Gender-Specific Impact of Metabolic Obesity Phenotypes on the Risk of Hashimoto's Thyroiditis: A Retrospective Data Analysis Using a Health Check-Up Database

Figures & data

Figure 1 Comparison of HT incidence between males and females with different metabolic status and obesity defined by BMI. ***:p<0.001.

Figure 2 Comparison of HT incidence between males and females with different metabolic status and obesity defined by WC. ***:p<0.001.

Table 1 Baseline Characteristics of All Subjects According to HT by Gender

Characteristic	Overall (n=3697)	Males (n=1745)		p value	Females (n=1952)		p value
		HT (n=358)	Non-HT (n=1387)		HT (n=512)	Non-HT (n=1440)
Age (years)	45.74±11.42	48.93±10.85	48.06±11.22	0.190	45.03±11.43	42.95±11.06	<0.001
Smoking (n, %)	1004 (27.2%)	169 (47.2%)	639 (46.1%)	0.441	56 (10.9%)	140 (9.7%)	0.721
Drinking (n, %)	646 (17.5%)	134 (37.4%)	484 (34.9%)	0.386	11 (2.1%)	17 (1.2%)	0.130
WC (cm)	80.54±10.15	90.24±7.86	86.90±7.58	<0.001	76.13±8.64	73.57±7.03	<0.001
HC (cm)	93.55±5.81	97.36±5.78	97.39±5.30	<0.001	92.37±5.99	91.23±5.07	<0.001
WHR	0.86±0.08	0.92±0.05	0.91±0.05	<0.001	0.82±0.07	0.81±0.06	<0.001
BMI (kg/m^2)	23.93±3.35	26.43±3.08	25.15±2.90	<0.001	23.27±3.57	22.37±2.87	<0.001
SBP (mmHg)	119.14±16.24	129.38±15.54	124.83±13.61	<0.001	115.52±16.20	112.41±15.44	<0.001
DBP (mmHg)	72.56±10.50	77.99±11.19	75.69±9.78	<0.001	70.43±9.76	68.96±9.71	0.003
Hypertension (n, %)	364 (9.8%)	77 (21.5%)	171 (12.3%)	<0.001	41 (8.0%)	75 (5.2%)	0.029
FBG (mmol/L)	5.23±1.02	5.54±1.46	5.46±1.20	0.286	5.04±0.62	5.01±0.70	0.391
DM (n, %)	169 (4.6%)	29 (8.1%)	100 (7.2%)	0.571	12 (2.3%)	28 (1.9%)	0.588
TC (mmol/L)	4.79 [4.23, 5.40]	4.89 [4.28, 5.46]	4.85 [4.25, 5.43]	0.695	4.68 [4.11, 5.32]	4.75 [4.22, 5.37]	0.108
TG (mmol/L)	1.12 [0.76, 1.74]	1.76 [1.19, 2.44]	1.48 [1.02, 2.15]	<0.001	0.96 [0.66, 1.47]	0.85 [0.62, 1.18]	<0.001
LDL-C (mmol/L)	2.84 [2.42, 3.30]	2.99 [2.52, 3.39]	2.95 [2.53, 3.36]	0.760	2.75 [2.36, 3.20]	2.75 [2.36, 3.21]	0.964
HDL-C (mmol/L)	1.37 [1.16, 1.60]	1.19 [1.05, 1.37]	1.22 [1.07, 1.40]	0.054	1.45 [1.23, 1.68]	1.53 [1.34, 1.76]	<0.001
WBC (×10^9/L)	5.87±1.39	6.27±1.38	6.23±1.43	0.666	5.54±1.30	5.55±1.28	0.921
NE (×10^9/L)	3.24±1.02	3.40±0.98	3.43±1.04	0.626	3.08±1.01	3.08±0.97	0.878
FT3 (pmol/L)	4.80 [4.45, 5.17]	5.01 [4.69, 5.35]	4.99 [4.65, 5.35]	0.518	4.63 [4.32, 4.96]	4.62 [4.31, 4.99]	0.977
FT4 (pmol/L)	11.06 [10.12, 12.11]	10.91 [9.85, 11.90]	11.33 [10.36, 12.32]	<0.001	10.89 [9.92, 11.86]	10.97 [10.03, 11.98]	0.105
TSH (mU/L)	1.99 [1.41, 2.81]	2.19 [1.60, 3.02]	1.83[1.32, 2.56]	<0.001	2.33 [1.64, 3.38]	1.99 [1.39, 2.77]	<0.001

Notes: Normally distributed continuous variables are presented as the mean ± standard deviation. Non-normally distributed continuous variables are presented as the mean [interquartile range]. Categorical variables are presented as the number (percentage).

Abbreviations: HT, Hashimoto’s thyroiditis; WC, waist circumference; HC, hip circumference; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; TG, triglycerides; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-c, high-density lipoprotein cholesterol; FBG, fasting blood glucose; DM, diabetes mellitus; WBC, white blood cells; NE, neutrophils; TSH, thyroid-stimulating hormone; FT3, free triiodothyronine; FT4, thyroxine.

Table 2 Association Between Metabolic Obesity Phenotypes and the Risk of HT Separately in Males and Females

Status of Metabolically Healthy and Obesity Phenotypes	Total (n=3697)	HT cases (n, %)	Unadjusted Model		Model 1		Model 2
			OR (95% CI)	p value	OR (95% CI)	p value	OR (95% CI)	p value
Males (n=1745)
GO defined by BMI
MHNGO	488	56 (11.5%)	1.00 (reference)	–	1.00 (reference)	–	1.00 (reference)	–
MHGO	38	9 (23.7%)	2.39 (1.08–5.32)	0.032	2.40 (1.08–5.34)	0.031	2.50 (1.11–5.60)	0.027
MUNGO	930	192 (20.6%)	2.01 (1.46–2.77)	<0.001	1.98 (1.43–2.74)	<0.001	1.86 (1.31–2.66)	0.001
MUGO	289	101 (34.9%)	4.14 (2.87–5.99)	<0.001	4.13 (2.85–5.99)	<0.001	3.78 (2.50–5.72)	<0.001
AO defined by WC
MHNAO	425	41 (9.6%)	1.00 (reference)	–	1.00 (reference)	–	1.00 (reference)	–
MHAO	101	24 (23.8%)	2.92 (1.67–5.11)	<0.001	2.96 (1.69–5.19)	<0.001	3.14 (1.78–5.54)	<0.001
MUNAO	650	107 (16.5%)	1.85 (1.26–2.71)	0.002	1.87 (1.27–2.76)	0.001	1.85 (1.22–2.78)	0.004
MUAO	569	186 (32.7%)	4.55 (3.15–6.56)	<0.001	4.68 (3.22–6.82)	<0.001	4.55 (3.00–6.90)	<0.001
Females (n=1952)
GO defined by BMI
MHNGO	1173	242 (20.6%)	1.00 (reference)	–	1.00 (reference)	–	1.00 (reference)	–
MHGO	13	5 (38.5%)	2.40 (0.78–7.42)	0.127	2.49 (0.81–7.69)	0.113	2.05 (0.66–6.38)	0.215
MUNGO	677	223 (32.9%)	1.89 (1.53–2.34)	<0.001	1.79 (1.43–2.24)	<0.001	1.55 (1.17–2.05)	0.002
MUGO	89	42 (47.2%)	3.44 (2.22–5.34)	<0.001	3.34 (2.15–5.21)	<0.001	2.62 (1.59–4.32)	<0.001
AO defined by WC
MHNAO	1064	223 (21.0%)	1.00 (reference)	–	1.00 (reference)	–	1.00 (reference)	–
MHAO	122	24 (19.7%)	0.92 (0.58–1.48)	0.740	0.89 (0.55–1.43)	0.624	0.83 (0.51–1.34)	0.438
MUNAO	459	120 (26.1%)	1.34 (1.03–1.72)	0.027	1.31 (1.01–1.70)	0.044	1.15 (0.84–1.57)	0.380
MUAO	307	145 (47.2%)	3.38 (2.58–4.41)	<0.001	3.24 (2.43–4.30)	<0.001	2.87 (2.01–4.09)	<0.001

Notes: Model 1: adjusted for age, smoking, and alcohol consumption. Model 2: adjusted for age, smoking, alcohol consumption, hypertension, TG, HDL-C, FT4, TSH.

Abbreviations: HT, Hashimoto’s thyroiditis; MHNGO, metabolically healthy non-general obesity; MHGO, metabolically healthy general obesity; MUNGO, metabolically unhealthy non-general obesity; MUGO, metabolically unhealthy general obesity; MHNAO, metabolically healthy non-abdominal obesity; MHAO, metabolically healthy abdominal obesity; MUNAO, metabolically unhealthy non-abdominal obesity, MUAO, metabolically unhealthy abdominal obesity.

Table 3 Test for Linear Trend for Association Between BMI Categories and Quartiles of WC with HT Risk

Obesity Phenotype	Total (n=3697)	HT cases (n, %)	Unadjusted Model		Model 1		Model 2
			OR (95% CI)	p value	OR (95% CI)	p value	OR (95% CI)	p value
GO defined by BMI
<18.5	125	27 (21.6%)	1.12 [0.72, 1.74]	0.618	1.32 [0.83, 2.11]	0.238	1.28 [0.80, 2.06]	0.304
18.5–23.9	1822	360 (19.8%)	1.00 (reference)	–	1.00 (reference)	–	1.00 (reference)	–
24–27.9	1256	308 (24.5%)	1.32 [1.11, 1.57]	0.002	1.23 [0.97, 1.55]	0.088	1.21 [0.96, 1.53]	0.113
≥28	445	161 (36.2%)	2.30 [1.84, 2.88]	<0.001	1.81 [1.24, 2.66]	0.002	1.75 [1.19, 2.58]	0.005
p for trend			<0.001		0.017		0.026
AO defined by WC
Q1(<73cm)	911	203 (22.3%)	1.00 (reference)	–	1.00 (reference)	–	1.00 (reference)	–
Q2(73–79.9cm)	861	172 (20.0%)	0.87 [0.69, 1.09]	0.235	0.81 [0.63, 1.06]	0.119	0.82 [0.63, 1.07]	0.141
Q3(80–87.9cm)	988	217 (22.0%)	0.98 [0.79, 1.22]	0.867	1.10 [0.79, 1.54]	0.578	1.13 [0.80, 1.60]	0.492
Q4(≥88cm)	937	278 (29.7%)	1.47 [1.19, 1.82]	<0.001	1.73 [1.09, 2.75]	0.021	1.77 [1.10, 2.83]	0.018
p for trend			<0.001		0.012		0.010

Notes: Model 1: adjusted for age, smoking, and alcohol consumption. Model 2: adjusted for age, smoking, alcohol consumption, hypertension, TGs, HDL-C, FT4, TSH.

Figure 3 Association between different obesity types with HT risk in metabolically healthy and unhealthy states.