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Purpose  The aim of the study is to explore the independent association of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance.    Methods  A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)], hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China.    Results  Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4 ± 44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1–3, respectively,  p  = 0.007) and fatty liver index (FLI) score (47.7 (33.9–60.8), 61.5 (45.1–88.9) and 90.5 (84.5–94.8), respectively,  p  < 0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (β (95%CI): 0.024 (0.004–0.043),  p  = 0.020), HOMA-IR (β (95%CI): 0.091 (0.007–0.174),  p  = 0.034), CAP (β (95%CI): 25.45 (2.59–48.31),  p  = 0.030) and FLI (β (95%CI): 0.121 (0.049–0.194),  p  = 0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis.    Conclusions  Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults.   Trial registration  Registration is not applicable for our study.

Independent associations of thyroid-related hormones with hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults