Objective. To evaluate the relation between serum thyroid-stimulating hormone (TSH) and lipids. Design. Cross-sectional epidemiological study, nested case-control study, and a placebo-controlled double-blind intervention study. Methods. In the 5th Tromsø study serum TSH, total cholesterol (TC), triglycerides (TG), highdensity lipoprotein cholesterol (HDL-C), and lowdensity lipoprotein cholesterol (LDL-C) were measured.Subjects with subclinical hypothyroidism (SHT) and a matching control group were re-examined and apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) were also measured. Subjects with SHT were included in an intervention study with thyroxine supplementation for 1 year.Results. A total of 5143 subjects from the 5th Tromsø study were included. A significant and positive correlation between serum TSH levels and serum TC and LDL-C levels were found in both genders. However, in the females this did not reach statistical significance after adjusting for age and BMI. The serum LDL-C were significantly higher and the Apo A1 levels significantly lower in 84 SHT subjects compared with 145 controls, and in the SHT females the TC levels were also significantly elevated. In the intervention study (32 subjects given thyroxine and 32 subjects given placebo), we observed a significant reduction in the Apo B levels after thyroxine medication. In those that at the end of the study had serum TSH levels in the range 0.2-2.0 mIU L )1 , the serum TC and LDL-C levels were also significantly reduced. Conclusions. There is a positive association between serum TSH levels and TC and LDL-C levels. These lipid levels are reduced with thyroxine treatment in subjects with SHT.

It appears to be an association between hypothyroidism and hypertension. However, the relation between thyroid function and blood pressure within the normal serum thyrotropin (TSH) range is uncertain. In the fifth Tromsø study, which is a population-based health survey, serum TSH and blood pressure were measured. This gave us the opportunity to test the hypothesis of a relation between serum TSH and blood pressure within the normal serum TSH range. In all 5872 subjects (2623 male subjects) not using blood pressure or thyroxine medication were included in the present study. Within the normal serum TSH range (0.20-4.00 mIU/l), there was a significant and positive relation between serum TSH and both systolic and diastolic blood pressure. Within this range, and adjusted for age, body mass index and smoking status, the systolic blood pressure was 1.4 mm Hg and the diastolic 1.6 mm Hg higher in male subjects in the highest versus those in the lowest serum TSH quartile. The corresponding differences in the female subjects were 4.0 and 2.7 mm Hg, respectively. When dividing this cohort in those with systolic (4160 mm Hg) and diastolic (495 mm Hg) hypertension, serum TSH was higher in the hypertensive subjects, but the differences were only statistically significant for diastolic hypertension (serum TSH 1.8870.82 versus 1.6970.74 mIU/l for male subjects, and 1.7970.78 versus 1.6370.75 mIU/l for female subjects, Po0.05). In conclusion, there is a modest, but significant positive association between serum TSH and blood pressure within the normal serum TSH range.

Post-CABG longitudinal motion of the RV lateral wall is reduced after uneventful CABG despite preserved RV ejection fraction and stroke volume. The discrepancy in various RV systolic performance indicators results from increased sphericity of the RV following opening the pericardium during surgery. Therefore, longitudinal functional parameters may underestimate RV systolic function for at least 8-10 months post-CABG. Changes in deformation parameters should thus always be interpreted in relation to changes in geometry.

With the possible exception of overt hypo- and hyperthyroidism, there is no significant association between serum TSH level and LVMI. Subjects with subclinical hypothyroidism, in whom the mean serum TSH level is slightly above the reference range, appear to have normal cardiac function, whereas subjects with serum TSH levels less than 0.5 mIU/liter appear to have changes in myocardial velocities detected by PWTD.

Persistently reduced longitudinal function was observed in more than half of pre-operatively viable but dysfunctional segments after CABG. We propose that such a functional impairment marks a regional remodelling process not amendable to re-established blood flow.