Plasma concentrations of free triiodothyronine predict weight change in euthyroid persons1–4

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Background: Factors that influence energy metabolism and substrate oxidation, such as thyroid hormones (THs), may be important regulators of body weight.

Objective: We investigated associations of THs cross-sectionally with obesity, energy expenditure, and substrate oxidation and prospectively with weight change.

Design: Euthyroid, nondiabetic, healthy, adult Pima Indians (n = 89; 47 M, 42 F) were studied. Percentage body fat (%BF) was measured by using dual-energy X-ray absorptiometry; sleeping metabolic rate (SMR), respiratory quotient, and substrate oxidation rates were measured in a respiratory chamber. Thyroid-stimulating hormone (TSH), free thyroxine (T4), free triiodothyronine (T3), and leptin concentrations were measured in fasting plasma samples.

Results: TSH, but neither free T3 nor free T4, was associated with %BF and leptin concentrations (r = 0.27 and 0.29, respectively; both: P ≤ 0.01). In multiple regression analyses adjusted for age, sex, fat mass, and fat-free mass, free T3 was a positive predictor of SMR (P = 0.02). After adjustment for age, sex, %BF, and energy balance, free T3 was a negative predictor of 24-h respiratory quotient (P < 0.05) and a positive predictor of 24-h lipid oxidation rate (P = 0.006). Prospectively, after an average follow-up of 4 ± 2 y, the mean increase in weight was 3 ± 9 kg. Baseline T3 concentrations were associated with absolute and annual percentage of changes in weight (r = −0.27, P = 0.02, and r = −0.28, P = 0.009, for the ageand sex-adjusted associations, respectively).

Conclusions: In euthyroid Pima Indians, lower free T3 but not free T4 concentrations were an independent predictor of SMR and lipid oxidation and a predictor of weight gain. This finding indicates that control of T4-to-T3 conversion may play a role in body weight regulation. Am J Clin Nutr 2007;85:440–5.

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