{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:56:11Z","timestamp":1780491371146,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,12]],"date-time":"2018-03-12T00:00:00Z","timestamp":1520812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81673166, 81372118, 81372467 and 81302422"],"award-info":[{"award-number":["81673166, 81372118, 81372467 and 81302422"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003347","name":"Fudan University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010002","name":"Ministry of Education","doi-asserted-by":"publisher","award":["GW2014\u20105"],"award-info":[{"award-number":["GW2014\u20105"]}],"id":[{"id":"10.13039\/100010002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Thyroid hormones (<jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content>s) are primarily responsible for the regulation of energy homeostasis and metabolism. However, few prospective studies have assessed the association between <jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content>s and metabolic syndrome (MetS) in a general population. We therefore designed a cohort study to examine whether serum <jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content> levels within the reference range are predictive factors for developing MetS in adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A prospective study (n\u00a0=\u00a06119) was performed in Tianjin, China. Participants without a history of MetS were followed up for 1 to 3\u00a0years with a median follow\u2010up duration of 2\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Serum free triiodothyronine (<jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>3), free\u00a0thyroxine\u00a0(<jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>4) and thyroid\u2010stimulating hormone (<jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>) levels were measured by chemiluminescence immunoassay. MetS was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. <jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content>s, <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> levels and MetS were assessed yearly during the follow\u2010up. Adjusted Cox proportional hazards regression models were used to assess the associations between <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>3, <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>4 and <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> quintiles and MetS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of MetS was 17.7% (96 per 1000 person\u2010years). In the final multivariate models, the hazard ratios (95% confidence interval) for MetS across serum <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>3 quintiles were 1.00 (reference), 1.03 (0.84, 1.25), 1.14 (0.94, 1.38), 1.09 (0.90, 1.32) and 1.33 (1.11, 1.61), respectively (<jats:italic>P<\/jats:italic> for trend &lt;.01). However, no significant associations between <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>4, <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> and MetS were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This population\u2010based prospective cohort study suggests that increased serum <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>3 level, rather than <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>4 and <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>, is an independent predictor for developing MetS in euthyroid subjects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13576","type":"journal-article","created":{"date-parts":[[2018,2,17]],"date-time":"2018-02-17T08:16:42Z","timestamp":1518855402000},"page":"735-743","source":"Crossref","is-referenced-by-count":16,"title":["The association between thyroid function and incidence of metabolic syndrome in euthyroid subjects: Tianjin chronic low\u2010grade systemic inflammation and health cohort study"],"prefix":"10.1111","volume":"88","author":[{"given":"Yeqing","family":"Gu","sequence":"first","affiliation":[{"name":"Nutritional Epidemiology Institute and School of Public Health Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Nutritional Epidemiology Institute and School of Public Health Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Health Management Centre Tianjin Medical University General Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Liu","sequence":"additional","affiliation":[{"name":"Health Management Centre Tianjin Medical University General Hospital  Tianjin 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