Hypothyroidism is not associated with increased carotid atherosclerosis when cardiovascular risk factors are accounted for in hyperlipidemic patients

F, Chiche; Jublanc, Christel; Coudert, Mathieu; Carreau, Valérie; Kahn, Jean-François; Bruckert, Éric

doi:10.1016/j.atherosclerosis.2008.06.011

Cited by 31 publications

(18 citation statements)

References 27 publications

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“…Low-normal thyroid function has been associated with coronary atherosclerosis measured by coronary angiography and with increased carotid intimamedia thickness (CIMT) and severity of carotid plaque, [3][4][5][6] but these findings were inconsistent in other studies. [7][8][9] The evidence on the association between thryroid hormone levels in the euthyroid range and atherosclerosis, however, is largely based on relatively small cross-sectional studies, often with highly selected clinical samples. In addition, few studies have reported the association between hyperthyroidism and atherosclerosis, but some evidence suggested that hyperthyroidism was also associated with increased CIMT.…”

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confidence: 99%

Thyroid Hormones and Coronary Artery Calcification in Euthyroid Men and Women

Zhang

Kim

Chang

et al. 2014

ATVB

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Objective— Overt and subclinical hypothyroidism are risk factors for atherosclerosis. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC). Approach and Results— We conducted a cross-sectional study of 41 403 apparently healthy young and middle-aged men and women with normal thyroid hormone levels. Free thyroxin, free triiodothyronine, and thyroid-stimulating hormone levels were measured by electrochemiluminescent immunoassay. CAC score was measured by multidetector computed tomography. The multivariable adjusted CAC ratios comparing the highest versus the lowest quartile of thyroid hormones were 0.74 (95% confidence interval, 0.60–0.91; P for trend <0.001) for free thyroxin, 0.81 (0.66–1.00; P for trend=0.05) for free triiodothyronine, and 0.78 (0.64–0.95; P for trend=0.01) for thyroid-stimulating hormone. Similarly, the odds ratios for detectable CAC (CAC >0) comparing the highest versus the lowest quartiles of thyroid hormones were 0.87 (0.79–0.96; P for linear trend <0.001) for free thyroxin, 0.90 (0.82–0.99; P for linear trend=0.02) for free triiodothyronine, and 0.91 (0.83–1.00; P for linear trend=0.03) for thyroid-stimulating hormone. Conclusions— In a large cohort of apparently healthy young and middle-aged euthyroid men and women, low-normal free thyroxin and thyroid-stimulating hormone were associated with a higher prevalence of subclinical coronary artery disease and with a greater degree of coronary calcification.

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confidence: 99%

Thyroid Hormones and Coronary Artery Calcification in Euthyroid Men and Women

Zhang

Kim

Chang

et al. 2014

ATVB

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“…However, contradictory results have been obtained in the studies and whilst some studies determined an increase in cardiovascular risk with subclinical hypothyroidism [31][32][33], some studies failed to demonstrate such a relation [24,25,34]. For example, Rotterdam study demonstrated that myocardial infarction and aortic calcification are associated with SCH [31].…”

Section: Discussionmentioning

confidence: 99%

Effect of L-thyroxin therapy on thyroid volume and carotid artery lntima-media thickness in the patients with subclinical hypothyroidism

Ünsal¹,

Topaloğlu²,

Çakır³

et al. 2014

J Med Disord

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Background: Subclinical hypothyroidism (SCH) is mild-to-moderate thyroid insufficiency that is characterized by thyrotropin (TSH) level higher than the upper limit despite normal serum free thyroxin (fT4) level. Likewise, SCH as well might be a risk factor for cardiovascular diseases. Some placebocontrolled studies showed beneficial effect of L-thyroxin replacement on the risk for early atherosclerosis and CVD in the patients with SCH. Methods: Fifty-six patients presented to our clinic with subclinical hypothyroidism were included in the study. Forty-six healthy euthyroid subjects were included as the control group. Patients with fT4>0.61ng/ dl and TSH>4.2 uIU/ml were considered as SCH. Serum LDL and HDL cholesterols, triglyceride level, thyroid antibodies (anti-TPOAb and anti-TgAb), and fasting plasma glucose levels of the patients and the control group were measured. Carotid artery intima-media thickness (CIMT) was measured via B-mode ultrasonography and thyroid volume was calculated. L-thyroxin replacement was commenced at a dose of 25-50 mcg/day. CIMT and thyroid volumes of the patients were reevaluated six months after they became euthyroid. Results: A statistically significant difference (p<0.05) was found between the CIMT values before and after the L-thyroxin therapy in the SCH group. Pretreatment CIMT values were significantly higher than the post-treatment CIMT values (p=0.0001). There was significant difference also between the pre-treatment and post-treatment thyroid volumes in the SCH group (p<0.05). Conclusion:The present study showed the reduction in CIMT with L-thyroxin therapy in the patients with subclinical hypothyroidism. Therefore, thyroid hormone replacement might help to slow down or prevent atherosclerosis in the subclinical hyperthyroidism as well.

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“…22 Altered arterial elasticity might be explained by altered lipid metabolism including serum cholesterol and LDL elevation in hypothyroid patients compared with euthyroid subjects. 19,23,24 During recombinant TSH management, TSH has been shown …”

Section: Discussionmentioning

confidence: 99%

Impaired aortic distensibility in hypothyroid patients with negative coronary angiograms: Simultaneous evaluation with 128-slice multiple row detector computed tomography

et al. 2013

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Objective: To determine the relationship between arterial distensibility and hypothyroidism by simultaneous assessment of coronary angiography and aortic distensibility, measured using 128-slice retrospective electrocardiogram-gated multiple row detector computed tomography (MDCT). Methods: Untreated hypothyroid patients and age-matched euthyroid patients, who underwent 128-slice retrospective electrocardiogram-gated MDCT to evaluate the coronary arteries, were assessed. Intraluminal aortic areas in systolic and diastolic phases of the cardiac cycle were measured with multiphase reformation at predefined locations including the ascending aorta, proximal descending aorta and distal descending aorta in the widest axial plane. Results: The study included 21 hypothyroid and 21 euthyroid patients. Patients with hypothyroidism exhibited decreased aortic distensibility between each location in the thoracic aorta (ascending aorta, proximal descending aorta and distal descending aorta) compared with euthryoid patients. Conclusions: Hypothyroidism was associated with preclinical vascular alteration, characterized by impaired aortic distensibility at each location of the thoracic aorta, which has been shown to be related to increased cardiovascular risk. Monitoring of aortic distensibility is relevant for evaluating coronary artery disease progression and treatment choices.

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Hypothyroidism is not associated with increased carotid atherosclerosis when cardiovascular risk factors are accounted for in hyperlipidemic patients

Cited by 31 publications

References 27 publications

Thyroid Hormones and Coronary Artery Calcification in Euthyroid Men and Women

Thyroid Hormones and Coronary Artery Calcification in Euthyroid Men and Women

Effect of L-thyroxin therapy on thyroid volume and carotid artery lntima-media thickness in the patients with subclinical hypothyroidism

Impaired aortic distensibility in hypothyroid patients with negative coronary angiograms: Simultaneous evaluation with 128-slice multiple row detector computed tomography

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