Association of low baseline free thyroxin levels with progression of coronary artery calcification over 4 years in euthyroid subjects: the Kangbuk Samsung Health Study

Park, Hye-Jeong; Kim, Jihyun; Han, Eun Jin; Park, Se Eun; Park, Cheol‐Young; Lee, Won Young; Oh, Ki-Won; Park, Sung Woo; Rhee, Eun-Jung

doi:10.1111/cen.12946

Cited by 13 publications

(11 citation statements)

References 39 publications

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“…This study showed that, although their thyroid function was within the normal range, the non-obese AIT patients had relatively lower FT3 and FT4 levels, and higher TSH than the controls. A recent cohort study from the euthyroid population showed that a low baseline FT4 level was associated with a high risk of the progression of coronary artery calcification over 4 years ( 18 ). An in vitro study also found that T3 inhibits the calcification and phenotype transformation of vascular smooth muscle cells ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Liu

Duan

et al. 2018

Front. Endocrinol.

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BackgroundHypothyroidism is an important risk factor for cardiovascular diseases, and autoimmune thyroiditis (AIT) is the leading cause of hypothyroidism. Recent studies showed that even AIT patients with euthyroidism still had an increased number of early atherosclerotic lesions. However, the precise mechanism is not yet known. This study aimed to investigate the association of thyroid function, thyroid autoimmunity, and cardiometabolic risk factors in non-obese AIT patients with euthyroidism.MethodsA total of 5,608 non-obese individuals including 1,402 AIT patient and 4,206 sex-, age-, and body mass index (BMI)-matched healthy controls were recruited.ResultsThe AIT patients had significantly lower free T3 and free T4 levels, and higher TSH, antithyroid peroxidase antibodies (TPOAb) and TgAb levels. The elevated levels of high sensitivity C reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA-IR) were observed in the AIT patients than the controls [hsCRP: 0.65 (0.27–1.33) vs. 0.20 (0.03–0.74) mg/L; HOMA-IR: 2.78 ± 1.60 vs. 2.33 ± 1.49; all P < 0.05]. Thyroid function was not associated with metabolic parameters and inflammatory makers, while the TPOAb titer was positively associated with the HOMA-IR and hsCRP levels after adjustment for confounding factors (all P < 0.05). Multivariate regression analysis demonstrated that the TPOAb level was an independent influencing factor for the HOMA-IR and hsCRP levels (HOMA-IR: β = 0.058, P < 0.05; hsCRP: β = 0.108, P < 0.05).ConclusionThe TPOAb level is associated with HOMA-IR and hsCRP levels independently of thyroid function in non-obese individuals. Mild deviation of thyroid function within the normal range, chronic inflammation, and insulin resistance may be the links between AIT and atherosclerosis in the non-obese population.

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Section: Discussionmentioning

confidence: 99%

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Liu

Duan

et al. 2018

Front. Endocrinol.

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“…In line with this concept, low-normal thyroid function is associated with a greater increased intima media thickness (cIMT), an established biomarker of subclinical atherosclerosis [3, 4]. Furthermore, low-normal thyroid function is associated with increased coronary artery calcification [5] and progression thereof [6], although an association of a high-normal TSH level with increased coronary heart disease risk has been variably reported [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Increased leptin/adiponectin ratio relates to low-normal thyroid function in metabolic syndrome

Tienhoven-Wind

Dullaart

2017

Lipids Health Dis

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BackgroundLow-normal thyroid function within the euthyroid range may contribute to increased atherosclerosis susceptibility. The leptin/adiponectin (L/A) ratio is associated with cardiovascular disease and reflects adipose tissue dysfunction. Relationships of the L/A ratio with low-normal thyroid function are unknown.MethodsRelationships of thyroid stimulating hormone (TSH) and free thyroxine (free T4) with leptin, adiponectin and the L/A ratio in euthyroid subjects were documented in 67 fasting subjects with metabolic syndrome (Mets) and 86 euthyroid subjects without MetS (TSH and free T4 levels within the institutional reference range).ResultsNeither plasma leptin nor adiponectin was significantly correlated with TSH or free T4 in subjects with and without MetS. In the whole group, high sensitivity C-reactive protein (hs-CRP) was positively correlated with the L/A ratio (r = 0.485, P < 0.001). Notably, the L/A ratio was positively correlated with TSH in subjects with MetS (r = 0.252, P = 0.040) but not in subjects without MetS (r = −0.068, P = 0.54; interaction term, P = 0.027). In MetS subjects, the L/A ratio remained positively related with TSH after adjustment for age, sex, diabetes status, hs-CRP and the use of antihypertensive and glucose lowering medication (β = 0.283, P = 0.018), as well as after adjustment for individual MetS components (β = 0.294, P = 0.020).ConclusionsIn the context of MetS, a higher TSH within the euthyroid range confers an increased L/A ratio, a proposed marker of atherosclerosis susceptibility and adipocyte dysfunction.

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“…In agreement with this concept, low-normal thyroid function associates with increased intima media thickness (cIMT), an established marker of subclinical atherosclerosis [4,5]. Moreover, it was documented recently that low-normal thyroid function is associated with progression of coronary artery calcification [6,7], although a high-normal TSH level is unlikely to predict new onset clinically manifest coronary heart disease [8].…”

Section: Introductionmentioning

confidence: 94%

Tumor Necrosis Factor-α is Inversely Related to Free Thyroxine in Euthyroid Subjects Without Diabetes

Tienhoven-Wind

Dullaart

2016

Horm Metab Res

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Lower thyroid functional status within the euthyroid range may confer increased atherosclerosis susceptibility, as evidenced by increased intima media thickness and coronary artery calcification. Associations of lower thyroid functional status with pro-atherogenic (inflammatory) biomarkers may also extend into the euthyroid range. Here we established relationships of plasma tumor necrosis factor-α (TNF-α) with thyroid stimulating hormone (TSH) and free thyroxine (free T) in euthyroid subjects with and without Type 2 diabetes mellitus (T2DM). Fasting TSH, free T, and TNF-α were measured in 81 nondiabetic subjects and in 73 T2DM subjects with Type 2 diabetes mellitus (T2DM; insulin using subjects were excluded) with TSH and free T levels each within the institutional reference ranges. TSH was similar and free T was slightly higher in T2DM (p<0.016). Plasma TNF-α was increased in T2DM (p=0.007). In nondiabetic subjects, TNF-α was correlated inversely with free T (r=-0.25, p=0.022), whereas such a relationship was absent in T2DM subjects (r=0.058, p=0.63). Multivariable linear regression analysis showed that in nondiabetic subjects TNF-α remained inversely associated with free T after adjustment for age and sex (β=-0.243, p=0.032) and additionally for thyroid autoantibodies (β=-0.251, p=0.027), contrasting the lack of relationship in T2DM subjects (interaction: p=0.053). In T2DM subjects, TNF-α was also unrelated to free T taking account of possible confounders, as well as after exclusion of subjects using metformin or antihypertensive medication. In conclusion, higher levels of TNF-α relate to lower free T. Low-normal thyroid function could influence pro-inflammatory pathways. This relationship appears to be disturbed in T2DM.

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Association of low baseline free thyroxin levels with progression of coronary artery calcification over 4 years in euthyroid subjects: the Kangbuk Samsung Health Study

Abstract: In this cohort of euthyroid men and women, a low baseline FT4 level was associated with a high risk of CACS progression over 4 years.

Cited by 13 publications

References 39 publications

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Increased leptin/adiponectin ratio relates to low-normal thyroid function in metabolic syndrome

Tumor Necrosis Factor-α is Inversely Related to Free Thyroxine in Euthyroid Subjects Without Diabetes

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