The Asp727Glu polymorphism in the TSH receptor is associated with insulin resistance in healthy elderly men
André G. Uitterlinden
Departments of Internal Medicine,
Clinical Chemistry, and
Epidemiology and Biostatistics, Erasmus University Medical Centre, Rotterdam, The Netherlands
Search for more papers by this authorAndré G. Uitterlinden
Departments of Internal Medicine,
Clinical Chemistry, and
Epidemiology and Biostatistics, Erasmus University Medical Centre, Rotterdam, The Netherlands
Search for more papers by this authorSummary
Background Variations in thyroid function within the normal range are associated with differences in metabolism and body composition. For instance, TSH is positively associated with body mass index (BMI). This could be due to alterations in thyroid hormone activity, or to direct effects of TSH, as the TSH receptor (TSHR) is also expressed in adipose tissue. The TSHR-Asp727Glu polymorphism is associated with lower serum TSH levels in vivo. In this study, we analysed whether serum thyroid parameters and the TSHR-Asp727Glu polymorphism were associated with glucose metabolism and insulin resistance. In addition, we analysed the Thr92Ala polymorphism in the type 2 deiodinase (D2), which was recently associated with insulin resistance.
Methods Genotypes were determined in a population of 349 elderly men (age 77·7 ± 3·5 years), for whom serum thyroid parameters and data on insulin resistance, such as fasting blood glucose, serum insulin and homeostasis model assessment (HOMA) values, were available.
Results In nondiabetic, euthyroid subjects, TSH was positively associated with leptin levels, whereas FT4 and rT3 were significantly negatively correlated with insulin and HOMA. Carriers of the TSHR-Glu727 allele had a significantly higher glucose (P = 0·01), insulin (P = 0·001), glycated haemoglobin (HbA1c) (P = 0·002), HOMA (P = 0·001) and leptin (P = 0·008). The D2-Ala92 allele showed a trend towards higher levels of insulin (P = 0·07) and a higher HOMA (P = 0·09).
Conclusion In this population of nondiabetic elderly men, serum thyroid parameters and the TSHR-Asp727Glu polymorphism were associated with relative insulin resistance. Our study suggests that genetic variation in TSHR plays a role in insulin resistance and thereby influences glucose metabolism.
References
- 1 Bianco, A.C., Salvatore, D., Gereben, B., Berry, M.J. & Larsen, P.R. (2002) Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Endocrine Reviews, 23, 38–89.
- 2 Leonard, J.L. & Koehrle, J. (2000) Intracellular pathways of iodothyronine metabolism. In: L.E. Braverman, R.D. Utiger eds. The Thyroid, 8th edn. Lippincott-Raven, Philadelphia, 136–173.
- 3 Toft, A.D. (2001) Clinical practice. Subclinical hyperthyroidism. New England Journal of Medicine, 345, 512–516.
- 4 Greenspan, S.L. & Greenspan, F.S. (1999) The effect of thyroid hormone on skeletal integrity. Annals of Internal Medicine, 130, 750–758.
- 5 Mariotti, S., Franceschi, C., Cossarizza, A. & Pinchera, A. (1995) The aging thyroid. Endocrine Reviews, 16, 686–715.
- 6 Van Den Beld, A.W., Visser, T.J., Feelders, R.A., Grobbee, D.E. & Lamberts, S.W. (2005) Thyroid hormone concentrations, disease, physical function, and mortality in elderly men. Journal of Clinical Endocrinology and Metabolism, 90, 6403–6409.
- 7 Magri, F., Cravello, L., Fioravanti, M., Vignati, G., Albertelli, N., Bonacina, M. & Ferrari, E. (2002) Thyroid function in old and very old healthy subjects. Journal of Endocrinological Investigation, 25, 60–63.
- 8 Al-Adsani, H., Hoffer, L.J. & Silva, J.E. (1997) Resting energy expenditure is sensitive to small dose changes in patients on chronic thyroid hormone replacement. Journal of Clinical Endocrinology and Metabolism, 82, 1118–1125.
- 9 Knudsen, N., Laurberg, P., Rasmussen, L.B., Bulow, I., Perrild, H., Ovesen, L. & Jorgensen, T. (2005) Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. Journal of Clinical Endocrinology and Metabolism, 90, 4019–4024.
- 10 Nyrnes, A., Jorde, R. & Sundsfjord, J. (2006) Serum TSH is positively associated with BMI. International Journal of Obesity (2005), 30, 100–105.
- 11 Bell, A., Gagnon, A., Grunder, L., Parikh, S.J., Smith, T.J. & Sorisky, A. (2000) Functional TSH receptor in human abdominal preadipocytes and orbital fibroblasts. American Journal of Physiology. Cell Physiology, 279, C335–C340.
- 12 Haraguchi, K., Shimura, H., Kawaguchi, A., Ikeda, M., Endo, T. & Onaya, T. (1999) Effects of thyrotropin on the proliferation and differentiation of cultured rat preadipocytes. Thyroid, 9, 613–619.
- 13 Hansen, P.S., Van Der Deure, W., Peeters, R.P., Iachine, I., Fenger, M., Sørensen, T.I.A., Kyvik, K.O., Visser, T.J. & Hegedüs, L. (2006) The impact of a TSH receptor gene polymorphism (Asp727Glu) on thyroid function and size in a healthy Danish twin population. 31st Annual Meeting of the European Thyroid Association, Naples, Italy. Abstract P 168.
- 14 Peeters, R.P., Van Toor, H., Klootwijk, W., De Rijke, Y.B., Kuiper, G.G., Uitterlinden, A.G. & Visser, T.J. (2003) Polymorphisms in thyroid hormone pathway genes are associated with plasma TSH and iodothyronine levels in healthy subjects. Journal of Clinical Endocrinology and Metabolism, 88, 2880–2888.
- 15 Mentuccia, D., Proietti-Pannunzi, L., Tanner, K., Bacci, V., Pollin, T.I., Poehlman, E.T., Shuldiner, A.R. & Celi, F.S. (2002) Association between a novel variant of the human type 2 deiodinase gene Thr92Ala and insulin resistance: evidence of interaction with the Trp64Arg variant of the beta-3-adrenergic receptor. Diabetes, 51, 880–883.
- 16 Canani, L.H., Capp, C., Dora, J.M., Meyer, E.L., Wagner, M.S., Harney, J.W., Larsen, P.R., Gross, J.L., Bianco, A.C. & Maia, A.L. (2005) The type 2 deiodinase A/G (Thr92Ala) polymorphism is associated with decreased enzyme velocity and increased insulin resistance in patients with type 2 diabetes mellitus. Journal of Clinical Endocrinology and Metabolism, 90, 3472–3478.
- 17 Grarup, N., Andersen, M.K., Andreasen, C.H., Albrechtsen, A., Borch-Johnsen, K., Jorgensen, T., Auwerx, J., Schmitz, O., Hansen, T. & Pedersen, O. (2006) Studies of the common DIO2 Thr92Ala polymorphism and metabolic phenotypes in 7342 Danish whites. Journal of Clinical Endocrinology and Metabolism, 92, 363–366.
- 18 Mentuccia, D., Thomas, M.J., Coppotelli, G., Reinhart, L.J., Mitchell, B.D., Shuldiner, A.R. & Celi, F.S. (2005) The Thr92Ala deiodinase type 2 (DIO2) variant is not associated with type 2 diabetes or indices of insulin resistance in the old order of Amish. Thyroid, 15, 1223–1227.
- 19 Van Den Beld, A., Huhtaniemi, I.T., Pettersson, K.S., Pols, H.A., Grobbee, D.E., De Jong, F.H. & Lamberts, S.W. (1999) Luteinizing hormone and different genetic variants, as indicators of frailty in healthy elderly men. Journal of Clinical Endocrinology and Metabolism, 84, 1334–1339.
- 20 Van Rossum, E.F., Koper, J.W., Van Den Beld, A.W., Uitterlinden, A.G., Arp, P., Ester, W., Janssen, J.A., Brinkmann, A.O., De Jong, F.H., Grobbee, D.E., Pols, H.A. & Lamberts, S.W. (2003) Identification of the BclI polymorphism in the glucocorticoid receptor gene: association with sensitivity to glucocorticoids in vivo and body mass index. Clinical Endocrinology, 59, 585–592.
- 21 Mazess, R.B., Barden, H.S., Bisek, J.P. & Hanson, J. (1990) Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. American Journal of Clinical Nutrition, 51, 1106–1112.
- 22 Gotfredsen, A., Jensen, J., Borg, J. & Christiansen, C. (1986) Measurement of lean body mass and total body fat using dual photon absorptiometry. Metabolism, 35, 88–93.
- 23 Bonora, E., Targher, G., Alberiche, M., Bonadonna, R.C., Saggiani, F., Zenere, M.B., Monauni, T. & Muggeo, M. (2000) Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care, 23, 57–63.
- 24 Emoto, M., Nishizawa, Y., Maekawa, K., Hiura, Y., Kanda, H., Kawagishi, T., Shoji, T., Okuno, Y. & Morii, H. (1999) Homeostasis model assessment as a clinical index of insulin resistance in type 2 diabetic patients treated with sulfonylureas. Diabetes Care, 22, 818–822.
- 25 Wallace, T.M., Levy, J.C. & Matthews, D.R. (2004) Use and abuse of HOMA modeling. Diabetes Care, 27, 1487–1495.
- 26 Matthews, D.R., Hosker, J.P., Rudenski, A.S., Naylor, B.A., Treacher, D.F. & Turner, R.C. (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28, 412–419.
- 27 Stephens, M., Smith, N.J. & Donnelly, P. (2001) A new statistical method for haplotype reconstruction from population data. American Journal of Human Genetics, 68, 978–989.
- 28 Peeters, R.P., Van Den Beld, A.W., Attalki, H., Toor, H., De Rijke, Y.B., Kuiper, G.G., Lamberts, S.W., Janssen, J.A., Uitterlinden, A.G. & Visser, T.J. (2005) A new polymorphism in the type II deiodinase gene is associated with circulating thyroid hormone parameters. American Journal of Physiology. Endocrinology and Metabolism, 289, E75–E81.
- 29 Chistiakov, D.A., Savost’anov, K.V. & Turakulov, R.I. (2004) Screening of SNPs at 18 positional candidate genes, located within the GD-1 locus on chromosome 14q23-q32, for susceptibility to Graves’ disease: a TDT study. Molecular Genetics and Metabolism, 83, 264–270.
- 30 Considine, R.V., Sinha, M.K., Heiman, M.L., Kriauciunas, A., Stephens, T.W., Nyce, M.R., Ohannesian, J.P., Marco, C.C., McKee, L.J., Bauer, T.L. & Caro, J.F. (1996) Serum immunoreactive-leptin concentrations in normal-weight and obese humans. New England Journal of Medicine, 334, 292–295.
- 31 Chan, J.L., Heist, K., DePaoli, A.M., Veldhuis, J.D. & Mantzoros, C.S. (2003) The role of falling leptin levels in the neuroendocrine and metabolic adaptation to short-term starvation in healthy men. Journal of Clinical Investigation, 111, 1409–1421.
- 32 Gomez, J.M., Maravall, F.J., Gomez, N., Guma, A., Casamitjana, R. & Soler, J. (2002) Pituitary–thyroid axis, thyroid volume and leptin in healthy adults. Hormone and Metabolic Research, 34, 67–71.
- 33 Zimmermann-Belsing, T., Brabant, G., Holst, J.J. & Feldt-Rasmussen, U. (2003) Circulating leptin and thyroid dysfunction. European Journal of Endocrinology, 149, 257–271.
- 34 Sykiotis, G.P., Neumann, S., Georgopoulos, N.A., Sgourou, A., Papachatzopoulou, A., Markou, K.B., Kyriazopoulou, V., Paschke, R., Vagenakis, A.G. & Papavassiliou, A.G. (2003) Functional significance of the thyrotropin receptor germline polymorphism D727E. Biochemical and Biophysical Research Communications, 301, 1051–1056.
- 35 Gabriel, E.M., Bergert, E.R., Grant, C.S., Van Heerden, J.A., Thompson, G.B. & Morris, J.C. (1999) Germline polymorphism of codon 727 of human thyroid-stimulating hormone receptor is associated with toxic multinodular goiter. Journal of Clinical Endocrinology and Metabolism, 84, 3328–3335.
- 36 Nogueira, C.R., Kopp, P., Arseven, O.K., Santos, C.L., Jameson, J.L. & Medeiros-Neto, G. (1999) Thyrotropin receptor mutations in hyperfunctioning thyroid adenomas from Brazil. Thyroid, 9, 1063–1068.
- 37 Bahn, R.S., Dutton, C.M., Natt, N., Joba, W., Spitzweg, C. & Heufelder, A.E. (1998) Thyrotropin receptor expression in Graves’ orbital adipose/connective tissues: potential autoantigen in Graves’ ophthalmopathy. Journal of Clinical Endocrinology and Metabolism, 83, 998–1002.
- 38 Bell, A., Gagnon, A., Dods, P., Papineau, D., Tiberi, M. & Sorisky, A. (2002) TSH signaling and cell survival in 3T3-L1 preadipocytes. American Journal of Physiology. Cell Physiology, 283, C1056–C1064.
- 39 Davies, T., Marians, R. & Latif, R. (2002) The TSH receptor reveals itself. Journal of Clinical Investigation, 110, 161–164.
- 40 Valyasevi, R.W., Erickson, D.Z., Harteneck, D.A., Dutton, C.M., Heufelder, A.E., Jyonouchi, S.C. & Bahn, R.S. (1999) Differentiation of human orbital preadipocyte fibroblasts induces expression of functional thyrotropin receptor. Journal of Clinical Endocrinology and Metabolism, 84, 2557–2562.
- 41 Morimura, T., Tsunekawa, K., Kasahara, T., Seki, K., Ogiwara, T., Mori, M. & Murakami, M. (2005) Expression of type 2 iodothyronine deiodinase in human osteoblast is stimulated by thyrotropin. Endocrinology, 146, 2077–2084.
- 42 Murakami, M., Araki, O., Hosoi, Y., Kamiya, Y., Morimura, T., Ogiwara, T., Mizuma, H. & Mori, M. (2001) Expression and regulation of type II iodothyronine deiodinase in human thyroid gland. Endocrinology, 142, 2961–2967.
- 43 Murakami, M., Kamiya, Y., Morimura, T., Araki, O., Imamura, M., Ogiwara, T., Mizuma, H. & Mori, M. (2001) Thyrotropin receptors in brown adipose tissue: thyrotropin stimulates type II iodothyronine deiodinase and uncoupling protein-1 in brown adipocytes. Endocrinology, 142, 1195–1201.