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Thyroid dysfunction has been implicated as a potential pathophysiological factor in glucose homeostasis and insulin resistance (IR). This study aimed to identify the correlation between thyroid dysfunction and IR. We used data from the sixth Korean National Health and Nutrition Examination Survey to evaluate a total of 5727 participants. The triglyceride glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated to represent IR. Correlation analysis was performed between thyroid dysfunction and IR. The log-transformed TSH (LnTSH) and free T4 were significantly correlated with the TyG index (TSH, beta coefficient 0.025, 95% confidence interval [CI] 0.014–0.036,  p  < 0.001; free T4, − 0.110 (− 0.166 to − 0.054),  p  < 0.001) but not HOMA-IR. Overt hypothyroidism is correlated with increased TyG index in pre-menopausal females (0.215 (0.122–0.309)  p  < 0.001). On the other hand, overt hyperthyroidism is correlated with increased HOMA-IR in males (0.304 (0.193–0.416),  p  < 0.001) and post-menopausal females (1.812 (1.717–1.907),  p  < 0.001). In euthyroid subjects, LnTSH and TyG index were significantly correlated in females. In conclusion, both hyperthyroidism and hypothyroidism might be associated with IR but by different mechanisms. It might be helpful to assess IR with appropriate indexes in patients with thyroid dysfunction.

Association between thyroid hormones and insulin resistance indices based on the Korean National Health and Nutrition Examination Survey