Thyroid function is associated with carotid intima-media thickness in euthyroid subjects

Takamura, Noboru; Akilzhanova, Ainur; Hayashida, Naomi; Kadota, Koichiro; Yamasaki, Hironori; Usa, Toshiro; Nakazato, Mio; Maeda, Takahiro; Ozono, Yoshiyuki; Aoyagi, Kiyoshi

doi:10.1016/j.atherosclerosis.2008.09.022

Cited by 70 publications

(69 citation statements)

References 26 publications

(22 reference statements)

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“…That is due to the lower number of men compared with women in the study, which is logical for thyroid diseases. Multiple linear regression analysis showed that TSH, triglycerides, and diastolic blood pressure are independent predictors of mean CIMT, while fT4 proved to be an independent predictor of max CIMT, which is similar to previous findings (21). As fT4 was significantly lower in the SCH group and negatively correlated with mean CIMT, and showed to be an independent predictor of max CIMT, lower fT4 is a risk factor for atherosclerosis, even when in reference range.…”

Section: Discussionsupporting

confidence: 78%

Subclinical hypothyroidism and risk to carotid atherosclerosis

Valentina

Bosevski²,

Chedo³

et al. 2011

Arq Bras Endocrinol Metab

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Objective: The aim of this study was to assess whether subclinical hypothyroidism (SCH) is associated with carotid atherosclerosis, as well as dyslipidemia, and arterial hypertension. Subjects and methods: The study included 69 consecutive patients with newly diagnosed SCH, and 30 matched healthy controls. Body mass index (BMI), TSH, fT4, antibodies to thyroid peroxidase (TPOabs), lipids, blood pressure, mean and maximum carotid intima-media thickness (CIMT) were determined in all participants. Results: Mean values of CIMT, triglycerides, and total cholesterol/HDL-C ratio were significantly different in SCH patients versus matched controls. Linear multiple regression analysis demonstrated that TSH, diastolic blood pressure and triglycerides were independent predictors of mean CIMT, fT4 for maximum CIMT; and that TSH, fT4, age, and total cholesterol/HDL-C ratio were independent predictors of the presence of carotid plaques. Conclusion: Our data revealed that SCH is associated with increase in CIMT and presence of carotid plaques, independent of classical risk factors for atherosclerosis. Arq Bras Endocrinol Metab. 2011;55(7):475-80 Keywords Subclinical hypothyroidism; atherosclerosis; dyslipidemia; arterial hypertension; carotid intima-media thickness ReSumoObjetivo: O objetivo deste estudo foi avaliar se o hipotireoidismo subclínico (HSC) está associado a aterosclerose de carótida, dislipidemia e hipertensão arterial. Sujeitos e métodos: O estudo incluiu 69 pacientes consecutivos recém-diagnosticados com HSC e 30 controles pareados. Índice de massa corpórea, TSH, T4L, anticorpos antiperoxidase (TPO), perfil lipídico, pressão arterial, espessamento carotídeo íntima-média máximo (ECIM) e médio foi determinado em todos os indivíduos. Resultados: Os valores médios de ECIM, triglicérides e razão colesterol total/C-HDL foram significantemente diferentes entre pacientes e controles. Regressão linear múltipla demonstrou que TSH, pressão arterial diastólica e triglicérides foram fatores independentes preditores de ECIM médio, T4L para ECIM máximo e TSH, T4L, idade e colesterol total/HDL-C para presença de placa carotídea. Conclusão: Nossos resultados indicam que HSC é associado com aumento do ECIM e presença de placas carotídeas, independentemente dos fatores de risco clássicos para aterosclerose. Arq Bras Endocrinol Metab. 2011;55(7):475-80 Descritores

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Section: Discussionsupporting

confidence: 78%

Subclinical hypothyroidism and risk to carotid atherosclerosis

Valentina

Bosevski²,

Chedo³

et al. 2011

Arq Bras Endocrinol Metab

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“…Nevertheless, our previous report in incident dialysis patients also observed, by means of receiving operator characteristics analysis, a significant association between T4 levels and mortality (16). The study by Takamura et al (32) in euthyroid patients demonstrated that carotid intima-media thickness was inversely and independently associated with T4 and fT4, suggesting an increased CV risk in subjects with low T4 even within the normal reference range. Differential effects of T4 and T3 on immune cells have also been reported: T4 stimulated whereas T3 inhibited peripheral lymphocyte proliferation (33).…”

Section: Discussionmentioning

confidence: 93%

Baseline Levels and Trimestral Variation of Triiodothyronine and Thyroxine and Their Association with Mortality in Maintenance Hemodialysis Patients

Meuwese

Dekker

Lindholm

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Conflicting evidence exists with regard to the association of thyroid hormones and mortality in dialysis patients. This study assesses the association between basal and trimestral variation of thyroid stimulating hormone, triiodothyronine, and thyroxine and mortality.Design, setting, participants, & measurements In 210 prevalent hemodialysis patients, serum triiodothyronine, thyroxine, thyroid stimulating hormone, and interleukin-6 were measured 3 months apart. Cardiovascular and non-cardiovascular deaths were registered during follow-up. Based on fluctuations along tertiles of distribution, four trimestral patterns were defined for each thyroid hormone: persistently low, decrease, increase, and persistently high. The association of baseline levels and trimestral variation with mortality was investigated with Kaplan-Meier curves and Cox proportional hazard models.Results During follow-up, 103 deaths occurred. Thyroid stimulating hormone levels did not associate with mortality. Patients with relatively low basal triiodothyronine concentrations had higher hazards of dying than patients with high levels. Longitudinally, patients with persistently low levels of triiodothyronine during the 3-month period had higher mortality hazards than those having persistently high levels. These associations were mainly attributable to cardiovascular-related mortality. The association between thyroxine and mortality was not altered after adjustment for triiodothyronine.Conclusions Hemodialysis patients with reduced triiodothyronine or thyroxine levels bear an increased mortality risk, especially due to cardiovascular causes. This was true when considering both baseline measurements and trimestral variation patterns. Our longitudinal design adds observational evidence supporting the hypothesis that the link may underlie a causal effect.

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“…However, some studies showed conflicting results about the association between (subclinical) hypothyroidism and atherosclerotic parameters [29,30]. Even though, for normal ranges of thyroid hormones, previous reports showed the significant relationships between them (normal ranges of thyroid hormones) and inflammatory markers [9], mitral annular calcification [31], and carotid IMT [10,11]. The present study has provided more evidence and extended the clinical significance of low-normal thyroid function to include an advanced atherosclerotic condition like ICS.…”

Section: Discussionmentioning

confidence: 58%

“…Both acute and chronic hypothyroidism can affect forearm blood flow [3]. Even within euthyroid ranges, low-normal thyroid function has been reported to be associated with increased inflammatory markers [9], and carotid atherosclerosis [10,11]. Drugs like L-thyroxine [12] and thyroid mimetics [13] have been reported to have beneficial effects in atherosclerosis or metabolic diseases.…”

mentioning

confidence: 99%