Obesity and thyroid disease: An update

doi:10.3877/cma.j.issn.2095-9605.2025.02.007

Abstract

Abstract:

Obesity is closely related to thyroid disease. Obesity may affect thyroid function through inflammatory response, insulin resistance and hormone imbalance. Obesity also increases an individual's risk of thyroid cancer. In addition, thyroid disease may also lead to weight gain and metabolic disorders. Evidence from available studies cannot demonstrate whether obese patients with thyroid disease require different treatment strategies than normal-weight patients. This paper summarizes the relationship between obesity and thyroid disease and discussed its possible mechanism to provide a reference for clinical practice.

Key words: Obesity, Thyroid Function, Autoimmune Thyroid Diseases, Thyroid Cancer

Lan Bai, Wenbin Wang, Zefeng Xia, Yang Liu. Obesity and thyroid disease: An update[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(02): 129-134.

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References 56

[1]	Afshin A, Forouzanfar MH, Reitsma MB, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years [J]. N Engl J Med, 2017, 377(1): 13-27.
[2]	Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body Fatness and Cancer--Viewpoint of the IARC Working Group [J]. N Engl J Med, 2016, 375(8): 794-798.
[3]	Kolb R, Sutterwala FS, Zhang W. Obesity and cancer: inflammation bridges the two [J]. Curr Opin Pharmacol, 2016, 29: 77-89.
[4]	Ochner CN, Gibson C, Carnell S, et al. The neurohormonal regulation of energy intake in relation to bariatric surgery for obesity [J]. Physiol Behav, 2010, 100(5): 549-559.
[5]	Schäffler A, Binart N, Schölmerich J, et al. Hypothesis paper Brain talks with fat--evidence for a hypothalamic-pituitary-adipose axis? [J]. Neuropeptides, 2005, 39(4): 363-367.
[6]	Fontenelle LC, Feitosa MM, Severo JS, et al. Thyroid Function in Human Obesity: Underlying Mechanisms [J]. Horm Metab Res, 2016, 48(12): 787-794.
[7]	Bambini F, Gatta E, D'Alessio R, et al. Thyroid disease and autoimmunity in obese patients: a narrative review [J]. Endokrynol Pol, 2023, 74(6): 10.
[8]	Longhi S, Radetti G. Thyroid function and obesity [J]. J Clin Res Pediatr Endocrinol, 2013, 5(Suppl 1): 40-44.
[9]	Franchini F, Palatucci G, Colao A, et al. Obesity and Thyroid Cancer Risk: An Update [J]. Int J Environ Res Public Health, 2022, 19(3): 1116.
[10]	Burrage LC, McLeod DSA, Jordan SJ. Obesity and thyroid cancer risk [J]. Curr Opin Endocrinol Diabetes Obes, 2023, 30(5): 244-251.
[11]	Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity [J]. Annu Rev Immunol, 2011, 29: 415-445.
[12]	Rupérez AI, Gil A, Aguilera CM. Genetics of oxidative stress in obesity [J]. Int J Mol Sci, 2014, 15(2): 3118-3144.
[13]	Bays HE, González-Campoy JM, Bray GA, et al. Pathogenic potential of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity [J]. Expert Rev Cardiovasc Ther, 2008, 6(3): 343-368.
[14]	Blüher M. Adipose tissue dysfunction in obesity [J]. Exp Clin Endocrinol Diabetes, 2009, 117(6): 241-250.
[15]	Silva JE. Thermogenic mechanisms and their hormonal regulation [J]. Physiol Rev, 2006, 86(2): 435-464.
[16]	Rosenbaum M, Hirsch J, Murphy E, et al. Effects of changes in body weight on carbohydrate metabolism, catecholamine excretion, and thyroid function [J]. Am J Clin Nutr, 2000, 71(6): 1421-1432.
[17]	Rotondi M, Leporati P, La Manna A, et al. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism? [J]. Eur J Endocrinol, 2009, 160(3): 403-408.
[18]	Hoermann R, Midgley JE, Larisch R, et al. Homeostatic control of the thyroid-pituitary axis: perspectives for diagnosis and treatment [J]. Front Endocrinol (Lausanne) 2015, 6: 177.
[19]	Hoermann R, Midgley JE, Larisch R, et al. Integration of peripheral and glandular regulation of triiodothyronine production by thyrotropin in untreated and thyroxine-treated subjects [J]. Horm Metab Res, 2015, 47(9): 674-680.
[20]	Little AG. A review of the peripheral levels of regulation by thyroid hormone [J]. J Comp Physiol B, 2016, 186(6): 677-688.
[21]	张小改, 陈国芳, 徐书杭, 等. 甲状腺激素与肥胖：孰因孰果? [J]. 国际内分泌代谢杂志, 2020, 40(2): 5.
[22]	Knudsen N, Laurberg P, Rasmussen LB, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population [J]. J Clin Endocrinol Metab, 2005, 90(7): 4019-4024.
[23]	Reinehr T. Obesity and thyroid function [J]. Mol Cell Endocrinol, 2010, 316(2): 165-171.
[24]	Fox CS, Pencina MJ, D'Agostino RB, et al. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample [J]. Arch Intern Med, 2008, 168(6): 587-592.
[25]	Bjergved L, Jørgensen T, Perrild H, et al. Thyroid function and body weight: a community-based longitudinal study [J]. PLoS One, 2014, 9(4): e93515.
[26]	Soriguer F, Valdes S, Morcillo S, et al. Thyroid hormone levels predict the change in body weight: a prospective study [J]. Eur J Clin Invest, 2011, 41(11): 1202-1209.
[27]	Gokosmanoglu F, Aksoy E, Onmez A, et al. Thyroid homeostasis after bariatric surgery in obese cases [J]. Obes Surg, 2020, 30(1): 274-278.
[28]	Fallahi P, Ferrari SM, Camastra S, et al. TSH normalization in bariatric surgery patients after the switch from l-thyroxine in tablet to an oral liquid formulation [J]. Obes Surg, 2017, 27(1): 78-82.
[29]	Guan B, Chen Y, Yang J, et al. Effect of bariatric surgery on thyroid function in obese patients: a systematic review and Meta-analysis [J]. Obes Surg, 2017, 27(12): 3292-3305.
[30]	Bianco AC, Salvatore D, Gereben B, et al. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases [J]. Endocr Rev, 2002, 23(1): 38-89.
[31]	Ruiz-Tovar J, Boix E, Galindo I, et al. Evolution of subclinical hypothyroidism and its relation with glucose and triglycerides levels in morbidly obese patients after undergoing sleeve gastrectomy as bariatric procedure [J]. Obes Surg, 2014, 24(5): 791-795.
[32]	Moulin de Moraes CM, Mancini MC, de Melo ME, et al. Prevalence of subclinical hypothyroidism in a morbidly obese population and improvement after weight loss induced by Roux-en-Y gastric bypass [J]. Obes Surg. 2005, 15(9): 1287-1291.
[33]	Teixeira PFDS, Dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome [J]. Ther Adv Endocrinol Metab, 2020, 11: 2042018820917869.
[34]	Stichel H, l'Allemand D, Grüters A. Thyroid function and obesity in children and adolescents [J]. Horm Res, 2000, 54(1): 14-19.
[35]	Nyrnes A, Jorde R, Sundsfjord J. Serum TSH is positively associated with BMI [J]. Int J Obes (Lond). 2006, 30(1): 100-105.
[36]	Song RH, Wang B, Yao QM, et al. The impact of obesity on thyroid autoimmunity and dysfunction: a systematic review and Meta-analysis [J]. Front Immunol, 2019, 10: 2349.
[37]	Marzullo P, Minocci A, Tagliaferri MA, et al. Investigations of thyroid hormones and antibodies in obesity: leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants [J]. J Clin Endocrinol Metab, 2010, 95(8): 3965-3972.
[38]	Duntas LH, Biondi B. The interconnections between obesity, thyroid function, and autoimmunity: the multifold role of leptin [J]. Thyroid, 2013, 23(6): 646-653.
[39]	Paschou SA, Vryonidou A, Goulis DG. Thyroid nodules: Α guide to assessment, treatment and follow-up [J]. Maturitas, 2017, 96: 1-9.
[40]	Chen X, Wang JJ, Yu L, et al. The association between BMI, smoking, drinking and thyroid disease: a cross-sectional study in Wuhan, China [J]. BMC Endocr Disord, 2021, 21(1): 184.
[41]	Kushchayeva YS, Kushchayev SV, Startzell M, et al. Thyroid abnormalities in patients with extreme insulin resistance syndromes [J]. J Clin Endocrinol Metab, 2019, 104(6): 2216-2228.
[42]	Wang K, Yang Y, Wu Y, et al. The association between insulin resistance and vascularization of thyroid nodules [J]. J Clin Endocrinol Metab, 2015, 100(1): 184-192.
[43]	Lee MH, Lee JU, Joung KH, et al. Thyroid dysfunction associated with follicular cell steatosis in obese male mice and humans [J]. Endocrinology, 2015, 156(3): 1181-1193.
[44]	Ma J, Huang M, Wang L, et al. Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies [J]. Med Sci Monit, 2015, 21: 283-291.
[45]	Hopkins BD, Goncalves MD, Cantley LC. Obesity and Cancer Mechanisms: Cancer Metabolism [J]. J Clin Oncol, 2016, 34(35): 4277-4283.
[46]	Marcello MA, Cunha LL, Batista FA, et al. Obesity and thyroid cancer [J]. Endocr Relat Cancer, 2014, 21(5): T255-T271.
[47]	Pazaitou-Panayiotou K, Polyzos SA, Mantzoros CS. Obesity and thyroid cancer: epidemiologic associations and underlying mechanisms [J]. Obes Rev, 2013, 14(12): 1006-1022.
[48]	Zhao J, Wen J, Wang S, et al. Association between adipokines and thyroid carcinoma: a meta-analysis of case-control studies [J]. BMC Cancer, 2020, 20(1): 788.
[49]	Aleksic T, Chitnis MM, Perestenko OV, et al. Type 1 insulin-like growth factor receptor translocates to the nucleus of human tumor cells [J]. Cancer Res, 2010, 70(16): 6412-6419.
[50]	Walker MP, Diaugustine RP, Zeringue E, et al. An IGF1/insulin receptor substrate-1 pathway stimulates a mitotic kinase (cdk1) in the uterine epithelium during the proliferative response to estradiol [J]. J Endocrinol, 2010, 207(2): 225-235.
[51]	Chen J, Cao H, Lian M, et al. Five genes influenced by obesity may contribute to the development of thyroid cancer through the regulation of insulin levels [J]. PeerJ, 2020, 8: e9302.
[52]	邵加庆, 田成功. 甲状腺激素治疗肥胖和非甲状腺疾病的系统回顾 [J]. 中华内分泌代谢杂志, 2010, (1): 3.
[53]	Fierabracci P, Martinelli S, Tamberi A, et al. Weight loss and variation of levothyroxine requirements in hypothyroid obese patients after bariatric surgery [J]. Thyroid, 2016, 26(4): 499-503.
[54]	Matrone A, Basolo A, Santini F, et al. Understanding the effect of obesity on papillary thyroid cancer: is there a need for tailored diagnostic and therapeutic management? [J]. Expert Rev Endocrinol Metab, 2022, 17(6): 475-484.
[55]	Chereau N, Vuillermet C, Tilly C, et al. Hypocalcemia after thyroidectomy in patients with a history of bariatric surgery [J]. Surg Obes Relat Dis, 2017, 13(3): 484-490.
[56]	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 中国医师协会外科医师分会甲状腺外科医师委员会. 肥胖代谢病合并甲状腺癌外科治疗专家共识(2021版) [J/OL]. 中华肥胖与代谢病电子杂志, 2022, 8(1): 9-14.

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