Effect of Thyroxin Treatment on Carotid Intima–Media Thickness (CIMT) Reduction in Patients with Subclinical Hypothyroidism (SCH): a Meta-Analysis of Clinical Trials

Aziz, Muhammad; Kandimalla, Yugandhar; Machavarapu, Archana; Saxena, Anshul; Das, Sankalp; Younus, Adnan; Nguyen, Michelle; Malik, Rehan; Anugula, Dixitha; Latif, Muhammad; Humayun, Choudhry; Khan, Idrees; Adus, Ali; Rasool, Aisha; Veledar, Emir

doi:10.5551/jat.39917

Cited by 49 publications

(35 citation statements)

References 56 publications

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“…Therefore, it is necessary to identify the relevant risk factors for CIMT to facilitate the early comprehensive prevention and treatment of macroangiopathy. According to previous studies, CIMT can be affected by many factors, including age [16][17][18], sex [16][17][18], smoking [19,20], blood pressure [21], blood lipid levels [22], thyroid function [23,24], blood glucose levels [25], blood glucose level fluctuations, and C-peptide levels [26,27].…”

Section: Introductionmentioning

confidence: 99%

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

Zhou

Qiu

Yang

et al. 2020

Diabetol Metab Syndr

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Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes (T2DM). Carotid intima-media thickness (CIMT) is considered a preclinical stage of atherosclerosis. Therefore, it is necessary to identify the related risk factors for CIMT to facilitate the early prevention of CVD. Previous studies have shown that visceral fat area (VFA) is a risk factor for T2DM and CVD. However, few studies have focused on the effects of VFA on CIMT associated with T2DM. Moreover, considering that the body fat distribution shows regional and racial heterogeneity, the purpose of this study was to investigate the predictive value of VFA and other risk factors for CIMT associated with T2DM in Western China. Methods: In a cross-sectional study, a total of 1372 patients with T2DM were divided into the CIMT (−) group (n = 965) and the CIMT (+) group (n = 407) based on CIMT values. In addition to the univariate analyses, logistic regression analysis and a decision tree model were simultaneously performed to establish a correlation factor model for CIMT. Results: Univariate analyses showed that sex, smoking status, age, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight, body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, VFA, subcutaneous fat area, and the levels of 2-h C-peptide, serum creatinine, urea nitrogen and uric acid were significantly different between the two groups (all p < 0.05). Smoking, increased VFA, female sex and increased BMI were risk factors in the logistic regression analyses (OR = 5.759, OR = 1.364, OR = 2.239, OR = 1.186, respectively). In the decision tree model, smoking was the root node, followed by sex, waist circumference, VFA and chronic kidney disease (CKD) in order of importance. Conclusions: In addition to smoking, sex and BMI, VFA has a significant effect on CIMT associated with T2DM in the Chinese Han population in Western China. In addition, the decision tree model could help clinicians make more effective decisions, with its simplicity and intuitiveness, making it worth promoting in future medical research.

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Section: Introductionmentioning

confidence: 99%

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

Zhou

Qiu

Yang

et al. 2020

Diabetol Metab Syndr

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“…Among the 52 included eligible MAs, 4628–73 (46/52, 88.5%) were published in English, and the rest74–79 (6/52, 11.5%) were published in Chinese. The 52 included MAs contained 685 studies, with an average of 13.2 (range: 3–39) studies per article.…”

Section: Resultsmentioning

confidence: 99%

“…Ten39 40 43 49 57 58 65 68–70 MAs were about the associations between OH and other diseases, and 3528–36 38 42 44–47 50–56 59–64 66 67 75–79 MAs have shown the associations between SCH and other diseases. Seven37 41 48 71–74MAs have investigated the effects of both OH and SCH on other diseases.…”

Section: Resultsmentioning

confidence: 99%

Hypothyroidism and related diseases: a methodological quality assessment of meta-analysis

Tian¹,

Shao²,

Qin³

et al. 2019

BMJ Open

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ObjectivesThere is an increasing prevalence of hypothyroidism and there is a growing body of meta-analyses (MAs) on the association between hypothyroidism and other diseases. However, the methodological quality of the MAs significantly varies. Thus, this study aimed to evaluate and summarise data on the methodological quality of MAs on the associations between hypothyroidism and other diseases using the Assessment of Multiple Systematic Reviews (AMSTAR) scale, providing suggestions for clinical decision-making processes.DesignTo assess the methodological quality of MAs using the AMSTAR scale.Data sourcesA systematic literature search was performed in PubMed, EMBASE, the Cochrane Library, web of science and Chinese Biomedicine Literature Database.Eligibility criteriaWe included MAs that had assessed the association between hypothyroidism and other diseases in humans and that had full texts regardless of the publication status. No restriction applied on language or date.Data extraction and synthesisTwo reviewers independently screened the titles and abstracts of all searched literature to acquire potentially eligible publications. The full texts of possible eligible publications were downloaded and assessed. Inconsistent comments were resolved through discussions with a third reviewer.Results52 studies were included. The average AMSTAR score of the included articles was 8.6 (range: 5–10), and those of English and Chinese MAs were 8.8 and 7.0, respectively. A total of 52 MAs were evaluated, and 19 (36.5%) and 33 (63.5%) of these MAs were of moderate and high quality, respectively. None of the MAs were of low quality. Only two MAs had an a priori design. Items 3, 5 and 9 had the highest compliance (50/52, 96.2%), and aside from item 1, items 7 and 8 had the lowest compliance (33/52,63.5%). According to the results of these MAs, hypothyroidism was significantly associated with cardiovascular diseases, metabolic diseases, neuropsychiatric disorders, breast cancer and pregnancy outcome.ConclusionsThe methodological quality of the included MAs on the association between hypothyroidism and other diseases was moderate to high. MAs with high qualities confirmed that hypothyroidism was significantly associated with cardiovascular diseases, metabolic syndrome, preterm birth and neonatal outcomes. Consideration of scientific quality when formulating conclusions should be made explicit and more attention should be paid to improving the methodological quality of MAs, and increasing their applicability for clinical decision-making.

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“…HT is atherogenic [5], and thyroxine supplementation could theoretically alleviate atherosclerosis through the mitigation of cholesterol composition and a decrease in in ammation [5]. However, the effects of thyroxine supplementation on the improvement of intima-media thickness have been controversial in previous reports [8,22]. Patients with clinical or subclinical HT are associated with a high frequency of internal CAS [23].…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy

Liu

Chang

Lee

et al. 2020

Preprint

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Background: Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear.Methods: Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to >50% stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group.Results: 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement.Conclusion: Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.

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Effect of Thyroxin Treatment on Carotid Intima–Media Thickness (CIMT) Reduction in Patients with Subclinical Hypothyroidism (SCH): a Meta-Analysis of Clinical Trials

Cited by 49 publications

References 56 publications

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

Hypothyroidism and related diseases: a methodological quality assessment of meta-analysis

Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy

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