Association Between Thyroid-Stimulating Hormone Levels and Metabolic Syndrome in Postmenopausal Women

Abstract

Background: After menopause, metabolic syndrome (MetS) is prevalent, and is linked to elevated cardiovascular and metabolic risk. Even tiny changes in thyroid function can help to cause these abnormalities within the euthyroid range. The relationship between MetS and serum levels of thyroid-stimulating hormone (TSH) was examined in this study.

Material and Methods: This analytical cross-sectional study included 120 postmenopausal women recruited from Sindh Government Hospital Saudabad, Karachi, and the Department of Obstetrics and Gynaecology, Sindh Rangers Hospital, Pakistan, from June 2022 to June 2023. Anthropometric measurements, blood pressure, fasting plasma glucose, lipid profile, TSH & free thyroxine were evaluated. Harmonized criteria were used for diagnosis of MetS. The correlation analysis and multivariable logistic regression model were employed to examine associations.

Results: MetS was present in 59 participants (49.2%). The median TSH level was significantly higher in women with MetS compared to women without MetS (2.61 vs. 1.79 mIU/L; p<0.001). The prevalence of MetS rose with each quartile of TSH levels, ranging from 30.0% in the lowest quartile to 73.3% in the highest quartile, with a p value of less than 0.001 for trend. TSH had positive correlation with waist circumference, BMI, triglycerides, blood pressure, fasting glucose and negative correlation with HDL-C. Multivariate analysis showed that women in the highest quartile of TSH level had higher risk for MetS compared with the lowest quartile of TSH level (adjusted OR 3.15; 95% CI 1.20–8.30; p=0.020).

Conclusions: Elevated TSH levels were independently linked to MetS in postmenopausal women. High normal TSH could help identify women at higher cardio-metabolic risk, and prompt metabolic evaluation.

Keywords: thyroid-stimulating hormone; metabolic syndrome; postmenopausal women; thyroid function; dyslipidemia; central obesity; cardiometabolic risk