<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2312-3893</journal-id>
<journal-title><![CDATA[Revista Virtual de la Sociedad Paraguaya de Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. virtual Soc. Parag. Med. Int.]]></abbrev-journal-title>
<issn>2312-3893</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2312-38932024000100005</article-id>
<article-id pub-id-type="doi">10.18004/rvspmi/2312-3893/2024.e11122406</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome metabólico e hipotiroidismo: un estudio transversal en una población ecuatoriana]]></article-title>
<article-title xml:lang="en"><![CDATA[Metabolic syndrome and hypothyroidism: a cross-sectional study in an Ecuadorian population]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tene Salcán]]></surname>
<given-names><![CDATA[Diego Mauricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Robalino Congacha]]></surname>
<given-names><![CDATA[Jorge Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pedreáñez Santana]]></surname>
<given-names><![CDATA[Adriana Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional del Chimborazo Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Riobamba ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General Andino  ]]></institution>
<addr-line><![CDATA[Riobamba ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad del Zulia Facultad de Medicina Escuela de Bioanálisis]]></institution>
<addr-line><![CDATA[Maracaibo ]]></addr-line>
<country>Venezuela</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>11</volume>
<numero>1</numero>
<fpage>5</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2312-38932024000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2312-38932024000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2312-38932024000100005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  el síndrome metabólico y el hipotiroidismo son condiciones muy frecuentes y a menudo superpuestas. Ambos son precursores bien establecidos de la enfermedad cardiovascular aterogénica.  Objetivo:  evaluar la asociación entre el hipotiroidismo y el síndrome metabólico en pacientes que asisten a la consulta de medicina interna del Hospital IESS de Riobamba, Ecuador.  Metodología:  se realizó una investigación de tipo descriptiva, correlacional con un diseño no experimental de corte transversal desde enero de 2022 hasta julio de 2023. Se incluyeron 985 sujetos de ambos sexos, mayores de 25 años. A todos los pacientes se les realizó un exhaustivo examen físico y se tomaron muestras de sangre para la realización de pruebas bioquímicas y hormonales.  Resultados:  84,97% de los participantes eran eutiroideos, 1,93% presentaron hipotiroidismo manifiesto y 4,97% hipotiroidismo subclínico, mientras que 32,99% tenían síndrome metabólico. Se encontraron diferencias significativas en la edad, peso, circunferencia de cintura, colesterol total, LDL colesterol, triglicéridos, glucosa postpandrial y HOMA-IR entre los sujetos con hipotiroidismo manifiesto y los eutiroideos (p&lt;0,05). Se observó una correlación positiva entre la TSH y todos los componentes del síndrome metabólico (p&lt;0,05). La prevalencia de síndrome metabólico fue significativamente mayor en los sujetos con hipotiroidismo manifiesto (p &lt; 0,05) que en los demás grupos. Se observó que los niveles de T4L (OR 8,82; IC 95% 1,56-49,8) y TSH (OR 1,61; IC 95% 1,19-2,18) son factores de riesgo para el desarrollo de síndrome metabólico.  Conclusión:  el hipotiroidismo y el síndrome metabólico están altamente asociados. Es recomendable que los sujetos con hipotiroidismo sean examinados para detectar síndrome metabólico y viceversa. La evaluación de la función tiroidea en pacientes con este síndrome puede ayudar a identificar y prevenir el riesgo de eventos cardiovasculares y cerebrovasculares.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Metabolic syndrome and hypothyroidism are widespread and often overlapping conditions. Both are well-established precursors of atherogenic cardiovascular disease.  Objective: To evaluate the association between hypothyroidism and metabolic syndrome in patients attending the internal medicine consultation at the IESS Hospital in Riobamba, Ecuador.  Methodology: A descriptive, correlational research study was conducted with a non-experimental cross-sectional design from January 2022 to July 2023. Nine hundred eighty-five subjects of both sexes and over 25 years of age, were included. All patients underwent a thorough physical examination and blood samples were taken for biochemical and hormonal tests.  Results: Eighty-four-point ninety-seven percent of the participants were euthyroid, 1.93% presented overt hypothyroidism, 4.97% had subclinical hypothyroidism, and 32.99% had metabolic syndrome. Significant differences in age, weight, waist circumference, total cholesterol, LDL cholesterol, triglycerides, postprandial glucose, and HOMA-IR were found between subjects with manifest hypothyroidism and euthyroid subjects (p&lt;0.05). A positive correlation was observed between TSH and all components of the metabolic syndrome (p&lt;0.05). The prevalence of metabolic syndrome was significantly higher in subjects with overt hypothyroidism (p &lt; 0.05) than in the other groups. It was observed that the levels of FT4 (OR 8.82; 95% CI 1.56-49.8) and TSH (OR 1.61; 95% CI 1.19-2.18) were risk factors for the development of the metabolic syndrome.  Conclusion: Hypothyroidism and metabolic syndrome are highly associated. It is recommended that subjects with hypothyroidism be screened for metabolic syndrome and vice versa. Evaluation of thyroid function in patients with this syndrome can help identify and prevent the risk of cardiovascular and cerebrovascular events.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[síndrome metabólico]]></kwd>
<kwd lng="es"><![CDATA[hipotiroidismo]]></kwd>
<kwd lng="es"><![CDATA[hormonas tiroideas]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo de enfermedad cardiaca]]></kwd>
<kwd lng="en"><![CDATA[metabolic syndrome]]></kwd>
<kwd lng="en"><![CDATA[hypothyroidism]]></kwd>
<kwd lng="en"><![CDATA[thyroid hormones]]></kwd>
<kwd lng="en"><![CDATA[heart disease risk factors]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Waring]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Rodondi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Harrison]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kanaya]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Simonsick]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Miljkovic]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid function and prevalent and incident metabolic syndrome in older adults]]></article-title>
<source><![CDATA[Clin Endocrinol (Oxf)]]></source>
<year>2012</year>
<volume>76</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>911-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Madan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Paliwal]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kesar]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Chauhan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Madan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metabolic Syndrome]]></article-title>
<source><![CDATA[Endocr Metab Immune Disord Drug Targets]]></source>
<year>2023</year>
<volume>23</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1491-504</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[O'Neill]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[O'Driscoll]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metabolic syndrome]]></article-title>
<source><![CDATA[Obes Rev]]></source>
<year>2015</year>
<volume>16</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-12</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alberti]]></surname>
<given-names><![CDATA[KGMM]]></given-names>
</name>
<name>
<surname><![CDATA[Zimmet]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Shaw]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metabolic syndrome--a new world-wide definition]]></article-title>
<source><![CDATA[Diabet Med]]></source>
<year>2006</year>
<volume>23</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>469-80</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brenta]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sosa Caballero]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Nunes]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Case finding for hypothyroidism should include type 2 diabetes and metabolic syndrome patients]]></article-title>
<source><![CDATA[Endocr Pract]]></source>
<year>2019</year>
<volume>25</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>101-5</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ding]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[ChY]]></surname>
<given-names><![CDATA[Zhu]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[LP]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[ZY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The association between subclinical hypothyroidism and metabolic syndrome]]></article-title>
<source><![CDATA[Endocr J]]></source>
<year>2021</year>
<volume>68</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1043-56</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[YY]]></given-names>
</name>
<name>
<surname><![CDATA[Brent]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid hormone crosstalk with nuclear receptor signaling in metabolic regulation]]></article-title>
<source><![CDATA[Trends Endocrinol Metab]]></source>
<year>2010</year>
<volume>21</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>166-73</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dimitriadis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Mitrou]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Lambadiari]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Boutati]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Maratou]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Panagiotakos]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin action in adipose tissue and muscle in hypothyroidism]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2006</year>
<volume>91</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>4930-7</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lemieux]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Després]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metabolic syndrome]]></article-title>
<source><![CDATA[Nutrients]]></source>
<year>2020</year>
<volume>12</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>3501</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[He]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Yao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Teng]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Shan]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The relationship between thyroid function and metabolic syndrome and its components]]></article-title>
<source><![CDATA[Front Endocrinol]]></source>
<year>2021</year>
<volume>12</volume>
<page-range>661160</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Teixeira]]></surname>
<given-names><![CDATA[PFDS]]></given-names>
</name>
<name>
<surname><![CDATA[Dos Santos]]></surname>
<given-names><![CDATA[PB]]></given-names>
</name>
<name>
<surname><![CDATA[Pazos-Moura]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of thyroid hormone in metabolism and metabolic syndrome]]></article-title>
<source><![CDATA[Ther Adv Endocrinol Metab.]]></source>
<year>2020</year>
<volume>11</volume>
<page-range>2042018820917869</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thygesen]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
<name>
<surname><![CDATA[Ersbøll]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[When the entire population is the sample]]></article-title>
<source><![CDATA[Eur J Epidemiol]]></source>
<year>2014</year>
<volume>29</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>551-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Su]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hyperlipidemia and hypothyroidism]]></article-title>
<source><![CDATA[Clin Chim Acta]]></source>
<year>2022</year>
<volume>527</volume>
<page-range>61-70</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gao]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cao]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Xiao]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Correlation between subclinical hypothyroidism and dyslipidemia in women in northeast China]]></article-title>
<source><![CDATA[Acta Endocrinol (Buchar)]]></source>
<year>2021</year>
<volume>17</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>282-5</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díez]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Iglesias]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Serum cholesterol and triglyceride concentrations in diabetic patients with subclinical hypothyroidism]]></article-title>
<source><![CDATA[Endocrinol Nutr]]></source>
<year>2014</year>
<volume>61</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>419-25</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Cheng]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[New insights into regulation of lipid metabolism by thyroid hormone]]></article-title>
<source><![CDATA[Curr Opin Endocrinol Diabetes Obes]]></source>
<year>2010</year>
<volume>17</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>408-13</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
<name>
<surname><![CDATA[Shiu]]></surname>
<given-names><![CDATA[SW]]></given-names>
</name>
<name>
<surname><![CDATA[Kung]]></surname>
<given-names><![CDATA[AW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of thyroid dysfunction on high-density lipoprotein subfraction metabolism]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>1998</year>
<volume>83</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>2921-4</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Feingold]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The effect of endocrine disorders on lipids and lipoproteins]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Feingold]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
<name>
<surname><![CDATA[Anawalt]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Blackman]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Boyce]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Chrousos]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Corpas]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Endotext]]></source>
<year>2000</year>
<publisher-loc><![CDATA[South Dartmouth (MA) ]]></publisher-loc>
<publisher-name><![CDATA[MDText.com]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Santi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Duarte]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Moresco]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
<name>
<surname><![CDATA[Menezes]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bagatini]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Schetinger]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Loro]]></surname>
<given-names><![CDATA[VL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between thyroid hormones, lipids and oxidative stress biomarkers in overt hypothyroidism]]></article-title>
<source><![CDATA[Clin Chem Lab Med]]></source>
<year>2010</year>
<volume>48</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1635-9</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[de Moura Souza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sichieri]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between serum TSH concentration within the normal range and adiposity]]></article-title>
<source><![CDATA[Eur J Endocrinol]]></source>
<year>2011</year>
<volume>165</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11-5</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[YK]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Oh]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[SW]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Cho]]></surname>
<given-names><![CDATA[YW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Serum TSH level in healthy Koreans and the association of TSH with serum lipid concentration and metabolic syndrome]]></article-title>
<source><![CDATA[Korean J Intern Med]]></source>
<year>2011</year>
<volume>26</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>432-9</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Ch]]></surname>
<given-names><![CDATA[Jin]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Shan]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Subclinical hypothyroidism increases insulin resistance in normoglycemic people]]></article-title>
<source><![CDATA[Front Endocrinol]]></source>
<year>2023</year>
<volume>14</volume>
<page-range>1106968</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koppad]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between insulin resistance and hypothyroidism - a case-control study]]></article-title>
<source><![CDATA[J Assoc Physicians India]]></source>
<year>2020</year>
<volume>68</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>46</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stanická]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Vondra]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Pelikánová]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Vlcek]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hill]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zamrazil]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin sensitivity and counter-regulatory hormones in hypothyroidism and during thyroid hormone replacement therapy]]></article-title>
<source><![CDATA[Clin Chem Lab Med]]></source>
<year>2005</year>
<volume>43</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>715-20</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Iwen]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Schröder]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Brabant]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid hormones and the metabolic syndrome]]></article-title>
<source><![CDATA[Eur Thyroid J]]></source>
<year>2013</year>
<volume>2</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>83-92</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bianco]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Dumitrescu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gereben]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[GW]]></given-names>
</name>
<name>
<surname><![CDATA[Bocco]]></surname>
<given-names><![CDATA[BMLC.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Paradigms of dynamic control of thyroid hormone signaling]]></article-title>
<source><![CDATA[Endocr Rev]]></source>
<year>2019</year>
<volume>40</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1000-47</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Klieverik]]></surname>
<given-names><![CDATA[LP]]></given-names>
</name>
<name>
<surname><![CDATA[Janssen]]></surname>
<given-names><![CDATA[SF]]></given-names>
</name>
<name>
<surname><![CDATA[van Riel]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Foppen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bisschop]]></surname>
<given-names><![CDATA[PH]]></given-names>
</name>
<name>
<surname><![CDATA[Serlie]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid hormone modulates glucose production via a sympathetic pathway from the hypothalamic paraventricular nucleus to the liver]]></article-title>
<source><![CDATA[Proc Natl Acad Sci U S A]]></source>
<year>2009</year>
<volume>106</volume>
<numero>14</numero>
<issue>14</issue>
<page-range>5966-71</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McAninch]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Bianco]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid hormone signaling in energy homeostasis and energy metabolism]]></article-title>
<source><![CDATA[Ann N Y Acad Sci]]></source>
<year>2014</year>
<volume>1311</volume>
<page-range>77-87</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fontenelle]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
<name>
<surname><![CDATA[Feitosa]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Severo]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Freitas]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
<name>
<surname><![CDATA[Morais]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Torres-Leal]]></surname>
<given-names><![CDATA[FL]]></given-names>
</name>
<name>
<surname><![CDATA[Henriques]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[do Nascimento Marreiro]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid function in human obesity]]></article-title>
<source><![CDATA[Horm Metab Res]]></source>
<year>2016</year>
<volume>48</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>787-94</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brenta]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Why can insulin resistance be a natural consequence of thyroid dysfunction?]]></article-title>
<source><![CDATA[J Thyroid Res.]]></source>
<year>2011</year>
<volume>2011</volume>
<page-range>152850</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Senese]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Lasala]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Leanza]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[de Lange]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[New avenues for regulation of lipid metabolism by thyroid hormones and analogs.]]></article-title>
<source><![CDATA[Front Physiol.]]></source>
<year>2014</year>
<volume>5</volume>
<page-range>475</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Razvi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Jabbar]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Pingitore]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Danzi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Biondi]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Klein]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Peeters]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zaman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Iervasi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid hormones and cardiovascular function and diseases]]></article-title>
<source><![CDATA[J Am Coll Cardiol]]></source>
<year>2018</year>
<volume>71</volume>
<numero>16</numero>
<issue>16</issue>
<page-range>1781-96</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Khatiwada]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sah]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Kc]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Baral]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Lamsal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid dysfunction in metabolic syndrome patients and its relationship with components of metabolic syndrome]]></article-title>
<source><![CDATA[Clin Diabetes Endocrinol]]></source>
<year>2016</year>
<volume>2</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bae]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[HK]]></given-names>
</name>
<name>
<surname><![CDATA[Byun]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Suh]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Yoo]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Triiodothyronine levels are independently associated with metabolic syndrome in euthyroid middle-aged subjects]]></article-title>
<source><![CDATA[Endocrinol Metab (Seoul)]]></source>
<year>2016</year>
<volume>31</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>311-9</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roos]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bakker]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Links]]></surname>
<given-names><![CDATA[TP]]></given-names>
</name>
<name>
<surname><![CDATA[Gans]]></surname>
<given-names><![CDATA[RO]]></given-names>
</name>
<name>
<surname><![CDATA[Wolffenbuttel]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2007</year>
<volume>92</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>491-6</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between thyroid hormone and components of metabolic syndrome in euthyroid Korean adults]]></article-title>
<source><![CDATA[Medicine]]></source>
<year>2021</year>
<volume>100</volume>
<numero>51</numero>
<issue>51</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
