Abstract
Metabolic syndrome is a cluster of diseases that include central obesity, hyperglycemia, dyslipidemia, and hypertension. Metabolic syndrome is a risk factor for type 2 diabetes and cardiovascular disease and the key pathophysiology is insulin resistance. Thyroid hormone has been known to play an important role in lipid and glucose metabolism and hypothyroidism causes atherosclerosis and insulin resistance. A number of clinical studies reported overt or subclinical hypothyroidism is associated with metabolic syndrome, and there has been the efforts elucidating a link between these two diseases. Recently, thyroid hormone analogue or thyromimetics has been developed to improve metabolic syndrome including dyslipidemia. I reviewed recently reported mechanisms explaining the association between hypothyroidism and metabolic syndrome, and current status of the development of thyromimetics was also reviewed.
References
1. Grundy SM. Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab. 2004; 89(6):2595–600.
3. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab. 2003; 88(6):2438–44.
4. Rochon C, Tauveron I, Dejax C, Benoit P, Capitan P, Fabricio A, et al. Response of glucose disposal to hyperinsulinaemia in human hypothyroidism and hyperthyroidism. Clin Sci (Lond). 2003; 104(1):7–15.
5. Waring AC, Rodondi N, Harrison S, Kanaya AM, Simonsick EM, Miljkovic I, et al. Thyroid function and prevalent and incident metabolic syndrome in older adults: the Health, Ageing and Body Composition Study. Clin Endocrinol (Oxf). 2012; 76(6):911–8.
6. Roos A, Bakker SJ, Links TP, Gans RO, Wolffenbuttel BH. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab. 2007; 92(2):491–6.
7. Stanicka S, Vondra K, Pelikanova T, Vlcek P, Hill M, Zamrazil V. Insulin sensitivity and counter-regulatory hormones in hypothyroidism and during thyroid hormone replacement therapy. Clin Chem Lab Med. 2005; 43(7):715–20.
8. McCulloch AJ, Johnston DG, Baylis PH, Kendall-Taylor P, Clark F, Young ET, et al. Evidence that thyroid hormones regulate gluconeogenesis from glycerol in man. Clin Endocrinol (Oxf). 1983; 19(1):67–76.
9. Peppa M, Koliaki C, Nikolopoulos P, Raptis SA. Skeletal muscle insulin resistance in endocrine disease. J Biomed Biotechnol. 2010; 2010:527850.
10. Teixeira PF, Cabral MD, Silva NA, Soares DV, Braulio VB, Couto AP, et al. Serum leptin in overt and subclinical hypothyroidism: effect of levothyroxine treatment and relationship to menopausal status and body composition. Thyroid. 2009; 19(5):443–50.
11. Menendez C, Baldelli R, Camina JP, Escudero B, Peino R, Dieguez C, et al. TSH stimulates leptin secretion by a direct effect on adipocytes. J Endocrinol. 2003; 176(1):7–12.
12. Fresno M, Alvarez R, Cuesta N. Toll-like receptors, inflammation, metabolism and obesity. Arch Physiol Biochem. 2011; 117(3):151–64.
13. Zhang YJ, Zhao W, Zhu MY, Tang SS, Zhang H. Thyroid-stimulating hormone induces the secretion of tumor necrosis factor-alpha from 3T3-L1 adipocytes via a protein kinase A-dependent pathway. Exp Clin Endocrinol Diabetes. 2013; 121(8):488–93.
14. Zhu X, Cheng SY. New insights into regulation of lipid metabolism by thyroid hormone. Curr Opin Endocrinol Diabetes Obes. 2010; 17(5):408–13.
15. Sundaram V, Hanna AN, Koneru L, Newman HA, Falko JM. Both hypothyroidism and hyperthyroidism enhance low density lipoprotein oxidation. J Clin Endocrinol Metab. 1997; 82(10):3421–4.
16. Tagami T, Tamanaha T, Shimazu S, Honda K, Nanba K, Nomura H, et al. Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroidism with Hashimoto thyroiditis. Endocr J. 2010; 57(3):253–8.
17. Tzotzas T, Krassas GE, Konstantinidis T, Bougoulia M. Changes in lipoprotein(a) levels in overt and subclinical hypothyroidism before and during treatment. Thyroid. 2000; 10(9):803–8.
18. Teixeira Pde F, Reuters VS, Ferreira MM, Almeida CP, Reis FA, Buescu A, et al. Lipid profile in different degrees of hypothyroidism and effects of levothyroxine replacement in mild thyroid failure. Transl Res. 2008; 151(4):224–31.
19. de Bruin TW, van Barlingen H, van Linde-Sibenius Trip M, van Vuurst de Vries AR, Akveld MJ, Erkelens DW. Lipoprotein(a) and apolipoprotein B plasma concentrations in hypothyroid, euthyroid, and hyperthyroid subjects. J Clin Endocrinol Metab. 1993; 76(1):121–6.
20. Raziel A, Rosenzweig B, Botvinic V, Beigel I, Landau B, Blum I. The influence of thyroid function on serum lipid profile. Atherosclerosis. 1982; 41(2-3):321–6.
21. Costantini F, Pierdomenico SD, De Cesare D, De Remigis P, Bucciarelli T, Bittolo-Bon G, et al. Effect of thyroid function on LDL oxidation. Arterioscler Thromb Vasc Biol. 1998; 18(5):732–7.
22. Diekman T, Demacker PN, Kastelein JJ, Stalenhoef AF, Wiersinga WM. Increased oxidizability of low-density lipoproteins in hypothyroidism. J Clin Endocrinol Metab. 1998; 83(5):1752–5.
23. Moon JH, Kim HJ, Kim HM, Choi SH, Lim S, Park YJ, et al. Decreased expression of hepatic low-density lipoprotein receptor-related protein 1 in hypothyroidism: a novel mechanism of atherogenic dyslipidemia in hypothyroidism. Thyroid. 2013; 23(9):1057–65.
24. Ness GC, Pendleton LC, Li YC, Chiang JY. Effect of thyroid hormone on hepatic cholesterol 7 alpha hydroxylase, LDL receptor, HMG-CoA reductase, farnesyl pyrophosphate synthetase and apolipoprotein A-I mRNA levels in hypophysectomized rats. Biochem Biophys Res Commun. 1990; 172(3):1150–6.
25. Cordeiro A, Souza LL, Einicker-Lamas M, Pazos-Moura CC. Non-classic thyroid hormone signalling involved in hepatic lipid metabolism. J Endocrinol. 2013; 216(3):R47–57.
26. Vargas F, Moreno JM, Rodriguez-Gomez I, Wangensteen R, Osuna A, Alvarez-Guerra M, et al. Vascular and renal function in experimental thyroid disorders. Eur J Endocrinol. 2006; 154(2):197–212.
27. Napoli R, Biondi B, Guardasole V, Matarazzo M, Pardo F, Angelini V, et al. Impact of hyperthyroidism and its correction on vascular reactivity in humans. Circulation. 2001; 104(25):3076–80.
28. Kuzman JA, Gerdes AM, Kobayashi S, Liang Q. Thyroid hormone activates Akt and prevents serum starvation-induced cell death in neonatal rat cardiomyocytes. J Mol Cell Cardiol. 2005; 39(5):841–4.
30. Laragh JH, Sealey JE. Relevance of the plasma renin hormonal control system that regulates blood pressure and sodium balance for correctly treating hypertension and for evaluating ALLHAT. Am J Hypertens. 2003; 16(5 Pt 1):407–15.
31. Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, et al. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy. J Clin Endocrinol Metab. 2003; 88(8):3731–7.
32. Meruvu S, Ayers SD, Winnier G, Webb P. Thyroid hormone analogues: where do we stand in 2013? Thyroid. 2013; 23(11):1333–44.
33. Ichikawa K, Miyamoto T, Kakizawa T, Suzuki S, Kaneko A, Mori J, et al. Mechanism of liver-selective thyromimetic activity of SK&F L-94901: evidence for the presence of a cell-type-specific nuclear iodothyronine transport process. J Endocrinol. 2000; 165(2):391–7.
34. Tancevski I, Wehinger A, Demetz E, Hoefer J, Eller P, Huber E, et al. The thyromimetic T-0681 protects from atherosclerosis. J Lipid Res. 2009; 50(5):938–44.
35. Baxter JD, Webb P. Thyroid hormone mimetics: potential applications in atherosclerosis, obesity and type 2 diabetes. Nat Rev Drug Discov. 2009; 8(4):308–20.