Peripheral Thyroid Hormone Sensitivity Mediates the Association Between Body Composition and Diabetes in Euthyroid Adults

作者：Nanfang Yao, Lan Liu, Yuqi Jiang, Dongmei Wang, Qianyi Lu, Yi Zeng, Genfeng Yu, Qintao Ma, Peiyi Li, Lingling Liu, Jie Shen, Heng Wan · 发表于：Journal of Cachexia Sarcopenia and Muscle · 年份：2025 · DOI：10.1002/jcsm.70061 · 被引用次数：7 · 研究领域：Thyroid Disorders and Treatments、Thyroid Cancer Diagnosis and Treatment、Parathyroid Disorders and Treatments

BACKGROUND: Body composition parameters, including fat-to-muscle ratio (FMR) and appendicular skeletal muscle mass (ASM), are closely associated with metabolic diseases. However, the mediating role of peripheral thyroid hormone sensitivity, reflected by the free triiodothyronine-to-free thyroxine ratio (FT3/FT4 ratio), in these associations remains unclear in euthyroid individuals. The current study aimed to investigate the associations of FMR and ASM/BMI with diabetes and to explore the potential mediating role of FT3/FT4 ratio in these relationships among euthyroid Chinese adults. METHODS: This cross-sectional study enrolled the participants from 10 communities in Guangdong Province, China, from November 2021 to September 2022. Body composition was measured using bioelectrical impedance analysis (BIA). Diabetes was defined based on fasting plasma glucose, 2-h postload glucose or glycated haemoglobin (HbA1c). Associations of FMR and ASM adjusted for body mass index (ASM/BMI) with diabetes were assessed using multivariable logistic regression. Structural equation modelling was applied to evaluate the mediating effect of FT3/FT4 ratio. RESULTS: A total of 5089 participants (mean age = 46 years, SD = 12) were included in the final analysis, consisting of 1957 men (38.5%) and 3132 women (61.5%). Participants in the third tertile (T3) of FMR exhibited a 79% higher prevalence of diabetes compared to those in the first tertile (T1) (OR 1.79, 95% CI 1.27-2.54) (p < 0.05). Conversely...