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Yu L, Pan G, Li Z, Li L, Gao S, Liu F, He Y, Liu Y, Liu Y, Zhao J, Yang R, Yu C. Impaired sensitivity to thyroid hormones is associated with different grades of hypertension: A multicenter cross-sectional study. Nutr Metab Cardiovasc Dis 2024; 34:1581-1589. [PMID: 38744581 DOI: 10.1016/j.numecd.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND AIM Accumulating evidence suggests a potential link between thyroid function with hypertension. However, the research results are limited, and there is no research to explore the relationship between central and peripheral thyroid hormones (THs) sensitivity and different grades of hypertension in patients with coronary heart disease (CHD). This study aims to prove the complex interaction between thyroid system and blood pressure, and provides new ideas for the assessment of hypertension in patients with CHD. METHODS AND RESULTS Calculate parameters representing central and peripheral sensitivity to THs. Logistic regression analysis was used to analyze the relationship between central and peripheral THs sensitivity of CHD patients and different grades of hypertension, especially in different ages, sexes, blood glucose levels, smoking, and drinking statuses. Among the 34,310 participants, 19,610 (57.16 %) were diagnosed with hypertension. The risk of hypertension and TSHI (OR: 0.88; 95 % CI: 0.87-0.90; P < 0.001), TT4RI (OR: 0.998; 95 % CI: 0.998-0.999; P < 0.001), TFQI (OR: 0.63; 95 % CI: 0.60-0.67; P < 0.001), PTFQI (OR: 0.63; 95 % CI: 0.59-0.67; P < 0.001) was negatively associated. The risk of hypertension was positively associated with FT3/FT4 (OR: 1.20; 95 % CI: 1.17-1.22; P < 0.001). After stratified analysis, these associations remained significant at different ages, sexes, blood glucose levels, grades of hypertension, smoking, and drinking statuses (P < 0.001). CONCLUSIONS This study shows that the decrease in central THs sensitivity index and the increase in peripheral THs sensitivity index are associated with a higher risk of hypertension in CHD patients.
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Affiliation(s)
- Lu Yu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Guangwei Pan
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Zhu Li
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Binjiang District, Hangzhou, China
| | - Lin Li
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Shan Gao
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Fanfan Liu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yuanyuan He
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yijia Liu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Yutong Liu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China
| | - Jia Zhao
- Tianjin Chest Hospital, Tianjin, 300222, China.
| | - Rongrong Yang
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
| | - Chunquan Yu
- Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
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2
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Birck MG, Janovsky CCPS, Goulart AC, Meneghini V, Pititto BDA, Sgarbi JA, Teixeira PDFDS, Bensenor IM. Associations of TSH, free T3, free T4, and conversion ratio with incident hypertension: results from the prospective Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2024; 68:e230301. [PMID: 38739525 PMCID: PMC11156177 DOI: 10.20945/2359-4292-2023-0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/08/2024] [Indexed: 05/16/2024]
Abstract
Objective To evaluate the association of TSH, free T3 (FT3), free T4 (FT4), and conversion (FT3:FT4) ratio values with incident hypertension. Materials and methods The study included data from participants of the ELSA-Brasil study without baseline hypertension. Serum TSH, FT4 and FT3 levels, and FT3:FT4 ratio values were assessed at baseline, and incident hypertension (defined by blood pressure levels ≥ 140/90 mmHg) was estimated over a median of 8.2 years of follow-up. The risk of incident hypertension was evaluated considering a 1-unit increase in TSH, FT4, FT3, and conversion ratio values and after dividing these variables into quintiles for further analysis using Poisson regression with robust variance. The results are presented as relative risks (RR) and 95% confidence intervals (CIs) before and after adjustment for multiple variables. Results The primary analysis incorporated data from 5,915 euthyroid individuals, and the secondary analysis combined data from all euthyroid individuals, 587 individuals with subclinical hypothyroidism, and 31 individuals with subclinical hyperthyroidism. The rate of incident hypertension was 28% (95% CI: 27%-29.3%). The FT4 levels in the first quintile (0.18-1.06 ng/dL) were significantly associated with incident hypertension (RR: 1.03, 95% CI: 1.01-1.06) at follow-up. The association between FT4 levels in the first quintile and incident hypertension was also observed in the analysis of combined data from euthyroid individuals and participants with subclinical thyroid dysfunction (RR: 1.04, 95% CI: 1.01-1.07). The associations were predominantly observed with systolic blood pressure levels in euthyroid individuals. However, in the combined analysis incorporating euthyroid participants and individuals with subclinical thyroid dysfunction, the associations were more pronounced with diastolic blood pressure levels. Conclusion Low FT4 levels may be a mild risk factor for incident hypertension in euthyroid individuals and persons with subclinical thyroid dysfunction.
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Affiliation(s)
- Marina Gabriela Birck
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
- MGP and CCPSJ share first authorship
| | - Carolina C. P. S. Janovsky
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
- Serviço de Endocrinologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
- MGP and CCPSJ share first authorship
| | - Alessandra Carvalho Goulart
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Vandrize Meneghini
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Bianca de Almeida Pititto
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - José Augusto Sgarbi
- Unidade de Endocrinologia, Faculdade de Medicina de Marília, Marília, SP, Brasil
| | | | - Isabela M Bensenor
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil,
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Hu M, Wang Y, Xu W, Bai J, Tang X. The impact of serum uric acid on psoriasis: NHANES 2005-2014 and Mendelian randomization. Front Genet 2024; 15:1334781. [PMID: 38784041 PMCID: PMC11111913 DOI: 10.3389/fgene.2024.1334781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Background Psoriasis is a chronic systemic inflammatory disease, and hyperuricemia is a common comorbidity in patients with psoriasis. However, the exact relationship between uric acid levels and psoriasis remains unclear. This study aimed to explore the association between uric acid levels and psoriasis. Methods Observational study participant data (≥16 years, n = 23,489) from NHANES 2003-2014. We conducted analyses using a weighted multiple logistic regression model. Genetic data sets for uric acid levels and psoriasis were obtained from the IEU database. We selected genetically independent loci closely associated with serum uric acid levels as instrumental variables and performed Mendelian randomization analyses using five complementary methods: inverse variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode. Results After adjusting for other covariates, the results revealed no significant association between serum uric acid levels and psoriasis (b = 0.999, 95% CI: 0.998, 1.001, p = 0.275). Subgroup analyses stratified by gender and ethnicity showed no significant association between sUA and psoriasis in any of the subgroups. Furthermore, the MR analysis involved the selection of 227 SNPs that were associated with both sUA and psoriasis. IVW results demonstrated no causal relationship between sUA and psoriasis (OR = 0.282, 95% CI: -0.094-0.657, p = 0.142). Conclusion Our study suggests that uric acid levels are not significantly causally related to psoriasis. This finding provides valuable insights for the treatment and prevention of psoriasis, indicating that merely reducing uric acid levels may not be an effective strategy to reduce the risk of psoriasis onset.
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Affiliation(s)
- Minghui Hu
- Department of Orthopedics, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
| | - Yangyang Wang
- Department of Internal Medicine, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
| | - Wenwu Xu
- Department of Orthopedics, Dongguan Tungwah Hospital, Dongguan, Guangdong, China
| | - Juan Bai
- Department of Orthopedics, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
| | - Xingming Tang
- Department of Internal Medicine, DongGuan SongShan Lake Tungwah Hospital, Dongguan, Guangdong, China
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Abasilim C, Persky V, Sargis RM, Argos M, Daviglus M, Freels S, Cai J, Tsintsifas K, Isasi CR, Peters BA, Talavera GA, Thyagarajan B, Turyk ME. Thyroid-related Hormones and Hypertension Incidence in Middle-Aged and Older Hispanic/Latino Adults: The HCHS/SOL Study. J Endocr Soc 2024; 8:bvae088. [PMID: 38741939 PMCID: PMC11088988 DOI: 10.1210/jendso/bvae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Indexed: 05/16/2024] Open
Abstract
Background Thyroid-related hormones act to regulate metabolic pathways and blood pressure (BP). However, the relationship of TSH and peripheral thyroid hormones and the role of the hypothalamic-pituitary-thyroid axis on hypertension development is not fully understood. We assessed sex-specific associations of thyroid-related hormones with BP and hypertension in Hispanic/Latino adults followed for 6 years. Methods We studied 1789 adults, ages 45 to 74, free of diabetes at baseline from a subcohort of the Hispanic Community Health Study/Study of Latinos. We assessed TSH, free T4 (FT4), T3, and various indicators of thyroid axis. Using multivariable linear and Poisson regression adjusted for survey design and confounding variables, we estimated a priori sex-specific associations of thyroid-related hormones with changes in BP and hypertension development. Results In men and women, TSH and TSH/FT4 ratios were associated with changes in diastolic BP and T3 with changes in pulse pressure and the development of hypertension from prehypertension. In men, a 1-SD increase in TSH [incident rate ratio (IRR) = 1.42; 95% confidence interval (CI): 1.15, 1.75] and TSH/FT4 ratio (IRR = 1.20; 95% CI: 1.07, 1.35) were positively associated with the development of hypertension from prehypertension while the TSH/FT4 ratio (IRR = 0.85; 95% CI: .72, 1.00) was protective in women. We observed sex-specific differences in associations of the T3/FT4 ratio and indices of pituitary sensitivity to thyroid hormones with changes in pulse pressure and hypertension development. Conclusion Thyroid-related hormones are associated with sex-specific changes in BP and hypertension among Hispanic/Latino adults consistent with selected studies conducted in other populations. Mechanisms underlying associations of pituitary sensitivity to thyroid hormones with BP and hypertension development warrant further study.
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Affiliation(s)
- Chibuzor Abasilim
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Robert M Sargis
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Konstantina Tsintsifas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55415, USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
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Prakash K, Hamid P. Thyroid Hormone Resistance Syndrome: From Molecular Mechanisms to Its Potential Contribution to Hypertension. Cureus 2023; 15:e49913. [PMID: 38174182 PMCID: PMC10762495 DOI: 10.7759/cureus.49913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Thyroid hormone resistance (THR) is a rare inherited disorder that affects approximately one in every 40,000 live births. This condition arises from a mutation in the thyroid hormone receptor β, leading to reduced responsiveness of target tissues. It can result in a combination of hypothyroidism and hyperthyroidism symptoms in different tissues. The thyroid hormone is crucial for controlling blood pressure, and even small changes in its levels can have an effect on vascular resistance, cardiac performance, and heart rhythm. Both hypo- and hyperthyroidism have been associated with elevated blood pressure, underscoring the significant link between thyroid hormone sensitivity and vascular function. Considering thyroid hormone sensitivity is essential in clinical practice, particularly when managing patients with hypertension, to ensure personalized and effective treatment approaches. Monitoring thyroid function is essential during the diagnosis of hypertension, as thyroid dysfunction can often be corrected to normalize blood pressure. It's crucial to distinguish between essential hypertension and hypertension associated with a thyroid abnormality in THR. The mechanisms behind the development of hypertension in THR include reduced nitric oxide production, dysregulation of the renin-angiotensin-aldosterone system, impaired endothelial function, and mutations in the deiodinases. Physicians should understand the underlying mechanisms of THR and identify new therapeutic targets for hypertension in THR.
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Affiliation(s)
- Keerthana Prakash
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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6
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Zhao G, Wang Z, Ji J, Cui R. Effect of coffee consumption on thyroid function: NHANES 2007-2012 and Mendelian randomization. Front Endocrinol (Lausanne) 2023; 14:1188547. [PMID: 37351106 PMCID: PMC10282749 DOI: 10.3389/fendo.2023.1188547] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023] Open
Abstract
Background Coffee is one of the most consumed beverages worldwide, but the effects on the thyroid are unknown. This study aims to examine the association between coffee and thyroid function. Methods Participant data (≥ 20 years, n = 6578) for the observational study were obtained from NHANES 2007-2012. Analysis was performed using weighted linear regression models and multiple logistic regression models. Genetic datasets for Hyperthyroidism and Hypothyroidism were obtained from the IEU database and contained 462,933 European samples. Mendelian randomization (MR) was used for the analysis, inverse variance weighting (IVW) was the main method of analysis. Results In the model adjusted for other covariates, participants who drank 2-4 cups of coffee per day had significantly lower TSH concentrations compared to non-coffee drinkers (b=-0.23, 95% CI: -0.30, -0.16), but no statistically significant changes in TT4, FT4, TT3 and FT3. In addition, participants who drank <2 cups of coffee per day showed a low risk of developing subclinical hypothyroidism. (OR=0.60, 95% CI: 0.41, 0.88) Observational studies and MR studies have demonstrated both that coffee consumption has no effect on the risk of hyperthyroidism and hypothyroidism. Conclusions Our study showed that drinking <2 cups of coffee per day reduced the risk of subclinical hypothyroidism and drinking 2-4 cups of coffee reduced serum TSH concentrations. In addition, coffee consumption was not associated with the risk of hyperthyroidism and hypothyroidism.
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Affiliation(s)
- Guoxu Zhao
- Mudanjiang Medical University, Mudanjiang, China
| | - Zhao Wang
- Chungnam National University School of Medicine, Daejeon Gwangyeoksi, Republic of Korea
| | - Jinli Ji
- Mudanjiang Medical University, Mudanjiang, China
| | - Rongjun Cui
- Mudanjiang Medical University, Mudanjiang, China
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Taylor PN, Lansdown A, Witczak J, Khan R, Rees A, Dayan CM, Okosieme O. Age-related variation in thyroid function - a narrative review highlighting important implications for research and clinical practice. Thyroid Res 2023; 16:7. [PMID: 37009883 PMCID: PMC10069079 DOI: 10.1186/s13044-023-00149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/05/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Thyroid hormones are key determinants of health and well-being. Normal thyroid function is defined according to the standard 95% confidence interval of the disease-free population. Such standard laboratory reference intervals are widely applied in research and clinical practice, irrespective of age. However, thyroid hormones vary with age and current reference intervals may not be appropriate across all age groups. In this review, we summarize the recent literature on age-related variation in thyroid function and discuss important implications of such variation for research and clinical practice. MAIN TEXT There is now substantial evidence that normal thyroid status changes with age throughout the course of life. Thyroid stimulating hormone (TSH) concentrations are higher at the extremes of life and show a U-shaped longitudinal trend in iodine sufficient Caucasian populations. Free triiodothyronine (FT3) levels fall with age and appear to play a role in pubertal development, during which it shows a strong relationship with fat mass. Furthermore, the aging process exerts differential effects on the health consequences of thyroid hormone variations. Older individuals with declining thyroid function appear to have survival advantages compared to individuals with normal or high-normal thyroid function. In contrast younger or middle-aged individuals with low-normal thyroid function suffer an increased risk of adverse cardiovascular and metabolic outcomes while those with high-normal function have adverse bone outcomes including osteoporosis and fractures. CONCLUSION Thyroid hormone reference intervals have differential effects across age groups. Current reference ranges could potentially lead to inappropriate treatment in older individuals but on the other hand could result in missed opportunities for risk factor modification in the younger and middle-aged groups. Further studies are now needed to determine the validity of age-appropriate reference intervals and to understand the impact of thyroid hormone variations in younger individuals.
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Affiliation(s)
- Peter N Taylor
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK.
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK.
| | - Andrew Lansdown
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
| | - Justyna Witczak
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
| | - Rahim Khan
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
| | - Aled Rees
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
- Neuroscience and Mental Health Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Colin M Dayan
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK
| | - Onyebuchi Okosieme
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK
- Diabetes Department, Prince Charles Hospital, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, UK
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Assessment of causal direction between thyroid function and cardiometabolic health: a Mendelian randomization study. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2022; 19:61-70. [PMID: 35233224 PMCID: PMC8832047 DOI: 10.11909/j.issn.1671-5411.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Growing evidence have demonstrated that thyroid hormones have been involved in the processes of cardiovascular metabolism. However, the causal relationship of thyroid function and cardiometabolic health remains partly unknown. METHODS The Mendelian randomization (MR) was used to test genetic, potentially causal relationships between instrumental variables and cardiometabolic traits. Genetic variants of free thyroxine (FT4) and thyrotropin (TSH) levels within the reference range were used as instrumental variables. Data for genetic associations with cardiometabolic diseases were acquired from the genome-wide association studies of the FinnGen, CARDIoGRAM and CARDIoGRAMplusC4D, CHARGE, and MEGASTROKE. This study was conducted using summary statistic data from large, previously described cohorts. Association between thyroid function and essential hypertension (EHTN), secondary hypertension (SHTN), hyperlipidemia (HPL), type 2 diabetes mellitus (T2DM), ischemic heart disease (IHD), myocardial infarction (MI), heart failure (HF), pulmonary heart disease (PHD), stroke, and non-rheumatic valve disease (NRVD) were examined. RESULTS Genetically predicted FT4 levels were associated with SHTN (odds ratio = 0.48; 95% CI = 0.04−0.82,P = 0.027), HPL (odds ratio = 0.67; 95% CI = 0.18−0.88,P = 0.023), T2DM (odds ratio = 0.80; 95% CI = 0.42−0.86,P = 0.005), IHD (odds ratio = 0.85; 95% CI = 0.49−0.98,P = 0.039), NRVD (odds ratio = 0.75; 95% CI = 0.27−0.97,P = 0.039). Additionally, genetically predicted TSH levels were associated with HF (odds ratio = 0.82; 95% CI = 0.68−0.99,P = 0.042), PHD (odds ratio = 0.75; 95% CI = 0.32−0.82,P = 0.006), stroke (odds ratio = 0.95; 95% CI = 0.81−0.97,P = 0.007). However, genetically predicted thyroid function traits were not associated with EHTN and MI.
CONCLUSIONS Our study suggests FT4 and TSH are associated with cardiometabolic diseases, underscoring the importance of the pituitary-thyroid-cardiac axis in cardiometabolic health susceptibility.
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Ahmadi N, Valizadeh M, Hadaegh F, Mahdavi M, Tasdighi E, Azizi F, Khalili D. Metabolic risk factors among prediabetic individuals and the trajectory toward the diabetes incidence. J Diabetes 2021; 13:905-914. [PMID: 34129291 DOI: 10.1111/1753-0407.13205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND This study investigates the trajectory of the risk factors of prediabetes progression to overt diabetes. METHODS The study retrospectively investigated 1610 prediabetic individuals. The trajectory of metabolic indicators was investigated using the generalized estimated equation method with autoregressive working correlation structure through a linear model with the identity link function. RESULTS During 15 years of follow-up, the trajectories of metabolic risk factors changed from 3 years before diabetes occurrence for fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG), 6 years for waist circumference (WC), 9 years for high-density lipoprotein cholesterol (HDL-C), and earlier for body mass index, triglyceride (TG), and TG:HDL ratio. It was shown that the differences in the trajectory of WC and HDL were stable after adjustment for other metabolic risk factors. The trajectories of FPG and 2hPG remained stable after considering multiple insulin resistance markers. CONCLUSIONS Deterioration of metabolic risk factor status can be a predictor of diabetes many years before its occurrence, but the abrupt change in plasma glucose is evident 3 years before diabetes mellitus onset. It seems that the HDL-C and WC trajectories are two independent predictors for diabetes incidence. It was also found that when the rising trend in plasma glucose starts, preventive strategies to lessen insulin resistance might not be efficient.
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Affiliation(s)
- Nooshin Ahmadi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Tasdighi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kuś A, Marouli E, Del Greco M F, Chaker L, Bednarczuk T, Peeters RP, Teumer A, Medici M, Deloukas P. Variation in Normal Range Thyroid Function Affects Serum Cholesterol Levels, Blood Pressure, and Type 2 Diabetes Risk: A Mendelian Randomization Study. Thyroid 2021; 31:721-731. [PMID: 32746749 DOI: 10.1089/thy.2020.0393] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Observational studies have demonstrated that variation in normal range thyroid function is associated with major cardiovascular risk factors, including dyslipidemia, hypertension, type 2 diabetes (T2D), and obesity. As observational studies are prone to residual confounding, reverse causality, and selection bias, we used a Mendelian randomization (MR) approach to investigate whether these associations are causal or not. Methods: Two-sample MR analysis using data from the largest available genome-wide association studies on normal range thyrotropin (TSH) and free thyroxine (fT4) levels, serum lipid levels, blood pressure measurements, T2D, and obesity traits (body mass index [BMI] and waist/hip ratio). Results: A one standard deviation (SD) increase in genetically predicted TSH levels was associated with a 0.037 SD increase in total cholesterol levels (p = 3.0 × 10-4). After excluding pleiotropic instruments, we also observed significant associations between TSH levels and low-density lipoprotein levels (β = 0.026 SD, p = 1.9 × 10-3), pulse pressure (β = -0.477 mmHg, p = 7.5 × 10-10), and T2D risk (odds ratio = 0.95, p = 2.5 × 10-3). While we found no evidence of causal associations between TSH or fT4 levels and obesity traits, we found that a one SD increase in genetically predicted BMI was associated with a 0.075 SD decrease in fT4 levels (p = 3.6 × 10-4). Conclusions: Variation in normal range thyroid function affects serum cholesterol levels, blood pressure, and T2D risk.
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Affiliation(s)
- Aleksander Kuś
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Eirini Marouli
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Centre for Genomic Health, Life Sciences, Queen Mary University of London, London, United Kingdom
| | - Fabiola Del Greco M
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lubeck, Bolzano, Italy
| | - Layal Chaker
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marco Medici
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Panos Deloukas
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Centre for Genomic Health, Life Sciences, Queen Mary University of London, London, United Kingdom
- Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Wang Y, Gu Y, Zhang Q, Liu L, Meng G, Wu H, Zhang S, Zhang T, Wang X, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K. The association between longitudinal trends of thyroid hormones levels and incident hypertension in a euthyroid population. J Hum Hypertens 2021; 35:1159-1169. [PMID: 33462390 DOI: 10.1038/s41371-020-00474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/11/2020] [Accepted: 12/09/2020] [Indexed: 11/09/2022]
Abstract
Thyroid hormones, including free triiodothyronine (FT3), free thyroxine (FT4), have well-recognized effects on the cardiovascular system. However, the evidence is lacking regarding the relationship between repeated FT3, FT4, and thyroid-stimulating hormone (TSH) measurements and incident hypertension. The aim of this cohort study was to examine how longitudinal trends of serum FT3, FT4, and TSH levels are related to the development of hypertension in a euthyroid population. A prospective study (n = 5926) was performed in Tianjin, China. Participants without a history of hypertension were followed up for ~4 years (median: 3 years). Hypertension was defined according to the criteria of JNC7. FT3, FT4, and TSH were determined by chemiluminescence immunoassay methods. FT3, FT4, TSH, and blood pressure were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationships between baseline, means, and annual changes in FT3, FT4, TSH, and hypertension. The incidence rate of hypertension per 1000 person-years was 73. Compared with the lowest quartile, the multivariable-adjusted hazards ratios (95% confidence interval) for hypertension in the highest quartiles of changes in FT3, FT4, and TSH were 1.51 (1.23-1.84), 2.04 (1.67-2.48), and 1.20 (0.99-1.45), respectively. Similar relationships were observed between the means of FT3, FT4, TSH, and hypertension. However, we found no correlations between baseline FT3, FT4, TSH, and incident hypertension. The present study is the first to demonstrate that the annual changes and means, but not baseline FT3 and FT4 values are independently related to the risk of incident hypertension in the euthyroid general population.
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Affiliation(s)
- Yawen Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China. .,Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tingjing Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China. .,Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China. .,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China. .,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.
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12
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Kotanidou EP, Giza S, Tsinopoulou VR, Vogiatzi M, Galli-Tsinopoulou A. Diagnosis and Management of Endocrine Hypertension in Children and Adolescents. Curr Pharm Des 2020; 26:5591-5608. [PMID: 33185153 DOI: 10.2174/1381612826666201113103614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022]
Abstract
Hypertension in childhood and adolescence has increased in prevalence. Interest in the disease was raised after the 2017 clinical practice guidelines of the American Academy of Paediatrics on the definition and classification of paediatric hypertension. Among the secondary causes of paediatric hypertension, endocrine causes are relatively rare but important due to their unique treatment options. Excess of catecholamine, glucocorticoids and mineralocorticoids, congenital adrenal hyperplasia, hyperaldosteronism, hyperthyroidism and other rare syndromes with specific genetic defects are endocrine disorders leading to paediatric and adolescent hypertension. Adipose tissue is currently considered the major endocrine gland. Obesity-related hypertension constitutes a distinct clinical entity leading to an endocrine disorder. The dramatic increase in the rates of obesity during childhood has resulted in a rise in obesity-related hypertension among children, leading to increased cardiovascular risk and associated increased morbidity and mortality. This review presents an overview of pathophysiology and diagnosis of hypertension resulting from hormonal excess, as well as obesity-related hypertension during childhood and adolescence, with a special focus on management.
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Affiliation(s)
- Eleni P Kotanidou
- Second Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Styliani Giza
- Fourth Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Vasiliki-Regina Tsinopoulou
- Second Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Maria Vogiatzi
- Division of Endocrinology and Diabetes, Children' s Hospital of Philadelphia, PA 19104, United States
| | - Assimina Galli-Tsinopoulou
- Second Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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13
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Cai P, Peng Y, Chen Y, Li L, Chu W, Wang Y, Wang X. Association of thyroid function with white coat hypertension and sustained hypertension. J Clin Hypertens (Greenwich) 2019; 21:674-683. [PMID: 30973206 DOI: 10.1111/jch.13536] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/04/2019] [Accepted: 03/19/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Peng Cai
- Department of Cardiology, Institute of Field Surgery, Daping Hospital Army Military Medical University Chongqing China
| | - Yan Peng
- Department of Cardiology, Institute of Field Surgery, Daping Hospital Army Military Medical University Chongqing China
| | - YuXi Chen
- Department of Cardiology, Institute of Field Surgery, Daping Hospital Army Military Medical University Chongqing China
| | - Li Li
- Department of Cardiology, Institute of Field Surgery, Daping Hospital Army Military Medical University Chongqing China
| | - Wei Chu
- Department of Cardiology, Institute of Field Surgery, Daping Hospital Army Military Medical University Chongqing China
| | - Yan Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education Joint International Research Laboratory of Ministry Education Zunyi Medical University Zunyi China
| | - Xukai Wang
- Department of Cardiology, Institute of Field Surgery, Daping Hospital Army Military Medical University Chongqing China
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14
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Ren R, Ma Y, Deng F, Li T, Wang H, Wei J, Jiang X, He M, Tian M, Liu D, Chen B, Deng W. Association between serum TSH levels and metabolic components in euthyroid subjects: a nationwide population-based study. Diabetes Metab Syndr Obes 2019; 12:1563-1569. [PMID: 31686877 PMCID: PMC6709806 DOI: 10.2147/dmso.s202769] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Whether a relationship exists between various metabolic factors and thyroid-stimulating hormone (TSH) levels in euthyroid persons remains unknown. This study aims to explore the relationship between TSH levels and metabolic factors in euthyroid individuals. METHODS A total of 2,663 subjects were enrolled from a nationwide population-based cross-sectional survey of iodine nutrition, thyroid disease and diabetes in China (2014-2017). Euthyroid individuals were divided into four groups according to quartiles of TSH levels: group A (n=305, 0.3-1.3 mIU/L), group B (n=829, 1.3-2.2 mIU/L), group C (n=673, 2.2-3.2 mIU/L) and group D (n=349, 3.2-4.2 mIU/L). Anthropometric parameters, biochemical indicators and TSH levels were determined. RESULTS A total of 2,156 euthyroid subjects with serum TSH levels within the normal range accounted for 86.8% of the sample. The systolic blood pressure (SBP) in group D was significantly higher than that in the other three groups. Group C displayed significantly lower thyroid peroxidase antibody (TPOAb) levels than the other three groups. Group C also had lower anti-thyroglobulin antibody (TgAb) levels than groups A and D, whereas the TgAb levels in group B were only lower than those in group A. Spearman's or Pearson's linear regression analysis showed that SBP (r=0.054; P=0.013) was positively correlated with TSH, but cholesterol (TC) (r=-0.043, P=0.047) was negatively correlated with TSH. Multiple stepwise regression analysis revealed that SBP, the urinary iodine concentration (UIC), waist circumference (WC), body mass index (BMI), TC, triglycerides (TGs) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of serum TSH levels. CONCLUSION This large population-based study demonstrates a significant interaction between metabolic factors and TSH levels. An adverse weight status, high blood pressure levels, blood lipid metabolism disorder and excessive iodine intake may be early manifestations of thyroid disease in euthyroid subjects.
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Affiliation(s)
- Rui Ren
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Yu Ma
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Fang Deng
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Tao Li
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Hongyan Wang
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Jing Wei
- Department of Endocrinology, General Hospital of Xinjiang Military Region, PLA, Urumqi, People’s Republic of China
| | - Xiaoyan Jiang
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Min He
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Mingyuan Tian
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dongfang Liu
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Bing Chen
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Wuquan Deng
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
- Correspondence: Wuquan DengDepartment of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, No. 1 Jiankang Road, Yuzhong District, Chongqing, People’s Republic of ChinaTel +86 236 369 2185Email
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15
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Zhang J, Huang C, Meng Z, Fan Y, Yang Q, Zhang W, Gao Y, Yang Z, Cai H, Bian B, Li Y, Yu X, Du X, Xu S, Nie J, Liu M, Sun J, Zhang Q, Gao Y, Song K, Wang X, Zhao L. Gender-Specific Differences on the Association of Hypertension with Subclinical Thyroid Dysfunction. Int J Endocrinol 2019; 2019:6053068. [PMID: 32082373 PMCID: PMC7012202 DOI: 10.1155/2019/6053068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Both hypertension and subclinical thyroid dysfunction (STD) have high prevalence and clinical importance, but their relationship is still a matter of debate. We aimed to explore gender-specific difference on the association between hypertension and STD in Chinese. METHODS We recruited 13,380 ostensible healthy participants (8,237 men and 5,143 women). The associations between hypertension and STD were analyzed on a gender-based setting after dividing STD into subclinical hypothyroidism, subclinical hyperthyroidism and further subgrouped euthyroidism. Crude and adjusted odds ratios of STD for hypertension were analyzed by binary logistic regression. RESULTS An increasing trend of hypertension prevalence was found along with aging in both genders. Yet, higher male hypertension prevalence was found until 65 years, and then it intersected with female hypertension prevalence. Women had significantly higher propensity for STD than men. Yet, in elderly participants, this gender-specific difference became less obvious. We displayed detrimental effects for subclinical hypothyroidism in both genders after multiple-covariate adjustments, yet no such effects were shown for subclinical hyperthyroidism. Moreover, females with subclinical hypothyroidism were more likely to be associated with hypertension than males, and the corresponding odds ratios were 1.619 (P < 0.01) and 1.557 (P < 0.01) and 1.557 (P < 0.01) and 1.557 (P < 0.01) and 1.557 (P < 0.01) and 1.557 (P < 0.01) and 1.557 (. CONCLUSION We demonstrate that hypertension is associated with subclinical hypothyroidism, but not with subclinical hyperthyroidism. Moreover, females with subclinical hypothyroidism are more likely to be associated with hypertension than males.
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Affiliation(s)
- Jingkai Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao Huang
- Hull York Medical School, University of Hull, Hull, UK
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxia Gao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhenwen Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Heng Cai
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bo Bian
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shaopeng Xu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Nie
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinhong Sun
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
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16
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He W, Li S, Zhang JA, Zhang J, Mu K, Li XM. Effect of Levothyroxine on Blood Pressure in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2018; 9:454. [PMID: 30154757 PMCID: PMC6103239 DOI: 10.3389/fendo.2018.00454] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/24/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Patients with subclinical hypothyroidism (SCH) have elevated blood pressure, but the effect of levothyroxine (LT4) therapy on blood pressure among those patients is still unclear. This study aimed to assess whether LT4 therapy could reduce blood pressure in SCH patients through a systematic review and meta-analysis. Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched. Randomized controlled trials (RCTs) assessing the effect of LT4 therapy on blood pressure or prospective follow-up studies comparing the blood pressure level before and after LT4 treatment were included, and the mean difference of systolic blood pressure (SBP) or diastolic blood pressure (DBP) was pooled using random-effect meta-analysis. Results: Twenty-nine studies including 10 RCTs and 19 prospective follow-up studies were eligible for the analysis. Meta-analysis of 10 RCTs suggested that LT4 therapy could significantly reduce SBP in SCH patients by 2.48 mmHg (95% CI -4.63 to -0.33, P = 0.024). No heterogeneity was observed among these 10 RCTs (I2 = 0%). Meta-analysis of the 19 prospective follow-up studies found that LT4 therapy significantly decreased SBP and DBP by 4.80 mmHg (95%CI -6.50 to -3.09, P < 0.001) and 2.74 mmHg (95%CI -4.06 to -1.43, P < 0.001), respectively. Conclusion: The findings suggest that LT4 replacement therapy can reduce blood pressure in SCH patients, which needs to be validated in more clinical trials with larger samples.
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Affiliation(s)
- Weiwei He
- Department of Endocrinology, Affiliated Hospital of Yanan Medical University, Shaanxi, China
| | - Sheli Li
- Department of Endocrinology, Affiliated Hospital of Yanan Medical University, Shaanxi, China
| | - Jin-an Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jing Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Kaida Mu
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xin-ming Li
- Department of Cardiology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- *Correspondence: Xin-ming Li
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