Flow chart of the study population. Article Swipe

Kyung-Hun Sung (22766203) , Jeongeun Kwak (22766206) , Mee Kyung Kim (22766209) , Dong-Jun Lim (3910636) , Jung-Min Lee (546902) , Sang-Ah Chang (3910642) , Jeongmin Lee (482745) ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1371/journal.pone.0336920.g001

Purpose Although overt thyroid dysfunction has been associated with changes in pulmonary function, the effects of thyroid hormone levels and thyroid autoimmunity on lung function in euthyroid individuals remain unclear. We investigated the associations between subtle changes in thyroid hormones and thyroid peroxidase antibodies (TPOAb) and pulmonary function in a nationally representative cohort of Korean adults. Methods We analyzed data from 2,626 euthyroid participants aged ≥ 40 years from the Korea National Health and Nutrition Examination Survey (2013–2015). Pulmonary function was assessed using spirometry-derived forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratio. Multivariable linear regression analyses were conducted after adjusting for age, sex, body mass index (BMI), smoking status, alcohol intake, and physical activity. Results In the unadjusted models, higher free thyroxine levels were positively associated with FVC and FEV1, while higher TSH levels were inversely associated. In contrast, elevated TPOAb levels were independently associated with reduced FEV1 (β = −0.330, P = 0.021). These associations were more pronounced among adults aged ≥60 years and individuals with a BMI ≤ 23 kg/m². Conclusion Thyroid autoimmunity, as reflected by elevated TPOAb levels, was associated with a decline in pulmonary function among euthyroid individuals, independent of thyroid hormone levels. Our results support the clinical utility of TPOAb status as an early marker for detecting subclinical pulmonary vulnerability, particularly in older adults and those with a lower BMI.

Related Topics

Thyroid-Stimulating Hormone

Physiology

Lung Volumes

Concepts

Medicine Euthyroid Vital capacity Subclinical infection Thyroid function Pulmonary function testing Body mass index Thyroid Cohort Internal medicine Thyroid function tests Spirometry Hormone Thyroid peroxidase Cohort study Young adult Endocrinology Physical examination National Health and Nutrition Examination Survey Thyroid-stimulating hormone Physiology Anti-thyroid autoantibodies Autoimmune thyroiditis Cross-sectional study Lung volumes

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DOI: https://doi.org/10.1371/journal.pone.0336920.g001

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Title: Flow chart of the study population.

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Publication year: 2025

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Publication date: 2025-12-02

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Authors: Kyung-Hun Sung (22766203), Jeongeun Kwak (22766206), Mee Kyung Kim (22766209), Dong-Jun Lim (3910636), Jung-Min Lee (546902), Sang-Ah Chang (3910642), Jeongmin Lee (482745)

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Concepts: Medicine, Euthyroid, Vital capacity, Subclinical infection, Thyroid function, Pulmonary function testing, Body mass index, Thyroid, Cohort, Internal medicine, Thyroid function tests, Spirometry, Hormone, Thyroid peroxidase, Cohort study, Young adult, Endocrinology, Physical examination, National Health and Nutrition Examination Survey, Thyroid-stimulating hormone, Physiology, Anti-thyroid autoantibodies, Autoimmune thyroiditis, Cross-sectional study, Lung volumes

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