1
|
Rodríguez-Vargas GS, Santos-Moreno P, Rubio-Rubio JA, Bautista-Niño PK, Echeverri D, Gutiérrez-Castañeda LD, Sierra-Matamoros F, Navarrete S, Aparicio A, Saenz L, Rojas-Villarraga A. Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared With Patients With Osteoarthritis. Front Cardiovasc Med 2022; 9:894577. [PMID: 35865390 PMCID: PMC9295407 DOI: 10.3389/fcvm.2022.894577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
IntroductionThe risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5–2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA.Materials and MethodsThis was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups.ResultsA total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2.ConclusionsWhen comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.
Collapse
Affiliation(s)
- Gabriel-Santiago Rodríguez-Vargas
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Rheumatology, Biomab - Center for Rheumatoid Arthritis, Bogotá, Colombia
- *Correspondence: Gabriel-Santiago Rodríguez-Vargas
| | | | | | | | - Darío Echeverri
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | - Luz-Dary Gutiérrez-Castañeda
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | | | - Stephania Navarrete
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Anggie Aparicio
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Luis Saenz
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | | |
Collapse
|
2
|
Arterial Stiffness in Thyroid and Parathyroid Disease: A Review of Clinical Studies. J Clin Med 2022; 11:jcm11113146. [PMID: 35683533 PMCID: PMC9180991 DOI: 10.3390/jcm11113146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
Growing evidence shows that arterial stiffness measurement provides important prognostic information and improves clinical stratification of cardiovascular risk. Thyroid and parathyroid diseases are endocrine diseases with a relevant cardiovascular burden. The objective of this review was to consider the relationship between arterial stiffness and thyroid and parathyroid diseases in human clinical studies. We performed a systematic literature review of articles published in PubMed/MEDLINE from inception to December 2021, restricted to English languages and to human adults. We selected relevant articles about the relationship between arterial stiffness and thyroid and parathyroid diseases. For each selected article, data on arterial stiffness were extracted and factors that may have an impact on arterial stiffness were identified. We considered 24 papers concerning hypothyroidism, 9 hyperthyroidism and 16 primary hyperparathyroidism and hypoparathyroidism. Most studies evidenced an increase in arterial stiffness biomarkers in hypothyroidism, hyperthyroidism and primary hyperparathyroidism, even in subclinical and mild forms, although heterogeneity of measurement methods and of study designs prevented a definitive conclusion, suggesting that the assessment of arterial stiffness may be considered in the clinical evaluation of cardiovascular risk in these diseases.
Collapse
|
3
|
Kumari B, Kumar B, Gupta D, Ganju N. FMD and CIMT: Surrogate Markers of Atherosclerosis in Subclinical and Overt Hypothyroidism in Sub Himalyan Region. Indian J Endocrinol Metab 2021; 25:220-225. [PMID: 34760677 PMCID: PMC8547403 DOI: 10.4103/ijem.ijem_247_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/06/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Hypothyroidism increases the risk of atherosclerosis. Carotid intima-media thickness (CIMT) and flow-mediated dilation (FMD) have been used as a noninvasive method to detect atherosclerosis. But the literature is scarce on patients with subclinical hypothyroidism. Such a study was not done in our region, so we conducted this study at a tertiary care center to compare CIMT and FMD among subclinical and overt hypothyroid patients and to analyze the risk of atherosclerosis. METHODS We evaluated 68 patients aged 18-50 years, with newly diagnosed hypothyroidism. We divided them into overt and subclinical hypothyroidism groups and compared the findings. All analyses were performed by the computerized SPSS 17.0. The results were noted as means ± SD and percentage. Student's t-test was used to compare continuous variables, and the Chi-square test was used to compare differences. RESULTS The total number of patients with dyslipidemia in the subclinical hypothyroidism (SCH) group was 22 (45.83%) and in the overt hypothyroidism (OH) group was 26 (54.16%) with a P- value of 0.009. The mean FMD% in subclinical hypothyroidism patients was 6.9816 ± 3.4224 and in overt hypothyroidism patients was 5.3670 ± 2.7278 (P = 0.03). The mean CIMT was 0.5009 ± 0.0732, CIMT in the SCH group was 0.5082 ± 0.0672 and in the OH group was 0.5305 ± 0.0799 (P = 0.2). CONCLUSION The outcome of this study specifies that hypothyroidism is associated with endothelial dysfunction as established by impaired FMD, and it may be the first marker of atherosclerosis appearing before any structural evidence like CIMT. We can speculate that there is a link between subclinical hypothyroidism and atherosclerosis, and thyroxine replacement in SCH may help to prevent the progression of atherosclerosis.
Collapse
Affiliation(s)
- Bandana Kumari
- Department of Medicine, IGMC, Shimla, Himachal Pradesh, India
| | - Bhupender Kumar
- Medicine Department, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Dalip Gupta
- Department of Medicine, IGMC, Shimla, Himachal Pradesh, India
| | - Neeraj Ganju
- Department of Cardiology, IGMC, Shimla, Himachal Pradesh, India
| |
Collapse
|
4
|
Morioka T, Mori K, Emoto M. Is Stiffness Parameter β Useful for the Evaluation of Atherosclerosis?~ Its Clinical Implications, Limitations, and Future Perspectives ~. J Atheroscler Thromb 2021; 28:435-453. [PMID: 33583910 PMCID: PMC8193788 DOI: 10.5551/jat.rv17047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Atherosclerosis comprises two components, atherosis and sclerosis, characterized by morphological wall thickening and functional stiffening, respectively, of the arterial wall. In recent years, much interest has been directed to the role of functional changes in large arteries, i.e., increased stiffness or decreased elasticity, on the development of cardiovascular diseases. In fact, the clinical evaluation of arterial stiffness is increasingly performed in patients with cardiovascular risk factors. Local arterial stiffness is measured using an ultrasound technique implemented with an echo-tracking system at the common carotid and femoral arteries. Several indices of local arterial stiffness are obtained by ultrasound, among which stiffness parameter β is unique because it is the least affected by blood pressure at the time of measurement. Evidence from cross-sectional studies indicates that increased stiffness parameter β is associated with a number of cardiovascular risk factors, such as older age, smoking, insufficient physical activity, hypertension, obesity, metabolic syndrome, insulin resistance, type 2 diabetes, chronic kidney disease, and comorbid cardiovascular disease. Results from several prospective observational studies also suggest that carotid stiffness parameter β is a useful surrogate marker of cardiovascular events and/or mortality, although the results differ depending on the characteristics of the study subjects. Furthermore, several interventional studies have shown that carotid stiffness parameter β improved after lifestyle modification or drug treatment. In this review, we summarize the current evidence of stiffness parameter β of the carotid artery and discuss its clinical implications as a marker of vascular health or as a predictor of cardiovascular outcomes.
Collapse
Affiliation(s)
- Tomoaki Morioka
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
| | - Katsuhito Mori
- Department of Nephrology, Osaka City University Graduate School of Medicine
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
| |
Collapse
|
5
|
Papadopoulou AM, Bakogiannis N, Skrapari I, Moris D, Bakoyiannis C. Thyroid Dysfunction and Atherosclerosis: A Systematic Review. In Vivo 2020; 34:3127-3136. [PMID: 33144416 DOI: 10.21873/invivo.12147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND/AIM Thyroid dysfunction, both hypo- and hyperthyroidism, has been associated with cardiovascular disease. The aim of this study was to evaluate the association between thyroid dysfunction and atherosclerosis measured mostly by carotid intima-media thickness, as well as discuss whether L-T4 replacement is able to reverse or slow down the progression of atherosclerosis. MATERIALS AND METHODS The review was conducted according the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed on PubMed a literature search from May 2004 to January 2020, using the search terms 'subclinical hypothyroidism' or 'thyroid disorders' and 'carotid artery', 'carotid intima-media thickness (IMT)', 'levothyroxine', and 'atherosclerosis'. RESULTS Twenty-six studies were eligible and included in the analysis. Overall, the studies encompassed a total of 36.434 patients included in this review. Most studies indicated a proportional correlation between IMT and thyroid dysfunction. Levothyroxine (L-T4) replacement led to significant decrease of IMT after 1 year in most studies. CONCLUSION Most studies have concluded that thyroid dysfunction is associated with arterial wall remodeling and, thus, with increased cardiovascular risk. However, the exact mechanistic background of pathological structural changes in the arterial wall is still unsettled. Large randomized controlled studies are required to definitively address the extent to which T4 replacement therapy might benefit patients with subclinical thyroid disorders.
Collapse
Affiliation(s)
| | | | - Ioanna Skrapari
- 1st Department of Internal Medicine, Evangelismos General Hospital, Athens, Greece
| | - Dimitrios Moris
- Department of Surgery, Duke University Medical Center, Durham, NC, U.S.A.
| | - Chris Bakoyiannis
- First Department of Surgery, Laikon General Hospital, Athens, Greece
| |
Collapse
|
6
|
Delitala AP, Scuteri A, Maioli M, Mangatia P, Vilardi L, Erre GL. Subclinical hypothyroidism and cardiovascular risk factors. Minerva Med 2019; 110:530-545. [PMID: 31726814 DOI: 10.23736/s0026-4806.19.06292-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Thyroid hormones have multiple effects on lipid metabolism as well as on the cardiovascular system function. These negative cardiovascular effects have long been recognized in overt hypothyroidism but can be reversed by treatment with levothyroxine. EVIDENCES ACQUISITION We performed on PubMed a literature search for the articles published until March 2019 by using the search terms "subclinical hypothyroidism," "cardiovascular disease," "cholesterol," "LDL," "HDL," "triglycerides," "coronary heart disease," "heart failure," "atherosclerosis," "all-cause mortality," "levothyroxine." EVIDENCES SYNTHESIS Subclinical hypothyroidism, defined as an elevated thyrotropin (TSH) with a normal free thyroxine (FT4), is frequent in the general population and increase with age. Subclinical hypothyroidism has been linked to cardiovascular risk factors, dyslipidemia and increased atherosclerosis. Although some studies have demonstrated that lipids are elevated in subclinical hypothyroidism, other studies did not confirm these data. Clinical trials have also demonstrated there is no clear evidence that levothyroxine therapy in subjects with milder form (TSH<10 mU/L) of subclinical hypothyroidism could improve lipid status and the other cardiovascular risk factors. Nevertheless, TSH level seems the best predictor of cardiovascular disease, in particular when its levels are above 10 mU/L. CONCLUSIONS Prospective studies are necessary to clarify the cardiovascular risk in patients with mild subclinical hypothyroidism and to assess the importance of treating elderly people in order to improve or counteract the correlated risks. However, until clinical recommendations will be updated, the decision to treat or not treat patients with subclinical hypothyroidism will still base on clinical judgment, clinical practice guidelines, and expert opinion.
Collapse
Affiliation(s)
| | - Angelo Scuteri
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Margherita Maioli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Center for Developmental Biology and Reprogramming (CEDEBIOR), Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Istitute of Genetic and Biomedical Research, National Research Council (CNR), Monserrato, Cagliari, Italy
| | - Paolo Mangatia
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Luca Vilardi
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Gian Luca Erre
- Unit of Rheumatology, Sassari University Hospital, Sassari, Italy
| |
Collapse
|
7
|
Lonardo A, Ballestri S, Mantovani A, Nascimbeni F, Lugari S, Targher G. Pathogenesis of hypothyroidism-induced NAFLD: Evidence for a distinct disease entity? Dig Liver Dis 2019; 51:462-470. [PMID: 30733187 DOI: 10.1016/j.dld.2018.12.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/05/2018] [Accepted: 12/15/2018] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD), the most common liver disease worldwide, may be associated with primary hypothyroidism. However, the pathogenesis underlying such an association is complex and not completely understood. Here, we specifically discuss the pathogenic mechanisms potentially involved in hypothyroidism-induced NAFLD. To this end, we summarize the general pathophysiology of thyroid hormones (TH). Next, we analyze the published data from rodent studies by discussing whether hypothyroid rats may develop NAFLD via hyperphagia; whether mitochondria become energetically more efficient; what the overall energy balance is and if diversion of fatty substrates occurs; and the latest advancements in molecular pathogenesis brought about by metabolomics, cell imaging, lipophagy, autophagy and genetically engineered mouse models. Moreover, we discuss the data published regarding humans on the pathogenic role of TH, metabolic syndrome and other risk factors in hypothyroidism-related NAFLD as well as the putative mechanisms underlying the development of NAFLD-related hepatocellular carcinoma in hypothyroidism. In conclusion, although many research questions still remain unanswered, the pathophysiology of hypothyroidism-induced NAFLD makes this a potentially curable and distinct disease entity. However, further studies are needed to better elucidate the underlying mechanisms, and to ascertain whether treatment with either TH or thyromimetic agents improves NAFLD.
Collapse
Affiliation(s)
- Amedeo Lonardo
- Operating Unit Internal Medicine, Department of Medicine, Azienda Ospedaliero-Universitaria Modena, Italy.
| | - Stefano Ballestri
- Operating Unit Internal Medicine, Department of Medicine, Azienda USL Modena, Italy
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Fabio Nascimbeni
- Operating Unit Internal Medicine, Department of Medicine, Azienda Ospedaliero-Universitaria Modena, Italy
| | - Simonetta Lugari
- Post-graduate school of Internal Medicine, University of Modena and Reggio Emilia, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| |
Collapse
|
8
|
Lugari S, Mantovani A, Nascimbeni F, Lonardo A. Hypothyroidism and nonalcoholic fatty liver disease - a chance association? Horm Mol Biol Clin Investig 2018; 41:/j/hmbci.ahead-of-print/hmbci-2018-0047/hmbci-2018-0047.xml. [PMID: 30367792 DOI: 10.1515/hmbci-2018-0047] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/11/2018] [Indexed: 02/07/2023]
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) defines the clinical-pathological spectrum of hepatic lipotoxicity, which may progress to hepatic fibrosis and its complications. Thyroid hormone is a master regulator of cell metabolism and body fat distribution. Whether hypothyroidism is associated or not with an increased risk of developing NAFLD and its fibrotic progression is both clinically and physiopathologically relevant. Indeed, answering this research question would carry major pathogenic and therapeutic implications. Method PubMed database was searched using relevant key-words such as hypothyroidism; NAFLD; nonalcoholic steatohepatitis; cirrhosis; hepatocellular carcinoma; epidemiology; pathogenesis; natural history. The epidemiological studies and the meta-analyses published so far were identified as well as those studies addressing the physiopathology underlying this association. Results Many observational studies have investigated the association between either subclinical or overt hypothyroidism and NAFLD. Data are conflicting: some original and meta-analytical studies demonstrated that hypothyroidism, (mainly subclinical hypothyroidism), was common, occurring in approximately 25% of individuals with imaging-defined or biopsy-proven NAFLD; other studies, however, failed to identify a significant association between hypothyroidism and NAFLD. Moreover, such an association is biologically plausible based on the specific physiopathological impact of thyroid hormone and thyroid stimulating hormone (TSH) on metabolism of hepatocytes and accumulation and distribution of body fat. Conclusions The findings from the present review support a significant association between primary hypothyroidism and risk of development and progression of NAFLD. However, further studies evaluating the relative importance of subclinical versus overt hypothyroidism as well as addressing the mechanisms underlying the association of hypothyroidism with NAFLD are eagerly awaited.
Collapse
Affiliation(s)
- Simonetta Lugari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Fabio Nascimbeni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Amedeo Lonardo
- Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, Azienda Ospedaliero-Universitaria, Ospedale Civile di Baggiovara, Modena, Italy
| |
Collapse
|
9
|
Lee Y, Lim YH, Shin JH, Park J, Shin J. Impact of subclinical hypothyroidism on clinical outcomes following percutaneous coronary intervention. Int J Cardiol 2018; 253:155-160. [PMID: 29306458 DOI: 10.1016/j.ijcard.2017.09.192] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 05/31/2017] [Accepted: 09/22/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Similar to overt hypothyroidism, subclinical hypothyroidism (SCH) has been reported to increase the risk of cardiovascular disease. However, the influence of SCH on clinical outcomes following percutaneous coronary intervention (PCI) remains unclear. METHODS We performed a prospective cohort study. SCH was defined as a thyroid-stimulating hormone (TSH) level ≥4.5mIU/l and a normal level of free thyroxine (FT4). A composite event was defined as the combination of cardiac death, non-fatal myocardial infarction (MI) and repeat revascularization. RESULTS Of 936 patients, who were observed for 3.1years, 100 patients (10.7%) were diagnosed with SCH. Repeat revascularization, cardiac death and a composite event occurred more frequently in the SCH group than in the euthyroidism group, while the incidence of non-fatal MI was similar between the two groups. Multiple Cox regression analysis showed that SCH was associated with the risk of a composite event (hazard ratio, 1.52; 95% confidence interval, 1.04-2.22) after adjustment for age, sex, current smoking, ST-segment elevation MI, prior PCI, diabetes, hypertension, renal function, left ventricular ejection fraction, B-type natriuretic peptide, stent numbers, total stent length, stent types, obesity and lipid profiles. Serum TSH levels were also significantly associated with the risk of a composite event. SCH was not associated with repeat PCIs for de novo stenotic lesions but was associated with repeated PCIs for in-stent restenotic lesions. CONCLUSIONS SCH negatively impacted clinical outcomes following PCIs. Therefore, patients with SCH should be carefully observed after undergoing a PCI.
Collapse
Affiliation(s)
- Yonggu Lee
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri City, Kyunggi-do, Republic of Korea
| | - Young-Hyo Lim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
| | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jinkyu Park
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| |
Collapse
|
10
|
Zhang X, Xie Y, Ding C, Xiao J, Tang Y, Jiang X, Shan H, Lin Y, Zhu Y, Li C, Hu D, Ling Z, Xu G, Sheng L. Subclinical hypothyroidism and risk of cerebral small vessel disease: A hospital-based observational study. Clin Endocrinol (Oxf) 2017; 87:581-586. [PMID: 28543314 DOI: 10.1111/cen.13383] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 05/02/2017] [Accepted: 05/21/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Subclinical hypothyroidism (SCH) has been associated with atherosclerosis and increased risk of ischaemic stroke. However, whether SCH is associated with cerebral small vessel disease (cSVD) remains largely unexplored. This study aimed to investigate the relationship between SCH and total cSVD burden, a composite measurement detected with magnetic resonance imaging (MRI), in patients with minor ischaemic stroke or transient ischaemic attack (TIA). DESIGN This was a prospective observational cohort study conducted in a tertiary referral hospital. METHODS Subclinical hypothyroidism (SCH) was defined as with mildly or moderately increased thyroid-stimulating hormone levels (TSH, 4.5-10.0 mIU/L), but with normal free thyroxine levels. Brain MRI presence of silent lacunar infarcts (LIs), white matter lesions (WMLs), cerebral microbleeds (CMBs) and enlarged perivascular spaces (EPVs) were summed to a validated scales ranging from 0 to 4 to represent the load of cSVD. The associations between SCH and cSVD were analysed by logistic regression analyses. RESULTS Subclinical hypothyroidism (SCH) was identified in 43 of 229 (18.8%) patients with minor stroke or TIA. Compared with patients without SCH, those with SCH had higher risks of WMLs, CMBs and total cSVD burden. Adjustment of potential confounders did not change these associations. CONCLUSIONS These findings showed that SCH might be associated with the presence of WMLs, CMBs, as well as cSVD burden in patients with minor stroke or TIA.
Collapse
Affiliation(s)
- Xiaohao Zhang
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yi Xie
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Caixia Ding
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jing Xiao
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yinyan Tang
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xuemei Jiang
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hua Shan
- Department of Radiology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yuankai Lin
- Department of Radiology, Hainan General Hospital, Haikou, Hainan, China
| | - Yujia Zhu
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chuanyou Li
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Dan Hu
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhixiang Ling
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Gelin Xu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Lei Sheng
- Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| |
Collapse
|
11
|
Feng X, Zhao L, Jiang J, Ma W, Shang X, Zhou Q, Zhang H, Yu S, Qi Y. Discriminatory value of carotid artery elasticity changes for the evaluation of thyroid dysfunction in patients with hashimoto's thyroiditis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2016; 44:298-304. [PMID: 26856968 DOI: 10.1002/jcu.22328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To evaluate the discriminatory value of carotid artery wall thickness and elasticity for thyroid dysfunction in Hashimoto's thyroiditis (HT) patients. METHODS A total of 180 female HT patients were assigned to three groups on the basis of laboratory testing: HT hyperthyroidism group (group A), HT hypothyroidism group (group B), and HT euthyroid group (group C). We used radiofrequency sonographic signal analysis for the measurement of intima-media thickness and arterial stiffness. RESULTS Intima-media thickness was significantly higher in group A than in other groups. After stepwise variable selection, distensibility coefficient (DC), compliance coefficient, stiffness index (β), and pulse wave velocity (PWV) were selected to discriminate different thyroid hormone levels, resulting in the following discriminant function: Z1 = -0.398DC + 0.803PWV. The receiver-operator characteristic curve analysis showed that the critical points were DC = 0.022 kPa(-1) and PWV = 5.36 m/s for HT hyperthyroidism, and DC = 0.016 kPa(-1) and PWV = 6.875 m/s for HT hypothyroidism. CONCLUSIONS DC and PWV may be useful for the evaluation of thyroid function in HT patients. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:298-304, 2016.
Collapse
Affiliation(s)
- Xiaolei Feng
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Linlin Zhao
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Jue Jiang
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Wenqi Ma
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Xue Shang
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Qi Zhou
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Hongli Zhang
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Shanshan Yu
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yanhua Qi
- Department of Ultrasound, The Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, 710004, China
| |
Collapse
|
12
|
Demir Ş, Ünübol M, Aypak SÜ, İpek E, Aktaş S, Ekren GS, Yılmaz M, Tunca R, Güney E. Histopathologic Evaluation of Nonalcoholic Fatty Liver Disease in Hypothyroidism-Induced Rats. Int J Endocrinol 2016; 2016:5083746. [PMID: 27143968 PMCID: PMC4838785 DOI: 10.1155/2016/5083746] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/17/2016] [Indexed: 12/21/2022] Open
Abstract
It is speculated that thyroid hormones may be involved in nonalcoholic fatty liver disease (NAFLD) pathogenesis. A literature scan, however, demonstrated conflicting results from studies investigating the relationship between hypothyroidism and NAFLD. Therefore, our study aims to evaluate NAFLD, from the histopathologic perspective, in hypothyroidism-induced rats. Wistar rats were divided into 2 groups: the experimental group consumed water containing methimazole 0.025% (MMI, Sigma, USA) for 12 weeks and the control group consumed tap water. At the end of week 12, serum glucose, ALT, AST, triglyceride, HDL, LDL, TSH, fT4, fT3, visfatin, and insulin assays were performed. Sections were stained with hematoxylin-eosin and "Oil Red-O" for histopathologic examination of the livers. In our study, we detected mild hepatosteatosis in all hypothyroidism-induced rats. There was statistically significant difference with respect to obesity between the two groups (p < 0.001). The mean fasting blood glucose was 126.25 ± 23.4 mg/dL in hypothyroidism-induced group and 102.63 ± 15.51 mg/dL in the control group, with a statistically significant difference between the groups (p = 0.032). The two groups did not differ statistically significantly with respect to visfatin levels (p > 0.05). In conclusion, we found that hypothyroidism-induced rats had mild hepatosteatosis as opposed to the control group histopathologically. Our study indicates that hypothyroidism can cause NAFLD.
Collapse
Affiliation(s)
- Şule Demir
- Department of Internal Medicine, Adnan Menderes University Faculty of Medicine, 09100 Aydin, Turkey
| | - Mustafa Ünübol
- Division of Endocrinology, Department of Internal Medicine, Adnan Menderes University Faculty of Medicine, 09100 Aydın, Turkey
| | - Serap Ünübol Aypak
- Department of Biochemistry, Adnan Menderes University Faculty of Veterinary Medicine, 09100 Aydın, Turkey
| | - Emrah İpek
- Department of Pathology, Adnan Menderes University Faculty of Veterinary Medicine, 09100 Aydın, Turkey
| | - Serdar Aktaş
- Department of Pharmacology Toxicology, Adnan Menderes University Faculty of Veterinary Medicine, 09100 Aydın, Turkey
| | - Gamze Sevri Ekren
- Department of Biochemistry, Adnan Menderes University Faculty of Veterinary Medicine, 09100 Aydın, Turkey
| | - Murat Yılmaz
- Department of General Surgery, Adnan Menderes University Faculty of Medicine, 09100 Aydın, Turkey
| | - Recai Tunca
- Department of Pathology, Adnan Menderes University Faculty of Veterinary Medicine, 09100 Aydın, Turkey
| | - Engin Güney
- Division of Endocrinology, Department of Internal Medicine, Adnan Menderes University Faculty of Medicine, 09100 Aydın, Turkey
| |
Collapse
|
13
|
del Busto-Mesa A, Cabrera-Rego JO, Carrero-Fernández L, Hernández-Roca CV, González-Valdés JL, de la Rosa-Pazos JE. Changes in arterial stiffness, carotid intima-media thickness, and epicardial fat after L-thyroxine replacement therapy in hypothyroidism. ACTA ACUST UNITED AC 2015; 62:270-6. [PMID: 25882083 DOI: 10.1016/j.endonu.2015.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/03/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the relationship between primary hypothyroidism and subclinical atherosclerosis and its potential changes with L-thyroxine replacement therapy. METHODS A prospective cohort study including 101 patients with primary hypothyroidism and 101 euthyroid patients as controls was conducted from July 2011 to December 2013. Clinical, anthropometrical, biochemical, and ultrasonographic parameters were assessed at baseline and after one year of L-thyroxine replacement therapy. RESULTS At baseline, hypothyroid patients had significantly greater values of blood pressure, total cholesterol, VLDL cholesterol, left ventricular mass, epicardial fat, and carotid intima-media thickness as compared to controls. Total cholesterol, VLDL cholesterol, ventricular diastolic function, epicardial fat, carotid intima-media thickness, carotid local pulse wave velocity, pressure strain elastic modulus, and β arterial stiffness index showed a significant and positive correlation with TSH levels. After one year of replacement therapy, patients with hypothyroidism showed changes in total cholesterol, VLDL cholesterol, TSH, carotid intima-media thickness, and arterial stiffness parameters. CONCLUSIONS Primary hypothyroidism is characterized by an increased cardiovascular risk. In these patients, L-thyroxine replacement therapy for one year is related to decreased dyslipidemia and improvement in markers of subclinical carotid atherosclerosis.
Collapse
|
14
|
Giri A, Edwards TL, LeGrys VA, Lorenz CE, Funk MJ, Schectman R, Heiss G, Robinson JG, Hartmann KE. Subclinical hypothyroidism and risk for incident ischemic stroke among postmenopausal women. Thyroid 2014; 24:1210-7. [PMID: 24827923 PMCID: PMC4106389 DOI: 10.1089/thy.2014.0106] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) is postulated to increase stroke risk via atherogenic changes associated with abnormal thyroid function. However, the direct relationship of SCH with subsequent stroke is poorly studied. METHODS In this nested case-cohort study, we prospectively evaluated the association between any SCH and severity of SCH in relation to incident ischemic stroke risk among postmenopausal women in the Women's Health Initiative Observational Study. Trained Women's Health Initiative staff, masked to thyroid status, adjudicated stroke cases. We assessed thyroid function using baseline blood specimens. Women with normal free thyroxine levels and thyrotropin (TSH) levels ≥4.69 mU/L were considered to have SCH. Primary analysis included 639 ischemic stroke cases and 2927 randomly selected subcohort members with an average of seven years of follow-up. RESULTS The multivariable adjusted hazard ratios (HR) from weighted Cox models were 1.06 (95% confidence interval [CI]: 0.77, 1.46) and 0.99 (95% CI: 0.67, 1.47) for women with any SCH and with mild SCH (TSH 4.69 to 6.99 mU/L), when compared with women with normal thyroid function. The HR for moderate/severe SCH (TSH ≥7.00 mU/L) was modestly elevated (HR: 1.22; 95% CI: 0.73, 2.05). CONCLUSIONS We found no evidence to suggest an association between SCH and ischemic stroke among healthy postmenopausal women.
Collapse
Affiliation(s)
- Ayush Giri
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center, Vanderbilt University, Nashville, Tennessee
| | - Todd L. Edwards
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center, Vanderbilt University, Nashville, Tennessee
| | - Vicky A. LeGrys
- Division of Clinical Laboratory Science, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Carol E. Lorenz
- Department of Epidemiology, Center for Women's Health Research, University of North Carolina, Chapel Hill, North Carolina
| | - Michele Jonsson Funk
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Robin Schectman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina
| | - Gerardo Heiss
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer G. Robinson
- Departments of Epidemiology and Medicine, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Katherine E. Hartmann
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center, Vanderbilt University, Nashville, Tennessee
- Department of Obstetrics and Gynecology, Vanderbilt University Medical School, Nashville, Tennessee
| |
Collapse
|
15
|
Masaki M, Komamura K, Goda A, Hirotani S, Otsuka M, Nakabo A, Fukui M, Fujiwara S, Sugahara M, Lee-Kawabata M, Tsujino T, Koshiba M, Masuyama T. Elevated arterial stiffness and diastolic dysfunction in subclinical hypothyroidism. Circ J 2014; 78:1494-500. [PMID: 24694766 DOI: 10.1253/circj.cj-13-1556] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Thyroid hormone is associated with arterial stiffness and left ventricular diastolic function in hypothyroid disease. The relationship of thyroid hormone level to cardio-ankle vascular index (CAVI) and left ventricular diastolic function, however, remains unclear in subjects with subclinical hypothyroidism. METHODS AND RESULTS We conducted a cross-sectional study of 83 patients with untreated subclinical hypothyroidism and compared them with 83 randomly selected controls from health check-ups. Log N-terminal prohormone of brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and arterial stiffness were measured. In addition, we measured early diastolic mitral annular velocity (E') in 43 participants with subclinical hypothyroidism and in 40 controls. When compared with the control group, patients with subclinical hypothyroidism had higher logNT-proBNP (1.9±0.5 vs. 1.7±0.3pg/ml, P<0.05), CRP (0.22±0.04 vs. 0.09±0.06mg/dl, P<0.05), and CAVI (8.8±1.7 vs. 7.8±1.4, P<0.001) and lower E' (5.8±1.7 vs. 7.5±2.1cm/s, P<0.001). CAVI was significantly associated with logNT-proBNP, CRP and E' in the subclinical hypothyroidism group. CONCLUSIONS High logNT-proBNP was associated with a raised CAVI in patients with subclinical hypothyroidism. Subclinical hypothyroidism may be a risk factor for cardiovascular events related to arterial stiffening and left ventricular diastolic dysfunction.
Collapse
Affiliation(s)
- Mitsuru Masaki
- Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Fatourechi MM, Fatourechi V. An update on subclinical hypothyroidism and subclinical hyperthyroidism. Expert Rev Endocrinol Metab 2014; 9:137-151. [PMID: 30743756 DOI: 10.1586/17446651.2014.887433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Subclinical thyroid dysfunction is characterized by normal levels of peripheral thyroid hormone, paired with a TSH level that is either lower than (subclinical hyperthyroidism) or higher than (subclinical hypothyroidism) the normal laboratory reference range. Slight shifts in peripheral hormone levels result in significant serum TSH changes. The exact upper limit of normal TSH and the management of subclinical hypothyroidism are still controversial. For those with TSH between high upper limit of normal and 10 mIU/L, the authors suggest selective use of thyroxine therapy. The authors agree with the general consensus in favor of therapy for those with serum TSH levels above 10 mIU/L. This recommendation is compatible with guidelines of American Thyroid Association and American Association of Clinical Endocrinologists. For subclinical hyperthyroidism persistent serum TSH <0.1 mIU/L should be treated particularly if the etiology is nodular toxic goiter. For serum TSH between 0.1 mIU/L and lower limit of normal, serum TSH co-morbidities such as cardiac risk factors and osteoporosis may favor therapy.
Collapse
Affiliation(s)
| | - Vahab Fatourechi
- b Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
17
|
Dusak A, Gokalp G, Erdogan C, Parlak M. Impaired aortic distensibility in hypothyroid patients with negative coronary angiograms: Simultaneous evaluation with 128-slice multiple row detector computed tomography. J Int Med Res 2013; 41:1691-8. [DOI: 10.1177/0300060513489479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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.
Collapse
Affiliation(s)
| | - Gokhan Gokalp
- Department of Radiology, Uludag University, Bursa, Turkey
| | - Cuneyt Erdogan
- Department of Radiology, Uludag University, Bursa, Turkey
| | - Mufit Parlak
- Department of Radiology, Uludag University, Bursa, Turkey
| |
Collapse
|
18
|
Ersoy K, Anaforoğlu İ, Algün E. Serum ischemic modified albumin levels might not be a marker of oxidative stress in patients with hypothyroidism. Endocrine 2013; 43:430-3. [PMID: 23001626 DOI: 10.1007/s12020-012-9796-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 09/05/2012] [Indexed: 12/01/2022]
Abstract
Overt hypothyroidism and subclinical hypothyroidism are thought to be associated with atherosclerosis and a chronic ischemic process. Ischemic modified albumin (IMA) is a novel marker of ischemia. We examined serum IMA levels in patients with subclinical and overt hypothyroidism. We recruited patients who presented to our clinic for thyroid disease control. We compared demographic data, fasting blood sugar, serum lipid levels, and the prevalence of metabolic syndrome by the presence of overt, subclinical, and no hypothyroidism. Cobalt binding to albumin capacity was analyzed using a rapid colorimetric technique and compared among the groups. We assessed 11 men and 74 women with a mean age of 39.9 ± 12 years. Of these, 48 (56.5 %) were euthyroid, 24 (28.2 %) had subclinical hypothyroidism, and 13 (15.3 %) had overt hypothyroidism. The groups did not differ significantly in terms of age; body mass index; waist circumference; systolic and diastolic blood pressures; levels of fasting and nonfasting blood sugar, high- and low-density lipoproteins, and triglycerides; and the presence of metabolic syndrome. Mean serum IMA level also did not differ significantly among the groups: 0.20 ± 0.08 absorbance units (ABSU) in the euthyroid participants, 0.18 ± 0.08 ABSU in those with subclinical hypothyroidism, and 0.20 ± 0.09 ABSU in those with overt hypothyroidism (P = 0.754). Mean IMA values did not differ significantly by sex, cigarette use, the presence of metabolic syndrome, or the presence of thyroid autoantibodies. Serum IMA levels did not differ among patients with overt or subclinical hypothyroidism in this case-control study.
Collapse
Affiliation(s)
- Kerem Ersoy
- Trabzon Numune Education and Research Hospital, Department of Endocrinology, Trabzon, Turkey
| | | | | |
Collapse
|
19
|
Kilic ID, Tanriverdi H, Fenkci S, Akin F, Uslu S, Kaftan A. Noninvasive indicators of atherosclerosis in subclinical hypothyroidism. Indian J Endocrinol Metab 2013; 17:271-275. [PMID: 23776901 PMCID: PMC3683203 DOI: 10.4103/2230-8210.109708] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Cardiovascular system is rich in thyroid hormone receptors and is one of the major sites of action for thyroid hormones. However, the effect of subclinical hypothyroidism (SCH) on atherosclerosis has not been cleared yet. MATERIALS AND METHODS SCH is defined as high thyroid-stimulating hormone (TSH) levels in the presence of normal serum T4 and T3 levels. A total of 32 patients with SCH and 29 controls were included in the study. Carotid intima-media thickness, flow-mediated dilatation, and aortic distensibility were compared between the groups. RESULTS FMD was lower in patients with SCH than in controls. GTN-induced vasodilatation was similar in the patients with SCH and controls. There was no statistically significant difference between the patients with SCH and controls with respect to CIMT and aortic distensibility. CONCLUSION SCH is associated with endothelial dysfunction as established by FMD. Inconsistent results of CIMT and aortic stiffness can be explained by these parameters being measures of structural changes whereas FMD is a dynamic measure that reflects the impact of both acute and chronic influences on endothelial function.
Collapse
Affiliation(s)
- Ismail Dogu Kilic
- Department of Cardiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Halil Tanriverdi
- Department of Cardiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Semin Fenkci
- Department of Endocrinology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Fulya Akin
- Department of Endocrinology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Sukriye Uslu
- Department of Cardiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Asuman Kaftan
- Department of Cardiology, Pamukkale University School of Medicine, Denizli, Turkey
| |
Collapse
|
20
|
Yurtdaş M, Gen R, Özcan T, Aydın MK. Assessment of the elasticity properties of the ascending aorta in patients with subclinical hypothyroidism by tissue Doppler imaging. ACTA ACUST UNITED AC 2013; 57:132-8. [DOI: 10.1590/s0004-27302013000200006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 10/25/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVE: We aimed to investigate whether aortic elastic properties were affected in subclinical hypothyroidism (SCH) by using tissue Doppler imaging (TDI). SUBJECTS AND METHODS: Forty-three patients with newly diagnosed SCH and forty-eight healthy controls were included to the study. Systolic and diastolic diameters of the ascending aorta were measured by M-mode transthoracic echocardiography, and the upper wall velocities of ascending aorta and mitral annulus velocities were measured by TDI. Aortic stiffness index (ASI) and aortic distensibility were computed using the formulas accepted in literature. RESULTS: The clinical and demographic features of both groups were comparable. Aortic distensibility was significantly lower, and ASI was significantly higher in SCH patients than in controls. Systolic aortic upper wall velocity (Sao) was also significantly lower in SCH patients. Early (Eao) and late diastolic aortic upper wall (Aao) velocities did not differ between the two groups. Mitral annulus (Sm, Em, and Am) velocities were also similar between the groups. Sao was negatively correlated with ASI, and positively correlated with aortic distensibility. TSH level was positively correlated with ASI, total cholesterol and low-density lipoprotein-cholesterol, and negatively correlated with aortic distensibility and Sao. CONCLUSIONS: In this study, our results showed that SCH is associated with impaired elasticity of the ascending aorta. Elastic properties of the ascending aorta can be directly evaluated by the reproducibly measurement of the upper wall movements of the ascending aorta by TDI in SCH patients.
Collapse
|
21
|
Ma SG, Yang LX, Bai F, Xu W, Hong B. Ischemia-modified albumin in patients with hyperthyroidism and hypothyroidism. Eur J Intern Med 2012; 23:e136-40. [PMID: 22863438 DOI: 10.1016/j.ejim.2012.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 04/16/2012] [Accepted: 04/17/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND The relationship between ischemia-modified albumin (IMA) and thyroid dysfunction remains uncertain. This study aimed to investigate the influence of overt hypothyroidism (Oho), overt hyperthyroidism (Ohe), and their treatments on serum IMA levels. METHODS A total of 35 untreated patients with Ohe, 35 untreated patients with Oho, and 35 control subjects were enrolled in the study. C-reactive protein (CRP), homocysteine (Hcy), IMA, and lipid profiles were measured and evaluated before and after treatment. RESULTS CRP, Hcy, and IMA levels and lipid profiles were higher in patients with Oho than in euthyroid or Ohe subjects (p<0.05). Basal IMA levels were reduced after treatments in all patients (p<0.05). In Ohe patients, serum IMA levels were positively correlated with free triiodothyronine (r=0.424, p=0.011) and free thyroxine (r=0.567, p<0.001) levels. In Oho patients, serum IMA levels were inversely correlated with free triiodothyronine (r=-0.555, p=0.001) and free thyroxine (r=-0.457, p=0.006) but positively correlated with anti-thyroid peroxidase antibody, C-reactive protein, and homocysteine levels (p<0.05). Linear regression analyses showed that free triiodothyronine was the most important factor affecting serum IMA levels in Ohe (β=0.694, p=0.019) and in Oho (β=-0.512, p=0.025). CONCLUSIONS IMA levels are increased in patients with thyroid dysfunction, particularly in overt hypothyroidism. Thyroid dysfunction has a significant impact on the oxidative stress status.
Collapse
Affiliation(s)
- Shao-gang Ma
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guilin Medical College, No. 15 Lequn Road, Guilin 541001, China.
| | | | | | | | | |
Collapse
|
22
|
Yamamoto N, Ishizawa K, Ishikawa M, Yamanaka G, Yamanaka T, Murakami S, Hiraiwa T, Okumiya K, Ishine M, Matsubayashi K, Otsuka K. Cognitive function with subclinical hypothyroidism in elderly people without dementia: one year follow up. Geriatr Gerontol Int 2012; 12:164-5. [PMID: 22188501 DOI: 10.1111/j.1447-0594.2011.00727.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
23
|
High normal thyroid-stimulating hormone is associated with arterial stiffness in healthy postmenopausal women. J Hypertens 2012; 30:592-9. [DOI: 10.1097/hjh.0b013e32834f5076] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
24
|
Valentina VN, Marijan B, Chedo D, Branka K. Subclinical hypothyroidism and risk to carotid atherosclerosis. ACTA ACUST UNITED AC 2011; 55:475-80. [DOI: 10.1590/s0004-27302011000700007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 10/10/2011] [Indexed: 11/22/2022]
Abstract
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.
Collapse
|