Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace

Abstract

CONTEXT AND OBJECTIVE: Subclinical thyroid dysfunction is very common in clinical practice and there is some evidence that it may be associated with cardiovascular disease. The aim here was to evaluate the frequencies of subclinical thyroid disease and risk factors for cardiovascular disease among women at a workplace, and to evaluate the association between subclinical thyroid disease and cardiovascular risk factors among them.DEsIgN AND sETTINg: Cross-sectional study on 314 women aged 40 years or over who were working at Universidade de São Paulo (USP).METhODs: All the women answered a questionnaire on sociodemographic characteristics and risk factors for cardiovascular disease and the Rose angina questionnaire. Anthropometric variables were measured and blood samples were analyzed for blood glucose, total cholesterol and fractions, highsensitivity C-reactive protein, thyroid-stimulating hormone (TSH), free thyroxine (free-T4) and anti-thyroperoxidase antibodies (anti-TPO).REsulTs: The frequencies of subclinical hypothyroidism and hyperthyroidism were, respectively, 7.3% and 5.1%. Women with subclinical thyroid disease presented higher levels of anti-TPO than did women with normal thyroid function (P = 0.01). There were no differences in sociodemographic factors and cardiovascular risk factors according to thyroid function status, except for greater sedentarism among the women with subclinical hypothyroidism.Restricting the comparison to women with subclinical hypothyroidism (TSH > 10 mIU/l) did not change the results.CONClusION: In this sample of women, there was no association between poor profile of cardiovascular risk factors and presence of subclinical thyroid disease that would justify screening at the workplace. RESUMOCONTEXTO E OBJETIVO: A doença tireoidiana subclínica é muito frequente na prática clínica e há evidências que sugerem associação com doença cardiovascular. O objetivo foi estabelecer a frequência das doenças subclínicas da tireóide e de fatores de risco para doença cardiovascular em mulheres no local de trabalho, bem como avaliar a associação da doença tireoidiana subclínica com fatores de risco para doença cardiovascular nessas mulheres. TIPO DE EsTuDO E lOCAl: Estudo transversal em 314 mulheres com 40 ou mais anos de idade que trabalham na Universidade de São Paulo.MéTODOs: Todas as mulheres responderam a questionário sobre características sócio-demográficas, fatores de risco para doença cardiovascular, questionário de angina de Rose, e foram realizadas medidas antropométricas e colhido sangue para dosagem de glicemia, colesterol total e frações, proteína C ultra-sensível, hormônio tireotrópico (TSH), tiroxina-livre (TS-livre) e anticorpos anti-tireoperoxidase.REsulTADOs: As frequências de hipotireoidismo subclínico e de hipertireoidismo subclínico foram respectivamente de 7,3% e 5,1%. Os níveis de anticorpos antiperoxidase foram mais elevados nas mulheres com doença subclínica da tireoide comparadas às mulheres com função tireoidiana normal (P = 0,01). Não houve nenhuma diferenç...

Evaluation of the relationship between subclinical hypothyroidism and metabolic syndrome components among workers

“…So far, most studies have shown controversial results with regard to the relationship of mildly elevated TSH with blood pressure and HDL levels. In addition, the finding that SCH was not associated with any cardiovascular risks in women concurs with a similar study of women in a workplace [33]. Thus, there is a possibility that a mild elevation of TSH may not result in cardiovascular risks in middle-aged women as compared to men of the same age.…”

Pattern of Thyroid Dysfunction in Patients with Metabolic Syndrome and Its Relationship with Components of Metabolic Syndrome

“…Thyroid dysfunction (TD) is defined as the altered serum thyroid stimulating hormone (TSH) level with normal or altered thyroid hormones (free triiodothyronine [fT3] and free thyroxine [fT4]) [6]. TD is risk factors for ASCVD mediated by the effects of thyroid hormones on lipid and glucose metabolism and blood pressure, hence on components of MetS [7].…”

Thyroid disorders in Brazil: the contribution of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

“…Few studies have reported information about prevalence of thyroid diseases in Brazil (4–6) (Table 1). The population-based Sao Paulo Ageing & Health Study (SPAH) reported the prevalence of thyroid disorders in 1373 subjects aged 65 years or more.…”

“…Most information about chronic diseases in the literature comes from large cohort studies in the United States and Western Europe, and there is little information about non-classical risk factors associated with cardiovascular disease in low-middle income countries like Brazil. Information about thyroid disease epidemiology in Brazil is scarce, but the studies that do exist suggest a high burden associated with thyroid disorders in the country (4–6) Therefore, data from the ELSA-Brasil is a very good opportunity to analyze, in a multicenter sample, the relationship between subclinical thyroid disorders and other conditions in a large Brazilian sample.…”