Objective: Studies showed that subclinical hypothyroidism(SCH) was associated with an elevated risk of atherosclerotic cardiovascular disease.This community-based cross-section study aimed to investigate the correlation of SCH and thyroid stimulating hormone(TSH) with carotid intima media thickness(CIMT). Methods: A total of 6 256 Chinese adults (aged≥40 years) with normal thyroid hormone level were enrolled, and standard questionnaire was performed as well as the measurement of anthropometric data and biochemical evaluation. Serum free triiodothyronine(FT3), free thyroxine (FT4), and TSH were determined by chemiluminescent immunoassay, while CIMT was measured by a high-resolution B-mode tomographic ultrasound system. Subjects with TSH>4.94 μIU/L and normal FT4 level were diagnosed as SCH and the others served as controls. Correlations of SCH and TSH level with CIMT were analyzed. Results: There were 458 cases of SCH, 5 798 cases with normal thyroid function, and 2 082 subjects having elevated CIMT. Compared with subjects with normal thyroid function,those with SCH had thicker CIMT [(0.73±0.007) mm vs(0.71±0.001) mm, P=0.003]. Multiple linear regression analysis showed that Log10-TSH was positively correlated with CIMT (β=0.02, P= 0.01). Adjusted logistic regression analysis revealed that SCH was associated with risk of elevated CIMT [odds ratio (OR)=1.28, 95% confidence interval (CI)=1.03-1.61, P=0.03)]. Conclusions: For middle aged and elderly population with normal thyroid function in Shanghai, prevalence of SCH was 7.3%, and subjects with elevated CIMT account for 34.6%. TSH is positively correlated with CIMT in middle-aged and elderly Chinese subjects, and SCH is the independent risk factor for elevated CIMT.
XUAN Liping, HOU Yanan, PENG Kui, ZHAO Zhiyun, LI Mian, CHEN Yuhong, DAI Meng, XU Min, BI Yufang, WANG Weiqing, ZHANG Di, XU Jiji
. Correlation of subclinical hypothyroidism with carotid intima media thickness in Chinese population[J]. Journal of Diagnostics Concepts & Practice, 2018
, 17(04)
: 444
-448
.
DOI: 10.16150/j.1671-2870.2018.04.017
[1] Vanderpump MP, Tunbridge WM, French JM, et al.The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey[J]. Clin Endocrinol (Oxf),1995,43(1):55-68.
[2] Rodondi N, Bauer DC.Subclinical hypothyroidism and cardiovascular risk: how to end the controversy[J]. J Clin Endocrinol Metab,2013,98(6):2267-2269.
[3] Hak AE, Pols HA, Visser TJ, et al.Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study[J]. Ann Intern Med,2000,132(4):270-278.
[4] de Groot E, Hovingh GK, Wiegman A, et al. Measurement of arterial wall thickness as a surrogate marker for atherosclerosis[J]. Circulation,2004,109(23 Suppl 1): Ⅲ33-Ⅲ38.
[5] Greenland P, Alpert JS, Beller GA, et al.2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. J Am Coll Cardiol,2010, 56(25):e50-e103.
[6] Stein JH, Korcarz CE, Post WS.Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: summary and discussion of the American Society of Echocardiography consensus statement[J]. Prev Cardiol,2009,12(1):34-38.
[7] Helfand M, Buckley DI, Freeman M, et al.Emerging risk factors for coronary heart disease: a summary of systema-tic reviews conducted for the U.S. Preventive Services Task Force[J]. Ann Intern Med,2009,151(7):496-507.
[8] Nagasaki T, Inaba M, Henmi Y, et al.Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function[J]. Clin Endocrinol (Oxf),2003,59(5):607-612.
[9] Nagasaki T, Inaba M, Henmi Y, et al.Change in von Willebrand factor and carotid intima-media thickness in hypothyroid patients with normal thyroid function after levothyroxine replacement therapy[J]. Eur J Endocrinol,2004,150(2):125-131.
[10] Monzani F, Caraccio N, Kozàkowà M, et al.Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo- controlled study[J]. J Clin Endocrinol Metab,2004,89(5):2099-2106.
[11] Völzke H, Robinson DM, Schminke U, et al.Thyroid function and carotid wall thickness[J]. J Clin Endocrinol Metab,2004,89(5):2145-2149.
[12] Huang Y, Bi Y, Xu M, et al.Nonalcoholic fatty liver di-sease is associated with atherosclerosis in middle-aged and elderly Chinese[J]. Arterioscler Thromb Vasc Biol,2012,32(9):2321-2326.
[13] Ying X, Song Z, Zhao C, et al.Analysis of homeostasis model assessment-insulin resistance HOMA-IR in healthy young Chinese adults[J]. Saudi Med J,2010,31(12):1375-1376.
[14] 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 甲状腺疾病诊治指南——甲状腺功能减退症[J]. 中华内科杂志,2007,46(11):967-971.
[15] 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 中国甲状腺疾病诊治指南——甲状腺功能亢进症[J]. 中华内科杂志,2007,46(10):876-882.
[16] Morris MS, Bostom AG, Jacques PF, et al.Hyperhomocysteinemia and hypercholesterolemia associated with hypothyroidism in the third US National Health and Nutrition Examination Survey[J]. Atherosclerosis,2001,155(1):195-200.
[17] Rotondi M, Magri F, Chiovato L.Risk of coronary heart disease and mortality for adults with subclinical hypothyroidism[J]. JAMA,2010,304(22):2481.
[18] Komorovsky R, Desideri A.Carotid ultrasound assessment of patients with coronary artery disease: a useful index for risk stratification[J]. Vasc Health Risk Manag,2005,1(2):131-136.
[19] O'Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group[J]. N Engl J Med,1999,340(1):14-22.
[20] Danese MD, Ladenson PW, Meinert CL, et al.Clinical review 115: effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature[J]. J Clin Endocrinol Metab,2000, 85(9):2993-3001.
[21] Kvetny J, Heldgaard PE, Bladbjerg EM, et al.Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years[J]. Clin Endocrinol (Oxf),2004,61(2):232-238.
[22] 谭寅寅. 甲状腺功能正常人群血清TSH水平与血脂的关联性研究[D]. 山东大学,2011.