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Bjarke R Medici Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Birte Nygaard Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jeppe L la Cour Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark

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Martin Krakauer Department of Clinical Physiology and Nuclear Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Physiology and Nuclear Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark

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Andreas Brønden Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark

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Mette P Sonne Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark

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Jens J Holst Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens F Rehfeld Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Tina Vilsbøll Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Herlev, Denmark

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Jens Faber Department of Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Filip K Knop Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Herlev, Denmark

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mass index (BMI) ( 4 , 5 ), and several factors have been proposed to contribute to this association such as fluid retention ( 6 ), reduced resting energy expenditure (REE) ( 7 ), and reduction in physical activity ( 8 ). Despite the common assumption

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Huixing Liu Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

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Daoquan Peng Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

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energy metabolism by activating the AMPK-SIRT1-PGC-1alpha pathway . PNAS 2010 107 12553 – 12558 . ( https://doi.org/10.1073/pnas.1006962107 ) 74 Iizuka K Takao K Kato T Horikawa Y Takeda J . ChREBP reciprocally regulates liver and plasma

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Shi-en Fu Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Rou-mei Wang Department of Ultrasonic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Xing-huan Liang Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Jing Xian Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Jie Pan Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Xue-lan Chen Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Cheng-cheng Qiu Department of Ultrasonic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Zhi-ping Tang Department of Ultrasonic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Ying-fen Qin Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Hai-yan Yang Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Li-li Huang Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
Department of Endocrinology, The Affiliated Hospital of Guilin Medical University, Guilin, China

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Ya-qi Kuang Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Yan Ma Department of Ultrasonic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Zuo-jie Luo Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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that coupled oxidative phosphorylation and uncoupled respiration may play an important role in the impairment of mitochondrial energy metabolism in skeletal muscles ( 49 , 50 ). Excess thyroid hormone levels accelerate protein catabolism and reduce

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Yukari Maki Department of Pediatric Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Kiyomi Horiuchi Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Takahiro Okamoto Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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patients on levothyroxine monotherapy have a low serum fT3 level, and those with a normal serum TSH level were not necessarily euthyroid in terms of energy expenditure, lipid metabolism, dissatisfaction, or quality of life, including fatigue ( 36 , 37

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Qiankai Jin Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Guoqing Huang Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Xiaoqing Tian Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Yimeng Shu Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Ximisinuer Tusongtuoheti Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Yushan Mao Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China

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MetS ( 4 ). Thyroid hormones (THs) are vital hormones that regulate the metabolism of substances ( 5 ) and therefore affect MetS and its components by regulating energy homeostasis, lipid metabolism, and gluconeogenesis. However, the association

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Sophie-Charlotte Drogge Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Mirjam Frank Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Carolin Girschik Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Karl-Heinz Jöckel Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Dagmar Führer-Sakel Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Börge Schmidt Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Introduction Thyroid hormones play an important role in almost all biological processes in humans such as energy metabolism, cell growth, development, cardiovascular system, CNS, immunity and bone metabolism ( 1 , 2 ). Importantly, several

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