Abstract
AIMS: We aim to explore the cumulative predictive value of elevated serum thyroid stimulating hormone (TSH) and visceral fat area (VFA) for metabolic syndrome (MS) development in postmenopausal women. METHODS: A total of 1006 postmenopausal females were enrolled in a 10-year prospective longitudinal study from 2011 to 2021 in the community of Banknote Printing Company of Chengdu. The sociodemographic information collection and anthropometric measurements were made by a professional nurse. Fasting blood samples were drawn for chemical analysis of fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and TSH. Magnetic resonance imaging was performed to measure VFA. All the participants were categorized into four groups according to median VFA and serum level of TSH. RESULTS: A total of 793 postmenopausal females without MS underwent a 10-year follow-up study grouping by TSH and VFA: Group 1 (TSH level <4.2 μIU/mL, and VFA < 70 cm(2) ), Group 2 (TSH level ≥4.2 μIU/mL, and VFA < 70 cm(2) ), Group 3 (TSH level <4.2 μIU/mL, and VFA ≥70 cm(2) ) and Group 4 (TSH level ≥4.2 μIU/mL, and VFA ≥70 cm(2) ). During the 10-year follow-up, MS was newly developed in 326 (41.1%) subjects. The incidence of MS was 29.8% (n = 53), 35.2% (n = 63), 41% (n = 87), and 55% (n = 123) from Group 1 to Group 4 (Group 4 vs other groups, p < .001). Cox regression analysis for MS prediction demonstrated that both TSH (Model 3, hazard ratio [HR] = 1.07 [95% confidence interval, 1.05-1.09]) and VFA (Model 4, HR = 1.02 [95% confidence interval, 1.01-1.08]) were not only independent predictors of MS but also involved some interaction between each other (p for interaction = .021). CONCLUSION: Our findings suggested that mutual interaction between higher TSH and VFA contributed to the development of MS. Further studies are needed to clarify these contributions.