the population in mainland China is sufficient. Iodine has the potential to alter the effect of certain factors on thyroid volume and effect is not regional. The new reference interval of adult thyroid volume based on sex and BSA has been updated, which can be used as a reliable reference for updating the diagnostic criteria of endemic goiter.

The prevalence and clustering of metabolic syndrome risk components in Chinese population: a cross-sectional study.

Objective: The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components. The present study evaluated the epidemiological characteristics of the MetS components and their clustering condition among Chinese adults. Methods: 68383 participants aged 18-80 years from TIDE were scored on a six-point (0-5) MetS severity score (MSSS), which quantified their cumulative amount of MetS risk components. We evaluated the epidemiological characteristics of these components and their clustering conditions. Additionally, we examined the relation of age with the prevalence of different MSSSs or specific MetS components using restricted cubic splines. Results: Among 68383 participants, 26113 men and 24582 women had abnormal MetS components. There were significant differences in most epidemiological characteristics between the 6 MSSS groups. The top three prevalence of abnormal metabolic components were high systolic blood pressure (SBP) (9.41%, n=6568), high waist circumference (WC) (8.13%, n=6120), and the cooccurrence of high SBP and high WC (6.33%, n=4622). Participants were more likely to have all five MetS components when HDL-C was low. Restricted cubic splines showed that when the MSSS ≥3, the MetS prevalence of male peaked and that of the female population increased most rapidly at 40-60 age group. Conclusion: The 40-60 age group can be regarded as the high-risk period of MetS, and elderly women have a higher risk of multiple metabolic disorders than men. The top three clustering of abnormal metabolic components were high SBP, high WC, and their combination. Multiple components aggregation was more likely to occur when HDL-C decreased.