1
|
Tan Q, Chen M, Yang H, Guo Y, Zou X. Subclinical Hypothyroidism Predicted Adverse Cardiovascular Events in Patients with Ejection Fraction Preserved Heart Failure. Ther Clin Risk Manag 2024; 20:227-237. [PMID: 38706881 PMCID: PMC11068049 DOI: 10.2147/tcrm.s433489] [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] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 04/11/2024] [Indexed: 05/07/2024] Open
Abstract
Background Subclinical hypothyroidism (SH) increases the risk of cardiovascular events, however the influence of SH on prognosis of ejection fraction preserved heart failure (HFpEF) is not fully understood. Methods In this prospective observational study, patients with HFpEF were divided into euthyroidism group (n = 413) and SH group (n = 79). Patients were followed up for at least 30 months to examine the association between SH and cardiovascular events in patients with HFpEF. The primary end point was composite cardiovascular events (cardiovascular death and re-hospitalization). The patients underwent flow-mediated dilation (FMD) measurement by ultrasound in order to value endothelial function. Results The rate of composite cardiovascular events was higher in SH group than in euthyroidism group (54.49% and 26.36%, respectively; p < 0.001). The higher risk of cardiovascular events in SH group was primarily due to a higher risk of re-hospitalization compared to euthyroidism group (45.56% and 20.58%, respectively; p < 0.001). The rate of cardiovascular death was higher in SH group than in euthyroidism group (13.92% and 5.81%, respectively; p = 0.017). Cox proportional hazards regression showed that SH (hazard ratios [HR] 1.921, 95% confidence interval [CI] 1.139-3.240), level of TSH (HR 1.025, 95% CI 1.010-1.054), age (HR 1.017, 95% CI 1.002-1.034), LVEF (HR 0.975, 95% CI 0.953-0.996), atrial fibrillation (HR 1.581, 95% CI 1.083-2.307), eGFR (HR 0.987, 95% CI 0.978-0.997), and NYHA cardiac function (HR 2.342, 95% CI 1.649-3.326) were independent predictors of cardiovascular events in patients with HFpEF (all P < 0.05). Conclusion Subclinical hypothyroidism was associated with increased cardiovascular events and death in patients with HFpEF.
Collapse
Affiliation(s)
- Qiang Tan
- Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of China
| | - Ming Chen
- Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of China
| | - Hongmei Yang
- Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of China
| | - Yao Guo
- Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of China
| | - Xiaoyi Zou
- Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of China
| |
Collapse
|
2
|
Isailă OM, Stoian VE, Fulga I, Piraianu AI, Hostiuc S. The Relationship between Subclinical Hypothyroidism and Carotid Intima-Media Thickness as a Potential Marker of Cardiovascular Risk: A Systematic Review and a Meta-Analysis. J Cardiovasc Dev Dis 2024; 11:98. [PMID: 38667716 PMCID: PMC11049994 DOI: 10.3390/jcdd11040098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/21/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Thyroid dysfunction is known to have significant consequences on the cardiovascular system. The correlation between carotid intima-media thickness (CIMT) and subclinical hypothyroidism (SCH) has been frequently evaluated in clinical studies in recent years. This study aimed to evaluate the significance of this association through a meta-analysis. METHODS We conducted a systematic search of PubMed, MedLine, Scopus, and Web of Science databases using the keywords 'subclinical hypothyroidism and carotid intima-media thickness', from the beginning of each database until January 2023. We established the inclusion and exclusion criteria and considered studies that met the inclusion criteria. We used Jamovi for statistical analysis of the data. RESULTS We identified 39 observational studies that met the inclusion criteria, with 3430 subjects: 1545 SCH and 1885 EU. Compared to euthyroid subjects (EU), subjects with subclinical hypothyroidism (SCH) had significantly increased carotid intima-media thickness (CIMT) values; the estimated average mean difference was 0.08 (95% CI 0.05 to 0.10), p < 0.01, I2 = 93.82%. After the sensitivity analysis, a total of 19 from the 39 abovementioned studies were analyzed, with most studies showing a positive association between SCH and thickening of the carotid wall; the estimated average mean difference was 0.04 (95% CI 0.02 to 0.07), p = 0.03, I2 = 77.7. In addition, female sex, advanced age, and high cholesterol levels statistically significantly influenced this association. CONCLUSIONS Our meta-analysis indicates a significant positive association between SCH and increased CIMT, but with some limitations.
Collapse
Affiliation(s)
- Oana-Maria Isailă
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Victor Eduard Stoian
- Department of Legal Medicine, Legal Medicine Service Dâmbovița, 130083 Târgoviște, Romania
| | - Iuliu Fulga
- Department of Legal Medicine, Dunărea de Jos University, 800201 Galați, Romania (A.-I.P.)
| | - Alin-Ionut Piraianu
- Department of Legal Medicine, Dunărea de Jos University, 800201 Galați, Romania (A.-I.P.)
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| |
Collapse
|
3
|
Buk OF, Ocak S, Uyanik MS, Daldal E, Avci MA, Akgün C. Laparoscopic Sleeve Gastrectomy: Impact on Body Mass Index and Thyroid Hormones in Euthyroid Obese Patients. Med Sci Monit 2023; 29:e942692. [PMID: 38102820 PMCID: PMC10731805 DOI: 10.12659/msm.942692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Obesity is still a major global public health problem and its incidence is increasing. Obesity leads to deterioration in thyroid functions. Even when they are within normal ranges, high normal levels of thyroid-stimulating hormone (TSH) increase morbidity and mortality. This study aimed to evaluate the body mass index (BMI) and TSH levels in 300 euthyroid patients with obesity before and after laparoscopic sleeve gastrectomy (LSG). MATERIAL AND METHODS A total of 300 euthyroid patients who underwent LSG between 2019 and 2021 were included in the study. Body mass index (BMI), thyroid-stimulating hormone (TSH), and free triiodothyronine (FT) 3 and tetraiodothyronine (FT4) levels were recorded before surgery and at 6 and 12 months after surgery and subsequently analyzed. RESULTS Mean BMI values were significantly lower at 6 and 12 months after surgery (P<0.001). There was a significant difference between mean TSH and FT4 levels before surgery and those at 6 and 12 months after surgery (P<0.001). However, mean FT3 levels remained unchanged 1 year after surgery (P=0.005). CONCLUSIONS LSG is not only effective in terms of weight loss, but also exhibits improving effects on thyroid hormone homeostasis in obese patients and provides protection against further adverse effects of TSH.
Collapse
Affiliation(s)
- Omer Faruk Buk
- Department of General Surgery, Samsun Research and Training Hospital, Atakum, Turkey
| | - Sönmez Ocak
- Department of General Surgery, Samsun Research and Training Hospital, Atakum, Turkey
| | - Mustafa Safa Uyanik
- Department of General Surgery, Samsun Research and Training Hospital, Atakum, Turkey
| | - Emin Daldal
- Department of General Surgery, Samsun Research and Training Hospital, Atakum, Turkey
| | - Mehmet Alperen Avci
- Department of General Surgery, Samsun Research and Training Hospital, Atakum, Turkey
| | - Can Akgün
- Department of General Surgery, Samsun University Faculty of Medicine, Samsun, Turkey
| |
Collapse
|
4
|
Theotokis P, Gkantaras A, Avramidou E, Meditskou S, Manthou M. MYOFIBROBLASTS HINDER RECOVERY OF HASHIMOTO THYROIDITIS IN THE ULTRASTRUCTURAL LEVEL. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2023; 19:415-420. [PMID: 38933253 PMCID: PMC11197825 DOI: 10.4183/aeb.2023.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Background Hashimoto thyroiditis (HT) is an autoimmune disorder associated with hypothyroidism. Lymphocyte infiltration leading to thyroid follicular cell destruction is counteracted by increased collagen production, deposition and scarring. However, only recently a specific subpopulation of modified fibroblasts with contractile properties, namely "myofibroblasts" (MFBs) have been linked to HT. Aim Our ultrastructural study aims to delineate the presence and contribution of MFBs to the fibrotic milieu of HT. Material and Methods Tissue biopsies were obtained from 5 HT-diagnosed patients and specimens were examined using a Transmission Electron Microscope (TEM). Results Histopathological examination indicated extensive microvilli atrophy and atypical vacuolations of the thyroid follicular cells in the HT samples. In addition to interstitial extravasated lymphocytes, capillaries were encircled by MFBs (mean distance from lumen 1.248± 0.43µm) with the characteristic electron-dense α-smooth muscle actin (α-SMA), confirmable in higher magnifications. Myofibroblastic projections were found to have significantly higher representation near the capillary lumen compared to the impaired endothelial lining (P < 0.01). Conclusion Our TEM findings suggest that the intrusion of endothelia by myofibroblastic projections can be a significant factor towards the malfunction of follicular cells in HT patients and offer a paradigmal understanding of the ultrastructural interactions that may underlie the HT pathology.
Collapse
Affiliation(s)
- P. Theotokis
- Aristotle University of Thessaloniki, School of Medicine, Laboratory of Histology and Embryology
| | - A. Gkantaras
- Aristotle University of Thessaloniki, Hippocrateion General Hospital, First Department of Pediatrics, Thessaloniki, Greece
| | - E. Avramidou
- Aristotle University of Thessaloniki, School of Medicine, Laboratory of Histology and Embryology
| | - S. Meditskou
- Aristotle University of Thessaloniki, School of Medicine, Laboratory of Histology and Embryology
| | - M.E. Manthou
- Aristotle University of Thessaloniki, School of Medicine, Laboratory of Histology and Embryology
| |
Collapse
|
5
|
Spahia N, Rroji M, Barbullushi M, Spasovski G. Subclinical Hypothyroidism, Kidney, and Heart from Normal to Uremic Milieu. Metab Syndr Relat Disord 2023; 21:415-425. [PMID: 37433213 DOI: 10.1089/met.2023.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
Thyroid hormone (TH) imbalances, particularly subclinical hypothyroidism (SCHT), are associated with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). SCHT is more prevalent in CKD and ESKD patients than in the general population, and this condition increases the risk of cardiovascular disease (CVD) morbidity and mortality. The risk of CVD is higher in CKD and ESKD patients compared with the general population. Traditional and nontraditional risk factors, including TH abnormalities, contribute to the high CVD burden in CKD and ESKD patients. The review discusses the link between CKD and hypothyroidism, with a focus on SCHT, and the mechanisms that lead to CVD burden.
Collapse
Affiliation(s)
- Nereida Spahia
- Department of Nephrology, University Hospital Center "Mother Teresa," Tirana, Albania
| | - Merita Rroji
- Department of Nephrology, University Hospital Center "Mother Teresa," Tirana, Albania
| | - Myftar Barbullushi
- Department of Nephrology, University Hospital Center "Mother Teresa," Tirana, Albania
| | - Goce Spasovski
- Department of Nephrology, Medical Faculty, University Sts. Cyril and Methodius, Skopje, North Macedonia
| |
Collapse
|
6
|
Teng Z, Feng J, Lv P. Subclinical Hypothyroidism is Associated with Cognitive Impairment in Patients with Cerebral Small Vessel Disease. Neuropsychiatr Dis Treat 2023; 19:303-310. [PMID: 36761397 PMCID: PMC9904226 DOI: 10.2147/ndt.s401020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the association between subclinical hypothyroidism (SCH) and cognitive function in patients with cerebral small vessel disease (CSVD). METHODS We evaluated 528 patients with CSVD in this retrospective study. SCH was defined as elevated levels of thyroid stimulating hormone with normal concentrations of free thyroxine. Magnetic resonance imaging was performed to assess the total CSVD burden score and the Montreal Cognitive Assessment was used to measure the cognitive function. Participants were grouped based on cognitive function or total CSVD burden score. Multivariate logistic regression and mediation analysis models were used to estimate the association of SCH with cognitive function and CSVD burden. RESULTS SCH was an independent risk factor for cognitive impairment in patients with CSVD after adjustment for potential confounding factors (OR: 1.939; 95% CI: 1.170 to 3.213; P=0.010). Additionally, SCH was independently associated with severe CSVD burden after adjustment for potential confounding factors (OR: 1.668; 95% CI: 1.085 to 2.564; P=0.020). Mediation analysis found a significant moderating effect (P=0.021) of the severe CSVD burden on the relation between SCH and cognitive impairment after adjustment for potential confounding factors. A 30.1% of the total effect between this relation was attributable to the presence of severe CSVD burden. CONCLUSION SCH was associated with an increased risk of cognitive impairment in patients with CSVD. The mediating role of severe CSVD burden suggests that SCH may lead to cognitive impairment through the presence of severe CSVD burden. These findings may suggest strategies for screening for SCH in the context of cognitive impairment in patients with severe CSVD.
Collapse
Affiliation(s)
- Zhenjie Teng
- Department of Neurology, Hebei Medical University, Shijiazhuang, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, People's Republic of China
| | - Jing Feng
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People's Republic of China
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, Shijiazhuang, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, People's Republic of China
| |
Collapse
|
7
|
Matta RA, Farrage HM, Saedii AA, Abdelrahman MM. Male subclinical hypogonadism and late-onset hypergonadotrophic hypogonadism: mechanisms, endothelial function, and interplay between reproductive hormones, undercarboxylated osteocalcin, and endothelial dysfunction. Aging Male 2022; 25:72-87. [PMID: 35291927 DOI: 10.1080/13685538.2022.2049744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Pathogenesis and endothelial function in subclinical hypogonadism (SCH) remain unclear. Undercarboxylated osteocalcin (ucOC) participates in atherosclerosis and reproduction. We explored the underlying mechanisms and interplay of endothelial dysfunction, unOC and reproductive hormones in SCH and primary late-onset hypogonadism (LOH). METHODS In the SCH, LOH, and healthy eugonadal male groups, we measured serum unOC, calculated luteinizing hormone/testosterone (LH/T), LH.T product, and estradiol/T (E/T) as indicators of impaired Leydig cells, androgen sensitivity index (ASI), and aromatase activity, respectively (LH set-point regulators), and assessed flow-mediated dilation of the brachial artery (FMD%), carotid-intima media thickness (CIMT), and aortic stiffness (AS). RESULTS ↑LH/T, ↑ASI, ↓aromatase activity, normal T, follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels, ↑unOC, and enhanced atherosclerotic markers (↓FMD%, ↑CIMT, ↑AS) are characteristics of SCH. Testosterone was positively correlated with FMD% in SCH. The independent predictors were: SHBG and LH for FMD% and CIMT, respectively, and LH/T, ucOC, FSH, estradiol, and E/T ratio for AS in the LOH group; and LH for FMD% & AS and LH and LH/T for CIMT in all study subjects. CONCLUSIONS SCH is a distinct clinical entity characterized by impaired androgen sensitivity and aromatase activity, compensatory elevated unOC, endothelial dysfunction, and anti-atherogenic role of testosterone.
Collapse
Affiliation(s)
- Ragaa Abedelshaheed Matta
- Diabetes and Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | | | | | | |
Collapse
|
8
|
Cao X, Lu M, Xie RR, Song LN, Yang WL, Xin Z, Yang GR, Yang JK. A high TSH level is associated with diabetic macular edema: a cross-sectional study of patients with type 2 diabetes mellitus. Endocr Connect 2022; 11:EC-22-0122. [PMID: 35686715 PMCID: PMC9254322 DOI: 10.1530/ec-22-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Abstract
AIMS In this study, we determined the association between thyroid-stimulating hormone (TSH) and diabetic macular edema (DME) by assessing the prevalence and risk factors for DME in type 2 diabetes mellitus (T2DM) patients with different thyroid dysfunctions. METHODS This was a retrospective cross-sectional study including 1003 euthyroid and 92 subclinical hypothyroidism (SCH) T2DM patients. DME status was detected by optical coherence tomography (OCT). The association between TSH and DME and the impact of TSH on DME were analyzed. RESULTS The DME prevalence was 28.3% in the SCH patients and 14.0% in the euthyroid population. The serum FT4 (P = 0.001) and FT3 (P < 0.001) levels were significantly higher in the non-DME group than in the DME group, and the TSH level (P < 0.001) was significantly lower. Four subgroups (G1-G4) were divided by TSH level, and the chi-square test indicated that even in the normal range, the TSH level was positively related to DME prevalence (P = 0.001). Subgroup data indicated that the association between TSH and DME detected by OCT (P = 0.001) was stronger than the correlation between TSH and diabetic retinopathy detected by digital retinal photographs (P = 0.027). The logistic regression model confirmed that elevated TSH was an independent risk factor for DME. The odds ratio was 1.53 (P = 0.02). CONCLUSIONS A high TSH level was an independent risk factor for DME. More attention should be given to the TSH level in T2DM patients due to its relationship with diabetic complications.
Collapse
Affiliation(s)
- Xi Cao
- Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ming Lu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rong-Rong Xie
- Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li-Ni Song
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei-Li Yang
- Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Correspondence should be addressed to J-K Yang:
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Guang-Ran Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Correspondence should be addressed to J-K Yang:
| | - Jin-Kui Yang
- Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Correspondence should be addressed to J-K Yang:
| |
Collapse
|
9
|
Shimizu Y, Kawashiri SY, Noguchi Y, Nakamichi S, Nagata Y, Hayashida N, Maeda T. Associations among Ratio of Free Triiodothyronine to Free Thyroxine, Chronic Kidney Disease, and Subclinical Hypothyroidism. J Clin Med 2022; 11:jcm11051269. [PMID: 35268361 PMCID: PMC8911058 DOI: 10.3390/jcm11051269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 02/05/2023] Open
Abstract
The ratio of free triiodothyronine (FT3) to free thyroxine (FT4) (FT3/FT4), a maker of peripheral thyroxin deiodination, could indicate activity of thyroid hormone. Since positive association between subclinical hypothyroidism (SCH) and chronic kidney disease (CKD) was reported, clarifying the association among FT3/FT4, SCH, and CKD could be an efficient tool to make a strategy for preventing CKD. A cross-sectional study with 1724 Japanese with normal thyroid hormone was conducted. Significant positive association between SCH and CKD was observed; the adjusted odds ratio (OR) and 95% confidence interval (95% CI) was 2.23 (1.38, 3.59). Even though, FT3/FT4 was found to be inversely associated with CKD whereas positively associated with SCH; the adjusted ORs and 95% CIs for 1 standard deviation (SD) increment of FT3/FT4 were 0.51 (0.35, 0.74) for CKD and 2.40 (1.34, 4.29) for SCH, respectively. FT3/FT4 was also found to be positively associated with SCH without CKD but not those with CKD; 1 SD increment of FT3/FT4 were 3.44 (1.72, 6.91) for SCH without CKD and 1.11 (0.40, 3.06) for SCH with CKD, respectively. Although further investigation is necessary, present study indicates that higher activity of peripheral thyroxin deiodination might have beneficial association on absence of CKD even among SCH which is positively associated with CKD.
Collapse
Affiliation(s)
- Yuji Shimizu
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka 537-8511, Japan
- Correspondence: ; Tel.: +81-95-819-7578
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (S.-Y.K.); (Y.N.); (Y.N.)
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
| | - Yuko Noguchi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (S.-Y.K.); (Y.N.); (Y.N.)
| | - Seiko Nakamichi
- Nagasaki University Health Center, Nagasaki 852-8523, Japan;
| | - Yasuhiro Nagata
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (S.-Y.K.); (Y.N.); (Y.N.)
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
| | - Naomi Hayashida
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
- Division of Promotion of Collaborative Research on Radiation and Environmental Health Effects, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
| |
Collapse
|
10
|
Effect of Subclinical Hypothyroidism on the Association between Hemoglobin A1c and Reduced Renal Function: A Prospective Study. Diagnostics (Basel) 2022; 12:diagnostics12020462. [PMID: 35204553 PMCID: PMC8871099 DOI: 10.3390/diagnostics12020462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 02/06/2023] Open
Abstract
Subclinical hypothyroidism (SCH) was reported to be associated with accelerating endothelial dysfunction, which is recognized as one of the upstream mechanisms that leads to glomerular injury (lower glomerular filtration rate (GFR)). SCH was also reported to be associated with hyperglycemia, which is associated with higher hemoglobin A1c (HbA1c) levels and induces endothelial dysfunction. Therefore, SCH status could influence the association between HbA1c and reduced eGFR. To clarify those associations, we conducted a prospective study of 1580 Japanese individuals who participated in an annual health check-up in 2014 with 2.8 years of follow-up. All participants had free triiodothyronine (T3) and free thyroxine (T4) levels in the normal range. Among study participants, 88 were diagnosed as having SCH. Even though no significant correlation was observed between HbA1c and annual change in estimated GFR among participants without SCH (multi-adjusted standardized parameter estimate (β) = 0.03, p = 0.250), a significant inverse association was observed among participants with SCH (β = −0.26, p = 0.014). When those analyses were performed among participants who were not taking glucose lowering medication, the observed associations were essentially the same: β = 0.03, p = 0.266 for participants without SCH and β = −0.32, p = 0.006 for participants with SCH, respectively. Therefore, SCH status could influence the association between HbA1c and renal function.
Collapse
|
11
|
Businge CB, Longo-Mbenza B, Kengne AP. Iodine deficiency in pregnancy along a concentration gradient is associated with increased severity of preeclampsia in rural Eastern Cape, South Africa. BMC Pregnancy Childbirth 2022; 22:98. [PMID: 35120491 PMCID: PMC8815178 DOI: 10.1186/s12884-021-04356-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 12/17/2021] [Indexed: 12/16/2022] Open
Abstract
Background Preeclampsia is a leading cause of maternal mortality and morbidity in South Africa. Iodine deficiency in pregnancy, which is amenable to correction through iodine supplementation, has been reported to increase the risk of preeclampsia. However, the association of iodine nutrition status with preeclampsia in South Africa has not been studied. Methods We enrolled 51 randomly selected normotensive pregnant controls at term together with 51 consecutively selected cases of preeclampsia and 51 cases of severe preeclampsia/eclampsia, all in the third trimester, from Mthatha Regional and Nelson Mandela Academic Hospital in the Eastern Cape Province. Urinary iodine concentration (UIC), serum thyroid-stimulating hormone (TSH), triiodothyronine (FT3), thyroxine (FT4) and thyroglobulin (Tg) levels were compared between cases and controls. Results The respective chronological and gestational ages at enrolment for normotensive, preeclampsia and severe preeclampsia/eclampsia participants were: age 23, 24 and 19 years (p = 0.001), and gestational age 38, 34, and 35 weeks (p < 0.001). The median gravidity was 1 for all three groups. The median UIC, FT4, FT3 revealed a decreasing and Tg a rising trend with the severity of preeclampsia (p < 0.05). TSH had a non-significant rising trend (p > 0.05). The respective median values for normotensive, preeclampsia and severe preeclampsia/eclampsia participants were UIC 217.1, 127.7, and 98.8 μg/L; FT4 14.2, 13.7, and 12. pmol/L; FT3 4.8, 4.4, and 4.0 pmol//L; Tg 19.4, 21.4, and 32. Nine microgram per liter; TSH 2.3, 2.3, and 2.5 mIU/L. UIC < 100 μg/L, Tg > 16 μg/L and FT4 < 11.3 pmol/L were independent predictors of preeclampsia/eclampsia syndrome. Conclusion Women with severe preeclampsia/eclampsia had significantly low UIC and high Tg, suggesting protracted inadequate iodine intake. Inadequate iodine intake during pregnancy severe enough to cause elevated Tg and FT4 deficiency was associated with an increased risk of severe preeclampsia/eclampsia.
Collapse
Affiliation(s)
- Charles Bitamazire Businge
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Walter Sisulu University, Private Bag x1 WSU, Mthatha, 5117, South Africa. .,Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Benjamin Longo-Mbenza
- Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.,LOMO University of Research, Kinshasa, Democratic Republic of Congo
| | - Andre Pascal Kengne
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|
12
|
Hu Y, Hu Z, Tang W, Liu W, Wu X, Pan C. Association of Thyroid Hormone Levels with Microvascular Complications in Euthyroid Type 2 Diabetes Mellitus Patients. Diabetes Metab Syndr Obes 2022; 15:2467-2477. [PMID: 35982763 PMCID: PMC9380826 DOI: 10.2147/dmso.s354872] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/25/2022] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To examine the prevalence of different microvascular complications and investigate the association between thyroid hormones (THs) and these complications in euthyroid patients with type 2 diabetes mellitus (T2DM). METHODS A total of 248 T2DM patients were analyzed retrospectively for the study. All patients received a detailed and standard assessment to identify diabetic peripheral neuropathy (DPN), diabetic nephropathy (DN), and diabetic retinopathy (DR). Multivariate logistic regression was carried out to analyze the association between THs and diabetic microvascular complications. RESULTS The study found the prevalence of any microangiopathy to be 72.18% (n = 179). At the same time, the prevalence of DPN was 54.84% (n=136), while that of DN was 31.85% (n=79). Likewise, the prevalence of DR was 35.48% (n=88). The odds ratios (ORs) for free triiodothyronine (FT3) developing any microangiopathy, DPN, DN and DR were 0.200, 0.361, 0.310, and 0.588 (P<0.05), respectively. Also, the ORs for free thyroxine (FT4) developing any microangiopathy, DPN, DN and DR were 0.643, 0.800, 0.702 and 0.726 (P<0.05), respectively. Lastly, the ORs for thyroid-stimulating hormone (TSH) developing DPN was 1.57 (95% CI: 1.148-2.137, P=0.005). CONCLUSION The study concludes that serum FT3 and FT4 levels are negatively associated with any microangiopathy, DPN, DN and DR in euthyroid patients with T2DM, independent of traditional risk factors. However, the TSH levels are positively associated with DPN. Future larger sample-size studies are needed to confirm the relationship between thyroid hormone levels and microvascular complications in euthyroid patients with T2DM.
Collapse
Affiliation(s)
- Yonghui Hu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Zhibo Hu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Wangna Tang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Wenjie Liu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Xiaoming Wu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Congqing Pan
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, People’s Republic of China
- Correspondence: Congqing Pan; Xiaoming Wu, NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China, Email ;
| |
Collapse
|
13
|
Thyroid Hormones, Peripheral White Blood Count, and Dose of Basal Insulin Are Associated with Changes in Nerve Conduction Studies in Adolescents with Type 1 Diabetes. Metabolites 2021; 11:metabo11110795. [PMID: 34822453 PMCID: PMC8619894 DOI: 10.3390/metabo11110795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 12/19/2022] Open
Abstract
Type 1 diabetes (T1D) in the child population is the third most common chronic disease. Diabetic peripheral neuropathy (DPN) is a very disabling and silently developing complication. This prospective, observational study enrolled 182 (93 girls) patients with T1D, aged 16.5-18 years. The aim of the study was to assess the correlation between factors of diabetes metabolic control, blood count, thyroid hormones, thyroid-stimulating hormone (TSH), level of cortisol, vitamin D3, metabolic factors, demographic data, and nerve conduction study (NCS) parameters. We revealed that in multivariate regression models for almost all NCS parameters, beside height and diabetes duration, significant factors were basal insulin dose per kilogram of weight (BID/kg), body mass index (BMI), and thyroid hormones. For conduction velocities of the motor nerves, mean HbA1c exists in models. In all models for all NCS parameters there exists at least one parameter of peripheral white blood cell counts (predominantly monocytes). There is a significant influence of thyroid hormones, peripheral blood white cells count, and BID per weight on parameters of NCS. It is essential to take care of the proper insulin dose per weight of patients and the adequate proportion of basal to prandial insulin.
Collapse
|
14
|
Yang C, He Z, Zhang Q, Lu M, Zhao J, Chen W, Gao L. TSH Activates Macrophage Inflammation by G13- and G15-dependent Pathways. Endocrinology 2021; 162:6225351. [PMID: 33851697 DOI: 10.1210/endocr/bqab077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Indexed: 12/17/2022]
Abstract
Thyroid-stimulating hormone (TSH) treatment activates inhibitor of NF-κB/nuclear factor κB (IκB/NFκB) and extracellular signal-regulated kinase (ERK)-P38 in macrophages, but how these pathways are activated, and how they contribute to the proinflammatory effect of TSH on macrophages remain unknown. The TSH receptor (TSHR) is coupled to 4 subfamilies of G proteins (Gs, Gi/o, Gq/11, and G12/13) for its downstream signaling. This study investigated the G protein subtypes responsible for the proinflammatory effect of TSH on macrophages. qPCR showed that Gi2, Gi3, Gas, Gq, G11, G12, G13, and G15 are abundantly expressed by macrophages. The contribution of different G protein pathways to the proinflammatory effect was studied by the corresponding inhibitors or siRNA interference. While TSH-induced IκB phosphorylation was not inhibited by Gs inhibitor NF449, Gi inhibitor pertussis toxin, or Gq or G11 siRNA, it was blocked by phospholipase C inhibitor U73122 or G15 siRNA interference. TSH-induced ERK and P38 phosphorylation was blocked by G13 but not G12 siRNA interference. Interference of either G13 or G15 could block the proinflammatory effect of TSH on macrophages. The present study demonstrate that TSH activates macrophage inflammation by the G13/ERK-P38/Rho GTPase and G15/phospholipase C (PLC)/protein kinases C (PKCs)/IκB pathways.
Collapse
Affiliation(s)
- Chongbo Yang
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Zhao He
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qunye Zhang
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Ministry of Public Health, the State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Ming Lu
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Wenbin Chen
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ling Gao
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, China
| |
Collapse
|
15
|
Yurtdaş M, Asoğlu R, Özaydın A, Doğan Z. Lymphocyte to monocyte ratio may predict increased carotid intima-media thickness in patients with subclinical hypothyroidism. Clin Hemorheol Microcirc 2021; 77:133-142. [PMID: 33074218 DOI: 10.3233/ch-200820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Inflammation has an important role in the pathogenesis of atherosclerosis. Lymphocyte-to-monocyte ratio (LMR) is accepted as an indicator of inflammation. OBJECTIVE Our aim was to scrutinize the relationship between LMR and subclinical atherosclerosis (SubAth) measured by carotid intima-media thickness (CIMT) in subclinical hypothyroidism (SubHT). METHODS Newly identified 190 SubHT patients were prospectively included into the study. Blood samples were taken for measuring laboratory parameters. Then, CIMT was computed. Patients were seperated into 2 groups by their CIMT value (Group-1: ≤0.9 and Group-2: >0.9 mm), and then stratified into tertiles pursuant to LMR and thyroid-stimulating hormone (TSH) levels, respectively. RESULTS 59 patients had an increased CIMT value (Group-2), and 131 patients had a normal CIMT value (Group-1). Group-2 had a lower LMR and a greater high-sensitivity C-reactive protein (hsCRP), CIMT and TSH than Group-1 (for all, p < 0.05). Patients in the lowest tertile of LMR had a higher hsCRP, TSH and CIMT than those in the highest tertile (for all, p < 0.05). LMR was negatively associated with hsCRP, CIMT and TSH (for all, p < 0.05). LMR and TSH were independent predictors of increased CIMT. CONCLUSIONS Pre-ultrasonographic LMR, which is a simple and inexpensive inflammatory marker, may give additional predictive information to determine SubAth in SubHT.
Collapse
Affiliation(s)
- Mustafa Yurtdaş
- Istanbul Atlas University, School of Medicine, Istanbul Medicine Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ramazan Asoğlu
- Adiyaman University, School of Medicine, Education and Research Hospital, Department of Cardiology, Adıyaman, Turkey
| | - Adnan Özaydın
- Balıkesir Sevgi Hospital, Department of Internal Medicine, Balıkesir, Turkey
| | - Zeki Doğan
- Istanbul Atlas University, School of Medicine, Istanbul Medicine Hospital, Department of Cardiology, Istanbul, Turkey
| |
Collapse
|
16
|
Long non-coding RNA NEAT1 regulates endothelial functions in subclinical hypothyroidism through miR-126/TRAF7 pathway. Hum Cell 2021; 34:825-835. [PMID: 33677813 DOI: 10.1007/s13577-021-00508-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/13/2021] [Indexed: 02/07/2023]
Abstract
Subclinical hypothyroidism (SCH) is associated with increased risks of endothelial dysfunction and atherosclerosis, but the mechanisms remain unclear. In our previous study, microRNA-126-3p was downregulated in SCH, but the role and regulatory mechanism of miR-126 in SCH has not been investigated. A SCH mouse model was established by feeding mice methimazole. Both primary endothelial cells (ECs) and HUVECs were cultured. The expression levels of key molecules were detected via quantitative RT-PCR, western blotting, and immunofluorescence. Wire myography was used to analyze the changes in vascular tones. A dual-luciferase assay was used to investigate the relationship between lncRNAs, microRNAs and target genes. In detail, it was shown that the expression levels of miR-126-3p were significantly decreased in both the SCH vasculature and HUVECs. MiR-126 supplementation suppressed HUVEC apoptosis and improved vascular function. Moreover, miR-126 could bind to the 3'-untranslated region of TRAF7, thus, regulating the C-FLIP pathway and endothelial apoptosis. Furthermore, lncRNA NEAT1 was upregulated upon TSH treatment and could function as a ceRNA and bind to miR-126, thus, modulating its expression level and vascular function. Finally, the NEAT1/miR-126/TRAF7 axis functions in response to TSH and regulates endothelial functions in SCH in vitro and in vivo. In conclusion, dysregulation of the NEAT1/miR-126/TRAF7 axis is responsible for impaired endothelial functions in SCH. Targeting this axis might become a promising treatment strategy or improving endothelial functions in SCH.
Collapse
|
17
|
Hu Y, Yao Z, Wang G. The Relationship Between the Impairment of Endothelial Function and Thyroid Antibodies in Hashimoto's Thyroiditis Patients with Euthyroidism. Horm Metab Res 2020; 52:642-646. [PMID: 32542626 DOI: 10.1055/a-1178-5882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Endothelial dysfunction is the important early step in the development of atherosclerosis. Hypothyroidism caused by Hashimoto's thyroiditis and other thyroid disease is one of the risk factors of endothelial dysfunction. The present study tried to investigate the endothelial function and its associated factors in Hashimoto thyroiditis with euthyroidism. A total of 95 newly diagnosed Hashimoto's thyroiditis patients with euthyroidism and 45 healthy controls were studied. Hashimoto's patients were divided into 3 subgroups namely, single thyroglobulin antibody (TGAb) positive subgroup, single thyroid peroxidase antibody (TPOAb) positive subgroup, and both TGAb and TPOAb positive subgroup. Endothelial function was tested by the reactive hyperemia index (RHI). Hashimoto's thyroiditis patients had lower RHI than healthy controls (1.73±0.42 vs 1.96±0.51, p<0.05). Hashimoto's thyroiditis with single TGAb positive patients had higher RHI than single TPOAb positive (1.98±0.57 vs. 1.69±0.33, p<0.05) and TGAB + TPOAb positive patients (1.98±0.57 vs. 1.68±0.42, p<0.05). RHI were negatively associated with total cholesterol (TC, r=-0.215, p<0.05), low density lipoprotein cholesterol (LDL-C, r=-0.268, p<0.05), triglyceride (TG, r=-0.192, p<0.05), and TPOAb (r=-0.288, p<0.05). In the regression analysis, LDL-C (β=-0.146, p<0.05), TG (β=-0.034, p<0.05) and TPOAb (β=-0.001, p<0.05) were independently associated with RHI. Hashimoto's patients had poor endothelial function. TPOAb levels were negatively associated with endothelial function.
Collapse
Affiliation(s)
- Yanjin Hu
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University. Beijing P.R. China
| | - Zhi Yao
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University. Beijing P.R. China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University. Beijing P.R. China
| |
Collapse
|
18
|
Chang CY, Chien YJ, Lin PC, Chen CS, Wu MY. Nonthyroidal Illness Syndrome and Hypothyroidism in Ischemic Heart Disease Population: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab 2020; 105:5847674. [PMID: 32459357 DOI: 10.1210/clinem/dgaa310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023]
Abstract
CONTEXT The association of non-thyroidal illness syndrome (NTIS) and hypothyroidism with the prognosis in ischemic heart disease (IHD) population is inconclusive. OBJECTIVE We aimed to evaluate the influence of NTIS and hypothyroidism on all-cause mortality and major adverse cardiac events (MACE) in IHD population. DATA SOURCES We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library from inception through February 17, 2020. STUDY SELECTION Original articles enrolling IHD patients, comparing all-cause mortality and MACE of NTIS and hypothyroidism with those of euthyroidism, and providing sufficient information for meta-analysis were considered eligible. DATA EXTRACTION Relevant information and numerical data were extracted for methodological assessment and meta-analysis. DATA SYNTHESIS Twenty-three studies were included. The IHD population with NTIS was associated with higher risk of all-cause mortality (hazard ratio [HR] = 2.61; 95% confidence interval [CI] = 1.89-3.59) and MACE (HR = 2.22; 95% CI = 1.71-2.89) than that without. In addition, the IHD population with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10-1.97) and MACE (HR = 1.53; 95% CI = 1.19-1.97) than that without. In the subgroup analysis, the acute coronary syndrome (ACS) subpopulation with NTIS was associated with higher risk of all-cause mortality (HR = 3.30; 95% CI = 2.43-4.48) and MACE (HR = 2.19; 95% CI = 1.45-3.30). The ACS subpopulation with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.67; 95% CI = 1.17-2.39). CONCLUSIONS The IHD population with concomitant NTIS or hypothyroidism was associated with higher risk of all-cause mortality and MACE. Future research is required to provide evidence of the causal relationship and to elucidate whether normalizing thyroid function parameters can improve prognosis.
Collapse
Affiliation(s)
- Chun-Yu Chang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yung-Jiun Chien
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Po-Chen Lin
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Sheng Chen
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Meng-Yu Wu
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
19
|
Gluvic ZM, Obradovic MM, Sudar-Milovanovic EM, Zafirovic SS, Radak DJ, Essack MM, Bajic VB, Takashi G, Isenovic ER. Regulation of nitric oxide production in hypothyroidism. Biomed Pharmacother 2020; 124:109881. [PMID: 31986413 DOI: 10.1016/j.biopha.2020.109881] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/25/2019] [Accepted: 01/06/2020] [Indexed: 02/08/2023] Open
Abstract
Hypothyroidism is a common endocrine disorder that predominantly occurs in females. It is associated with an increased risk of cardiovascular diseases (CVD), but the molecular mechanism is not known. Disturbance in lipid metabolism, the regulation of oxidative stress, and inflammation characterize the progression of subclinical hypothyroidism. The initiation and progression of endothelial dysfunction also exhibit these changes, which is the initial step in developing CVD. Animal and human studies highlight the critical role of nitric oxide (NO) as a reliable biomarker for cardiovascular risk in subclinical and clinical hypothyroidism. In this review, we summarize the recent literature findings associated with NO production by the thyroid hormones in both physiological and pathophysiological conditions. We also discuss the levothyroxine treatment effect on serum NO levels in hypothyroid patients.
Collapse
Affiliation(s)
- Zoran M Gluvic
- Zemun Clinical Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Milan M Obradovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, Belgrade, Serbia.
| | - Emina M Sudar-Milovanovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, Belgrade, Serbia.
| | - Sonja S Zafirovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, Belgrade, Serbia.
| | | | - Magbubah M Essack
- King Abdullah University of Science and Technology (KAUST), Computational Bioscience Research Center (CBRC), Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division, Thuwal, Saudi Arabia.
| | - Vladimir B Bajic
- King Abdullah University of Science and Technology (KAUST), Computational Bioscience Research Center (CBRC), Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division, Thuwal, Saudi Arabia.
| | - Gojobori Takashi
- King Abdullah University of Science and Technology (KAUST), Computational Bioscience Research Center (CBRC), Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division, Thuwal, Saudi Arabia; King Abdullah University of Science and Technology (KAUST), Biological and Environmental Sciences and Engineering Division (BESE), Thuwal 23955-6900, Saudi Arabia.
| | - Esma R Isenovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, Belgrade, Serbia.
| |
Collapse
|
20
|
Low TSH level predicts a poor clinical outcome in patients with anterior circulation ischemic stroke after endovascular thrombectomy. Neurol Sci 2020; 41:1821-1828. [DOI: 10.1007/s10072-020-04281-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 02/03/2020] [Indexed: 01/02/2023]
|
21
|
Manolis AA, Manolis TA, Melita H, Manolis AS. Subclinical thyroid dysfunction and cardiovascular consequences: An alarming wake-up call? Trends Cardiovasc Med 2020; 30:57-69. [DOI: 10.1016/j.tcm.2019.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/14/2019] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
|
22
|
Dong XF, Kong FZ, Shen MQ, Huang J, Gao ZE, Guo QZ, Zhao Z, Luo WF, Cheng QZ, Wu GH. Triiodothyronine levels were positively correlated with opening of collateral circulation in cerebral infarction patients with large artery atherosclerosis. Arch Med Sci 2020; 16:51-57. [PMID: 32051705 PMCID: PMC6963139 DOI: 10.5114/aoms.2020.91286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/21/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Non-thyroidal illness syndrome (NTIS) is one of the signs for poor prognosis of cerebral infarction (CI), but its risk factors had never been explored. In this study, we analyzed the potential effect of collateral circulation on prognosis prediction of triiodothyronine for large artery atherosclerosis cerebral infarction (LAA-CI) patients. MATERIAL AND METHODS Clinical data of CI patients between 2012 and 2014 were collected. Imaging inspection was used for determining TOAST classification and evaluating collateral circulation. One-year follow-up was conducted for mRS score by telephone. RESULTS T3 level in the NTIS group (p = 0.001) was significantly decreased while TSH level (p < 0.001) was increased. Patients in the NTIS group had a poorer prognosis (p = 0.008) and the main reason was the high mortality (p = 0.002). NTIS predicted poor collateral circulation (p = 0.026) and good collateral circulation tended to be less likely concomitant with NTIS (p = 0.001). Logistic regression analysis showed that triiodothyronine concentrations (OR = 4.760, 95% CI: 1.981-11.456, p < 0.001) were positively correlated with but advanced age (OR = 0.756, 95% CI: 0.645-0.886, p = 0.001) negatively with opening of collateral circulation. CONCLUSIONS Poor opening of collateral circulation was likely to mediate the prediction of NTIS for prognosis of LAA-CI patients.
Collapse
Affiliation(s)
- Xiao-Feng Dong
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Fan-Zhen Kong
- Department of Psychology, Suzhou Guangji Hospital, Suzhou Psychiatric Hospital, Suzhou, China
| | - Ming-Qiang Shen
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jiang Huang
- Ophthalmology Department, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zong-En Gao
- Neurology Department, Shengli Oilfield Central Hospital, Suzhou, China
| | - Qian-Zhu Guo
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Zhong Zhao
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Wei-Feng Luo
- Neurology Department, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qing-Zhang Cheng
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Guan-Hui Wu
- Neurology Department, Suzhou Municipal Hospital, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| |
Collapse
|
23
|
Zynat J, Li S, Ma Y, Han L, Ma F, Zhang Y, Xing B, Wang X, Guo Y. Impact of Abdominal Obesity on Thyroid Auto-Antibody Positivity: Abdominal Obesity Can Enhance the Risk of Thyroid Autoimmunity in Men. Int J Endocrinol 2020; 2020:6816198. [PMID: 32256575 PMCID: PMC7093900 DOI: 10.1155/2020/6816198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/29/2019] [Accepted: 12/06/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The interrelation between obesity and autoimmune thyroid diseases is complex and has not been confirmed. The aim of the present study was to observe the relationship between thyroid autoimmunity and obesity, especially abdominal obesity, in a large population. METHODS A total of 2253 residents who had lived in Xinjiang for more than 3 years were enrolled. Serum thyroid hormone concentration, thyroid autoantibodies, lipid parameters, Weight, height, and waist and hip circumference were measured. RESULTS The prevalence of thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) positive was 32.1% (21.2% in men and 37% in women, P < 0.01). Compared with women, men had significantly higher TG levels, waist circumference, and hip circumference levels (P < 0.01), while women showed higher TSH, TPOAb, and TgAb levels (P < 0.01). The prevalence of overweight and obesity was 71.1% in men and 63.5% in women. Men had a higher prevalence of abdominal obesity than women (56.6% in men and 47.6% in women, P < 0.01). TPOAb correlates positively with waist circumference (r = 0.100, P < 0.05) in men. Binary logistic analysis showed that TPOAb positivity had increased risks of abdominal obesity in men, and the OR was 1.1044 (95% CI 1.035, 1.151, P < 0.05). CONCLUSION Our results indicate that men had higher lipid levels, thicker waist circumference, and higher prevalence of overweight, obesity, and abdominal obesity. Abdominal obesity is a risk factor for TPOAb positivity in men, suggesting that abdominal obesity can enhance the risk of thyroid autoimmunity in men.
Collapse
Affiliation(s)
- Jazyra Zynat
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Suli Li
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Yanrong Ma
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Li Han
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Fuhui Ma
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Yuyuan Zhang
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Bei Xing
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Xinling Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| | - Yanying Guo
- Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China
| |
Collapse
|
24
|
Effect of acute aerobic exercise on arterial stiffness and thyroid-stimulating hormone in subclinical hypothyroidism. Heart Vessels 2019; 34:1309-1316. [PMID: 30725214 DOI: 10.1007/s00380-019-01355-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/01/2019] [Indexed: 12/28/2022]
Abstract
Acute exercise has been reported to increase thyroid hormone levels and decrease arterial stiffness in healthy young subjects. However, the effect of acute aerobic exercise on circulating thyroid hormone levels and arterial stiffness in patients with subclinical hypothyroidism remains unclear. The aim of this study was to investigate the effects of acute aerobic exercise on arterial stiffness and thyroid hormone levels, and any relationship between these endpoints, in patients with subclinical hypothyroidism. We studied patients with untreated subclinical hypothyroidism (n = 53, 65 ± 12 years old) compared with euthyroid subjects (n = 55, 64 ± 10 years old). Exercise analysis was performed with a ramp cycle ergometer test. Arterial stiffness (cardio-ankle vascular index, CAVI) was measured at baseline and 5 min after exercise. We collected participant blood samples for serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) measurements before and 5 min after exercise. The CAVI and serum TSH levels significantly decreased after exercise in the subclinical hypothyroidism group (CAVI; 8.1 ± 1.6 vs. 8.5 ± 1.5, p < 0.001, TSH; 6.7 ± 1.4 vs. 7.6 ± 1.2 μIU/ml, p < 0.001) and euthyroid group (CAVI; 7.6 ± 1.0 vs. 8.3 ± 0.9, p < 0.001, TSH; 2.2 ± 1.1 vs. 2.4 ± 1.2 μIU/ml, p = 0.005). The changes in CAVI from baseline compared with after exercise were lower, in absolute values, in the subclinical hypothyroidism group than in the euthyroid group (subclinical hypothyroidism group vs euthyroid group; ΔCAVI: - 0.4 ± 0.6 vs. - 0.7 ± 0.7, p = 0.012). The changes in serum TSH from baseline to after exercise were higher, in absolute values, in the subclinical hypothyroidism group than in the euthyroid group (subclinical hypothyroidism group vs euthyroid group; Δ serum TSH: - 1.3 ± 1.4 vs. - 0.3 ± 0.5, p < 0.001). The changes in CAVI from baseline to after exercise were negatively correlated with changes in TSH (r = - 0.32, p = 0.038) in the subclinical hypothyroidism group. In conclusion, acute aerobic exercise decreased both arterial stiffness and serum TSH levels in patients with subclinical hypothyroidism and euthyroid subjects. While the absolute change in arterial stiffness decreased, the absolute change in serum TSH levels increased in patients with subclinical hypothyroidism compared with euthyroid subjects. These data suggest that subclinical hypothyroidism reduces CAVI during acute aerobic exercise. Further changes in absolute levels of serum TSH in subclinical hypothyroidism may result in reduced CAVI improvement by acute aerobic exercise.
Collapse
|
25
|
El-Hefnawy KA, Elsaid HH. Assessment of some inflammatory markers and lipid profile as risk factors for atherosclerosis in subclinical hypothyroid patients. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_94_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
26
|
Zhu Y, Xu F, Shen J, Liu Y, Bi C, Liu J, Li Y, Wang X, Gao Z, Liang L, Chen Y, Sun W, Guan Q, Zhang J, Luo Z, Guo L, Cai X, Li L, Xiu L, Yan L, Li C, Shi X, Zhu M, Kuang J, Li G, Ji L. Prevalence of thyroid dysfunction in older Chinese patients with type 2 diabetes-A multicenter cross-sectional observational study across China. PLoS One 2019; 14:e0216151. [PMID: 31048873 PMCID: PMC6497275 DOI: 10.1371/journal.pone.0216151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/15/2019] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes [T2D] and thyroid dysfunction [TD] often co-occur, have overlapping pathologies, and their risk increases with age. Since 1995, universal salt iodization has been implemented in China to prevent disorders caused by iodine deficiency. However, after two decades of implementation of universal salt iodization, the prevalence of TD in elderly Chinese patients with T2D is not well described and may have been underestimated. We conducted a questionnaire-based survey across 24 endocrinology centers in China between December 2015 and July 2016. Demographic and clinical data from 1677 patients with T2D were obtained and analyzed to examine the prevalence of TD along with T2D in these patients. We assessed TD prevalence according to the four TD subtypes [subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism], TD history, gender, and age. The diagnosis rates were calculated for TD and also for the TD subtype. The number of patients reaching treatment goals for T2D [hemoglobin A1c <7%] and TD [normal free thyroxine and thyroid-stimulating hormone [TSH]] and the incidences of complications and comorbidities were recorded. Among the enrolled patients with T2D [N = 1677], TD was diagnosed in 23.79% [399/1677] out of which 61% (245/399) were previously diagnosed and 38.59% (154/399) were newly diagnosed cases. Subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism were reported in 4.89%, 9.3%, 1.13%, and 3.16% of the total population, respectively. Among patients previously diagnosed with TD, the incidence in women [166/795; 20.88%] was higher than in men [79/882; 8.96%]. The treatment goals for TD and T2D were attained in 39.6% [97/245] and 34.41% [577/1677] of the cases, respectively. Diabetic complications and comorbidities were reported in 99.7% of patients, with peripheral neuropathy being the most common [43.46%] followed by cataract [24.73%]. We had found that the incidences of dyslipidemia, elevated LDL levels, and osteoporosis were significantly higher in patients with TD than those without TD. TD is underdiagnosed in elderly Chinese patients with T2D.
Collapse
Affiliation(s)
- Yu Zhu
- Peking University People’s Hospital, Beijing, China
| | - Fengmei Xu
- General Hospital of Hebi Coal Industry [Group] Co., Ltd., Hebi, China
| | - Jie Shen
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Youshuo Liu
- The Second Xiangya Hospital of Central South University, Changsha, China
| | | | - Jing Liu
- Gansu Provincial Hospital, Lanzhou, China
| | - Yufeng Li
- Beijing Pinggu Hospital, Beijing, China
| | - Xueqin Wang
- Beijing Huairou Hospital of University of Chinese Academy Sciences, Beijing, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian, China
| | - Linlang Liang
- The General Hospital of Shenyang Military Region, Shenyang, China
| | - Yanyan Chen
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Weiping Sun
- The First People’s Hospital of Xiangtan City, Xiangtan, China
| | - Qingbo Guan
- Shandong Provincial Hospital, Shandong, China
| | | | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | | | - Xiaopin Cai
- China-Japan Friendship Hospital, Beijing, China
| | - Ling Li
- Shengjing Hospital of China Medical University, Shenyang, China
| | - Lingling Xiu
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chunlin Li
- The General Hospital of the People's Liberation Army [301 Hospital], Beijing, China
| | - Xiaoyun Shi
- The General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Mei Zhu
- General Hospital, Tianjin Medical University, Tianjin, China
| | - Jian Kuang
- Guangdong General Hospital, Guangzhou, China
| | - Guangwei Li
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Linong Ji
- Peking University People’s Hospital, Beijing, China
| |
Collapse
|
27
|
Yang C, Lu M, Chen W, He Z, Hou X, Feng M, Zhang H, Bo T, Zhou X, Yu Y, Zhang H, Zhao M, Wang L, Yu C, Gao L, Jiang W, Zhang Q, Zhao J. Thyrotropin aggravates atherosclerosis by promoting macrophage inflammation in plaques. J Exp Med 2019; 216:1182-1198. [PMID: 30940720 PMCID: PMC6504213 DOI: 10.1084/jem.20181473] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/07/2019] [Accepted: 02/11/2019] [Indexed: 12/31/2022] Open
Abstract
The increased cardiovascular risk in subclinical hypothyroidism has traditionally been attributed to the associated metabolic disorders. This paper, however, revealed that TSH can aggravate atherosclerosis by promoting macrophage inflammation in the plaque, which deepens our understanding of the significance of TSH elevation in subclinical hypothyroidism. Subclinical hypothyroidism is associated with cardiovascular diseases, yet the underlying mechanism remains largely unknown. Herein, in a common population (n = 1,103), TSH level was found to be independently correlated with both carotid plaque prevalence and intima-media thickness. Consistently, TSH receptor ablation in ApoE−/− mice attenuated atherogenesis, accompanied by decreased vascular inflammation and macrophage burden in atherosclerotic plaques. These results were also observed in myeloid-specific Tshr-deficient ApoE−/− mice, which indicated macrophages to be a critical target of the proinflammatory and atherogenic effects of TSH. In vitro experiments further revealed that TSH activated MAPKs (ERK1/2, p38α, and JNK) and IκB/p65 pathways in macrophages and increased inflammatory cytokine production and their recruitment of monocytes. Thus, the present study has elucidated the new mechanisms by which TSH, as an independent risk factor of atherosclerosis, aggravates vascular inflammation and contributes to atherogenesis.
Collapse
Affiliation(s)
- Chongbo Yang
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Ming Lu
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Wenbin Chen
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Zhao He
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China.,School of Medicine, Shandong University, Jinan, Shandong, China
| | - Xu Hou
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Mei Feng
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Hongjia Zhang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China
| | - Tao Bo
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Xiaoming Zhou
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Yong Yu
- Department of Sonography, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Meng Zhao
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Laicheng Wang
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Chunxiao Yu
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| | - Ling Gao
- Scientific Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Wenjian Jiang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China
| | - Qunye Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Ministry of Public Health, the State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong University, Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong, China
| |
Collapse
|
28
|
Falkowski B, Rogowicz-Frontczak A, Grzelka A, Uruska A, Schlaffke J, Araszkiewicz A, Zozulinska-Ziolkiewicz D. Higher free triiodothyronine concentration is associated with lower prevalence of microangiopathic complications and better metabolic control in adult euthyroid people with type 1 diabetes. Endocrine 2018; 60:458-465. [PMID: 29603069 PMCID: PMC5937901 DOI: 10.1007/s12020-018-1582-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/09/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE Type 1 diabetes mellitus (T1DM) is a disorder of insulin deficiency but with a wide range of hormones simultaneously disturbed. The study was performed to explore relation of free triiodothyronine (FT3) with metabolic control and occurrence of microangiopathic complications. METHODS A total of 266 adult T1DM participants [56% men; 32 (interquartile range, IQR: 25-39) years and disease duration 13 (IQR: 8-19) years] in euthyroid state with negative history for hypothyroidism were included to the study. Participants were screened for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and FT3. Moreover, microangiopathic complications (retinopathy, diabetic kidney disease, peripheral and autonomic neuropathy), markers of metabolic control such as glycated hemoglobin (HbA1c) were evaluated. RESULTS A total of 114 (42.9%) people had diagnosed at least one microangiopathic complication. In multivariable linear regression higher HbA1c was statistically significant independent predictor of lower FT3 (β = -0.25; p < 0.0001) after adjustment for sex, T1DM duration, HbA1c, waist-to-hip ratio (WHR) (R2 = 0.15, p < 0.0001). Higher FT3 was simultaneously a predictor of lower prevalence of microangiopathy in multivariate logistic regression analysis (odds ratio, 0.51; 95% confidence interval, 0.27-0.98; p = 0.04) after an adjustment for: age, hypertension, HbA1c, WHR and total cholesterol (TC). CONCLUSIONS FT3 as tissue active hormone plays a clinically important role in T1DM people. The higher FT3 concentration is related to the lower prevalence of microangiopathy and better metabolic control of the disease in adult euthyroid people with T1DM.
Collapse
Affiliation(s)
- Bogusz Falkowski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland.
| | - Anita Rogowicz-Frontczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland
| | - Agata Grzelka
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland
| | - Aleksandra Uruska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland
| | - Judyta Schlaffke
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland
| | - Aleksandra Araszkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland
| | - Dorota Zozulinska-Ziolkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, Poznan, 60-834, Poland
| |
Collapse
|
29
|
Liu J, Duan Y, Fu J, Wang G. Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function. Front Endocrinol (Lausanne) 2018; 9:130. [PMID: 29674996 PMCID: PMC5895644 DOI: 10.3389/fendo.2018.00130] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/13/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hypothyroidism is an important risk factor for cardiovascular diseases, and autoimmune thyroiditis (AIT) is the leading cause of hypothyroidism. Recent studies showed that even AIT patients with euthyroidism still had an increased number of early atherosclerotic lesions. However, the precise mechanism is not yet known. This study aimed to investigate the association of thyroid function, thyroid autoimmunity, and cardiometabolic risk factors in non-obese AIT patients with euthyroidism. METHODS A total of 5,608 non-obese individuals including 1,402 AIT patient and 4,206 sex-, age-, and body mass index (BMI)-matched healthy controls were recruited. RESULTS The AIT patients had significantly lower free T3 and free T4 levels, and higher TSH, antithyroid peroxidase antibodies (TPOAb) and TgAb levels. The elevated levels of high sensitivity C reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA-IR) were observed in the AIT patients than the controls [hsCRP: 0.65 (0.27-1.33) vs. 0.20 (0.03-0.74) mg/L; HOMA-IR: 2.78 ± 1.60 vs. 2.33 ± 1.49; all P < 0.05]. Thyroid function was not associated with metabolic parameters and inflammatory makers, while the TPOAb titer was positively associated with the HOMA-IR and hsCRP levels after adjustment for confounding factors (all P < 0.05). Multivariate regression analysis demonstrated that the TPOAb level was an independent influencing factor for the HOMA-IR and hsCRP levels (HOMA-IR: β = 0.058, P < 0.05; hsCRP: β = 0.108, P < 0.05). CONCLUSION The TPOAb level is associated with HOMA-IR and hsCRP levels independently of thyroid function in non-obese individuals. Mild deviation of thyroid function within the normal range, chronic inflammation, and insulin resistance may be the links between AIT and atherosclerosis in the non-obese population.
Collapse
|
30
|
Olmedo Carrillo P, Santiago Fernández P, García Fuentes E, Ureña Fernández T, Gutiérrez Alcántara C, Sánchez-Malo C, Gassó Campos M, Martínez Ramírez MJ. Definición de los rangos de referencia de T4 libre, TSH y tiroglobulina en sujetos sanos del Distrito Sanitario de Jaén. ENDOCRINOL DIAB NUTR 2017; 64:417-423. [DOI: 10.1016/j.endinu.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 05/24/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
|
31
|
Lin HJ, Wang TD. Nocturnal Non-Dipping: An Overlooked Clinical Manifestation of Subclinical Hypothyroidism Linking to Increased Cardiovascular Risk. ACTA CARDIOLOGICA SINICA 2017; 33:495-497. [PMID: 28959102 PMCID: PMC5611346 DOI: 10.6515/acs20170626b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/26/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Hung-Ju Lin
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tzung-Dau Wang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
32
|
Unal E, Akın A, Yıldırım R, Demir V, Yildiz İ, Haspolat YK. Association of Subclinical Hypothyroidism with Dyslipidemia and Increased Carotid Intima-Media Thickness in Children. J Clin Res Pediatr Endocrinol 2017; 9:144-149. [PMID: 28008862 PMCID: PMC5463287 DOI: 10.4274/jcrpe.3719] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Subclinical hypothyroidism (SH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with free thyroxine (fT4) level in the normal range. There are very few studies in the literature reporting on the effect of SH on lipid metabolism and carotid intima-media thickness (CIMT) in children. METHODS The study included 38 children diagnosed with SH and a control group comprising 38 healthy, euthyroid children. SH was diagnosed based on an elevated TSH level (4.2-20 mIU/L) and normal fT4 level measured in two morning fasting blood samples obtained at an interval of 2 to 6 weeks. Blood samples were collected by venipuncture in the morning after an overnight fast. RESULTS The patient group included 38 children (16 male, 22 female) with SH and the control group -38 healthy, euthyroid children (20 male, 18 female). Mean age was 8.1±3.6 (range, 3.5-15) years in the patient group and 8.9±2.4 (range, 4.5-15) years in the control group. In the patient group, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C were higher compared to the control group (p=0.049, p=0.014, p=0.002, and 0.003, respectively). In the patient group, CIMT was also significantly higher compared to the control group (p=0.001). The patient group was further divided into two subgroups based on their serum TSH level: (I) patients with mildly elevated TSH (TSH=4.2±10 mIU/L) (n=33) and (II) patients with high TSH (TSH≥10 mIU/L) (n=5). However, no significant difference was found between the patients with mild and severe SH with regard to TC, LDL-C, HDL-C, triglyceride level and CIMT levels (p=0.635, p=0.424, p=0.310, p=0.342, and 0.610, respectively). CONCLUSION Subclinical hypothyroidism leads to increased dyslipidemia (increased TC and LDL) and increased CIMT, which leads to increased risk of cardiovascular disease. Further studies are needed to substantiate these findings in children with SH.
Collapse
Affiliation(s)
- Edip Unal
- Dicle University Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey, Phone: +90 412 248 80 01 E-mail:
| | - Alper Akın
- Dicle University Faculty of Medicine, Department of Pediatric Cardiology, Diyarbakır, Turkey
| | - Ruken Yıldırım
- Dicle University Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Vasfiye Demir
- Dicle University Faculty of Medicine, Department of Family Medicine, Diyarbakır, Turkey
| | - İsmail Yildiz
- Dicle University Faculty of Medicine, Department of Biostatistics, Diyarbakır, Turkey
| | - Yusuf Kenan Haspolat
- Dicle University Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey
| |
Collapse
|
33
|
Aziz M, Kandimalla Y, Machavarapu A, Saxena A, Das S, Younus A, Nguyen M, Malik R, Anugula D, Latif MA, Humayun C, Khan IM, Adus A, Rasool A, Veledar E, Nasir K. Effect of Thyroxin Treatment on Carotid Intima-Media Thickness (CIMT) Reduction in Patients with Subclinical Hypothyroidism (SCH): a Meta-Analysis of Clinical Trials. J Atheroscler Thromb 2017; 24:643-659. [PMID: 28566564 PMCID: PMC5517537 DOI: 10.5551/jat.39917] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aim: Research shows that subclinical hypothyroidism (SCH) is related to an increased carotid intima –media thickness (CIMT), a surrogate marker of subclinical cardiovascular disease (CVD). It is controversial whether or not SCH should be treated to reduce CVD morbidity and mortality. This meta-analysis aimed to determine whether SCH is associated with an increase in CIMT as compared to Euthyroidism (EU) and whether thyroxin (T4) treatment in SCH can reverse the change in CIMT. Methods: Two independent reviewers conducted an extensive database research up to December 2016. A total of 12 clinical trials discussed the effect of Thyroxin on CIMT values at pre- and post-treatment in subjects with SCH. Results: CIMT was significantly higher among SCH (n = 280) as compared to EU controls (n = 263) at baseline; the pooled weighted mean difference (WMD) of CIMT was 0.44 mm [95% confidence interval (CI) 0.14, 0.74], p = 0.004; I2 = 65%. After treatment with thyroxin in subjects with SCH (n = 314), there was a statistically significant decrease in CIMT from pre- to post-treatment; the pooled WMD of CIMT decrease was [WMD −0.32; 95% CI (−0.47, −0.16), p = < 0.0001; I2 = 2%], and it was no longer different from EU controls [WMD 0.13 mm; 95% CI (−0.04, 0.30); p = 0.14; I2 = 27%]. The total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) were higher in SCH as compared to EU controls and decreased significantly after treatment with thyroxin. Conclusion: This meta-analysis shows that thyroxin therapy in subjects with SCH significantly decreases CIMT and improves lipid profile, modifiable CVD risk factors. Thyroid hormone replacement in subjects with SCH may play a role in slowing down or preventing the progression of atherosclerosis.
Collapse
Affiliation(s)
- Muhammad Aziz
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida.,Benedictine University, Department of Public Health
| | | | | | - Anshul Saxena
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Sankalp Das
- Baptist Health South Florida, Wellness Advantage
| | - Adnan Younus
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | | | - Rehan Malik
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Dixitha Anugula
- Department of Internal Medicine, Creighton University Medical Center
| | - Muhammad A Latif
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Choudhry Humayun
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Idrees M Khan
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Ali Adus
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Aisha Rasool
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida
| | - Emir Veledar
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida.,Florida International University, Department of Epidemiology, Robert Stempel College of Public Health
| | - Khurram Nasir
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida.,Director High Risk Cardiovascular Disease Clinic, Baptist Health South Florida.,Florida International University, Department of Medicine, Herbert Wertheim College of Medicine.,Johns Hopkins University, Johns Hopkins Ciccarone Center for Prevention of Heart Disease.,Florida International University, Department of Epidemiology, Robert Stempel College of Public Health
| |
Collapse
|
34
|
Du J, Leng J, Zhang L, Bai G, Yang D, Lin H, Qin J. Angiotensin II-Induced Apoptosis of Human Umbilical Vein Endothelial Cells was Inhibited by Blueberry Anthocyanin Through Bax- and Caspase 3-Dependent Pathways. Med Sci Monit 2016; 22:3223-8. [PMID: 27616275 PMCID: PMC5029175 DOI: 10.12659/msm.896916] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background This study aimed to investigate the inhibitory effect of blueberry anthocyanin (BBA) on Angiotensin II (Ang II)-induced apoptosis of human umbilical vein endothelial cells (HUVECs), and its regulation mechanisms involving Bax and Caspase 3. Material/Methods HUVECs were first treated by different concentrations of Ang II (10−9, 10−8, 10−7, 10−6, 10−5, and 10−4 mol/L) and BBA (80, 40, 20, 10, 5, and 2.5 μg/ml). After 24 h and 48 h of treatment, MTT was performed to detect the viability of HUVECs. Then, HUVECs were randomly divided into the Ang II group (10−6 mol/L Ang II) and Ang II + BBA group (10−6 mol/L Ang II and 20 μg/ml BBA), and the apoptosis rate was detected by flow cytometry. Western blot analysis was performed to detect the expression of Bax and Caspase 3 in these 2 groups. During the whole process, HUVECs without any treatments served as the control group. Results The cell viability of HUVECs was significantly reduced by Ang II in a time- and concentration-dependent manner (P<0.05), while BBA significantly elevated the cell viability of HUVECs until a peak of 20.0 μg/ml. The apoptosis rate of HUVECs was significantly increased by Ang II (P<0.01) and reduced by the BBA intervention (P<0.05). Ang II significantly elevated the expression of Bax and Caspase 3 in HUVECs, but their expression was significantly inhibited by BBA. Conclusions BBA increased cell viability and reduced apoptosis rate of HUVECs induced by Ang II through Bax- and Caspase 3-dependent pathways.
Collapse
Affiliation(s)
- Jian Du
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Jiyan Leng
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Li Zhang
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Guangxin Bai
- , China Jilin Forest Industry Group, Changchun, Jilin, China (mainland)
| | - Di Yang
- , China Jilin Forest Industry Group, Changchun, Jilin, China (mainland)
| | - Huan Lin
- , China Jilin Forest Industry Group, Changchun, Jilin, China (mainland)
| | - Junjie Qin
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, Jilin, China (mainland)
| |
Collapse
|
35
|
Berezin AE, Kremzer AA, Martovitskaya YV, Samura TA, Berezina TA. Pattern of circulating endothelial-derived microparticles among chronic heart failure patients with dysmetabolic comorbidities: The impact of subclinical hypothyroidism. Diabetes Metab Syndr 2016; 10:29-36. [PMID: 26319410 DOI: 10.1016/j.dsx.2015.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
UNLABELLED The study aim was to evaluate the impact of dysmetabolic comorbidities including subclinical hypothyroidism (SH) on pattern of circulating endothelial-derived microparticles (EMPs) in chronic heart failure (CHF) patients. METHODS It was retrospectively involved a cohort of 388 patients with CHF. Fifty three CHF subjects had SH and 335 patients were free from thyroid dysfunction. Circulating levels of NT-pro brain natriuretic peptide (NT-pro-BNP), high-sensitivity C-reactive protein (hs-CRP), thyroid stimulating hormone (TSH), total and free thyroxine (T4) and triiodothyronine (T3) EMPs were measured at baseline. SH was defined per contemporary clinical guideline as state associated with elevated level of serum TSH>10 μU/L and basal normal free T3 and T4 concentration. RESULTS Circulating CD31+/annexin V+ EMPs were higher in SH patients compared with none SH subjects. In contrast, activated CD62E+ EMP numbers were not significantly different between both patient cohorts. Using C-statistics for Models with TSH, New York Heart Association (NYHA) class, dyslipidemia, and circulating biomarkers (hs-CRP, NT-proBNP, serum uric acid) as Continuous Variables we found that adding of NYHA class alone, NT-proBNP alone or their combination to the based model (TSH) improved the relative integrated discrimination improvement (IDI) for increased CD31+/annexin V+ to CD62E+ ratio by 4.9%; 9.2% and 9.6% respectively. NT-proBNP improves significantly predictive model based on TSH for increased CD31+/annexin V+ to CD62E+ ratio. Among patient study population for category-free net reclassification improvement (NRI), 4% of events (P=0.026) and 6% of non-events (P=0.012) were correctly reclassified by the addition of circulating NT-proBNP to the base model (TSH) for Increased CD31+/annexin V+ to CD62E+ ratio. Therefore, 4% of events (P=0.028) and 5% of non-events (P=0.014) were correctly reclassified using category-free NRI for increased CD31+/annexin V+ to CD62E+ ratio. CONCLUSION We found that SH state in CHF patients associates with impaired pattern of circulating EMPs with predominantly increased number of apoptotic-derived microparticles.
Collapse
Affiliation(s)
- Alexander E Berezin
- Cardiology Unit, Internal Medicine Department, State Medical University, 26, Mayakovsky av., Zaporozhye, UA-69035, Ukraine.
| | - Alexander A Kremzer
- Clinical Pharmacology Department, State Medical University, Zaporozhye, Ukraine
| | | | - Tatyana A Samura
- Clinical Pharmacology Department, State Medical University, Zaporozhye, Ukraine
| | | |
Collapse
|
36
|
Berezin AE, Kremzer AA, Martovitskaya YV, Samura TA, Berezina TA. The Association of Subclinical Hypothyroidism and Pattern of Circulating Endothelial-Derived Microparticles Among Chronic Heart Failure Patients. Res Cardiovasc Med 2015; 4:e29094. [PMID: 26528453 PMCID: PMC4623383 DOI: 10.5812/cardiovascmed.29094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/09/2015] [Accepted: 06/07/2015] [Indexed: 12/28/2022] Open
Abstract
Background: Subclinical hypothyroidism (SH) is diagnosed biochemically by the presence of normal serum free thyroxine concentration, in conjunction with an elevated serum thyroid-stimulating hormone level. Recent studies have demonstrated the frequent association between SH and cardiovascular diseases and risk factors. Objectives: To evaluate the impact of SH on patterns of circulating endothelial-derived microparticles, (EMPs) among chronic heart failure (CHF) patients Patients and Methods: This is a retrospective study involving a cohort of 388 patients with CHF. Fifty-three CHF subjects had SH and 335 patients were free from thyroid dysfunction. Circulating levels of N-terminal-pro brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), thyroid-stimulating hormone (TSH), total and free thyroxine (T4), and triiodothyronine (T3), and endothelial apoptotic microparticles (EMPs), were measured at baseline. SH was defined, according to contemporary clinical guidelines, as a biochemical state associated with an elevated serum TSH level of greater 10 μU/L and normal basal free T3 and T4 concentrations. Results: Circulating CD31+/annexin V+ EMPs were higher in patients with SH compared to those without SH. In contrast, activated CD62E+ EMP numbers were not significantly different between both patient cohorts. Using uni (bi) variate and multivariate age- and gender-adjusted regression analysis, we found several predictors that affected the increase of the CD31+/annexin V+ to CD62E+ ratio in the patient study population. The independent impact of TSH per 6.5 μU/L (odds ratio [OR] = 1.23, P = 0.001), SH (OR = 1.22, P = 0.001), NT-proBNP (OR = 1.19, P = 0.001), NYHA class (OR = 1.09, P = 0.001), hs-CRP per 4.50 mg/L (OR = 1.05, P = 0.001), dyslipidemia (OR = 1.06, P = 0.001), serum uric acid per 9.5 mmol/L (OR = 1.04, P = 0.022) on the increase in the CD31+/annexin V+ to CD62E+ ratio, was determined. Conclusions: We believe that the SH state in CHF patients may be associated with the impaired pattern of circulating EMPs, with the predominantly increased number of apoptotic-derived microparticles.
Collapse
Affiliation(s)
- Alexander E. Berezin
- Consultant of Therapeutic Unit, Internal Medicine Department, State Medical University, Zaporozhye, Ukraine
- Corresponding author: Alexander E. Berezin, Consultant of Therapeutic Unit, Internal Medicine Department, State Medical University, Zaporozhye, Ukraine. Tel: +38-0612894585, E-mail:
| | | | | | - Tatyana A. Samura
- Clinical Pharmacology Department, State Medical University, Zaporozhye, Ukraine
| | | |
Collapse
|
37
|
Hollan I, Dessein PH, Ronda N, Wasko MC, Svenungsson E, Agewall S, Cohen-Tervaert JW, Maki-Petaja K, Grundtvig M, Karpouzas GA, Meroni PL. Prevention of cardiovascular disease in rheumatoid arthritis. Autoimmun Rev 2015; 14:952-69. [PMID: 26117596 DOI: 10.1016/j.autrev.2015.06.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 06/17/2015] [Indexed: 12/12/2022]
Abstract
The increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) has been recognized for many years. However, although the characteristics of CVD and its burden resemble those in diabetes, the focus on cardiovascular (CV) prevention in RA has lagged behind, both in the clinical and research settings. Similar to diabetes, the clinical picture of CVD in RA may be atypical, even asymptomatic. Therefore, a proactive screening for subclinical CVD in RA is warranted. Because of the lack of clinical trials, the ideal CVD prevention (CVP) in RA has not yet been defined. In this article, we focus on challenges and controversies in the CVP in RA (such as thresholds for statin therapy), and propose recommendations based on the current evidence. Due to the significant contribution of non-traditional, RA-related CV risk factors, the CV risk calculators developed for the general population underestimate the true risk in RA. Thus, there is an enormous need to develop adequate CV risk stratification tools and to identify the optimal CVP strategies in RA. While awaiting results from randomized controlled trials in RA, clinicians are largely dependent on the use of common sense, and extrapolation of data from studies on other patient populations. The CVP in RA should be based on an individualized evaluation of a broad spectrum of risk factors, and include: 1) reduction of inflammation, preferably with drugs decreasing CV risk, 2) management of factors associated with increased CV risk (e.g., smoking, hypertension, hyperglycemia, dyslipidemia, kidney disease, depression, periodontitis, hypothyroidism, vitamin D deficiency and sleep apnea), and promotion of healthy life style (smoking cessation, healthy diet, adjusted physical activity, stress management, weight control), 3) aspirin and influenza and pneumococcus vaccines according to current guidelines, and 4) limiting use of drugs that increase CV risk. Rheumatologists should take responsibility for the education of health care providers and RA patients regarding CVP in RA. It is immensely important to incorporate CV outcomes in testing of anti-rheumatic drugs.
Collapse
Affiliation(s)
- I Hollan
- Lillehammer Hospital for Rheumatic Diseases, Norway
| | - P H Dessein
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - N Ronda
- Department of Pharmacy, University of Parma, Italy
| | - M C Wasko
- Department of Rheumatology, West Penn Hospital Allegheny Health Network, USA
| | - E Svenungsson
- Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - S Agewall
- Department of Cardiology, Oslo University Hospital Ullevål, University of Oslo, Oslo, Norway; Institute of Clinical Sciences, University of Oslo, Oslo, Norway
| | - J W Cohen-Tervaert
- Clinical and Experimental Immunology, Maastricht University, Maastricht, The Netherlands
| | - K Maki-Petaja
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom
| | - M Grundtvig
- Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway
| | - G A Karpouzas
- Division of Rheumatology, Harbor-UCLA Medical Center, Torrance, USA; Los Angeles Biomedical Research Institute, Torrance, USA
| | - P L Meroni
- Department of Clinical Sciences and Community Health, University of Milan, Italy; IRCCS Istituto Auxologico Italiano, Italy
| |
Collapse
|
38
|
Gluvic Z, Sudar E, Tica J, Jovanovic A, Zafirovic S, Tomasevic R, Isenovic ER. Effects of levothyroxine replacement therapy on parameters of metabolic syndrome and atherosclerosis in hypothyroid patients: a prospective pilot study. Int J Endocrinol 2015; 2015:147070. [PMID: 25821465 PMCID: PMC4363579 DOI: 10.1155/2015/147070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to investigate the effect of levothyroxine (LT4) replacement therapy during three months on some parameters of metabolic syndrome and atherosclerosis in patients with increased thyroid-stimulating hormone (TSH) level. This study included a group of 30 female patients with TSH level >4 mIU/L and 15 matched healthy controls. Intima media complex thickness (IMCT) and peak systolic flow velocity (PSFV) of superficial femoral artery were determined by Color Doppler scan. In hypothyroid subjects, BMI, SBP, DBP, and TSH were significantly increased versus controls and decreased after LT4 administration. FT4 was significantly lower in hypothyroid subjects compared with controls and significantly higher by treatment. TC, Tg, HDL-C, and LDL-C were similar to controls at baseline but TC and LDL-C were significantly decreased by LH4 treatment. IMCT was significantly increased versus controls at baseline and significantly reduced by treatment. PSFV was similar to controls at baseline and significantly decreased on treatment. In this study, we have demonstrated the effects of LT4 replacement therapy during three months of treatment on correction of risk factors of metabolic syndrome and atherosclerosis.
Collapse
Affiliation(s)
- Zoran Gluvic
- Zemun Clinical Hospital, Vukova 9, 11080 Belgrade, Serbia
| | - Emina Sudar
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, P.O. Box 522, Mike Petrovica Alasa 12-14, 11001 Belgrade, Serbia
- *Emina Sudar:
| | - Jelena Tica
- Zemun Clinical Hospital, Vukova 9, 11080 Belgrade, Serbia
| | - Aleksandra Jovanovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, P.O. Box 522, Mike Petrovica Alasa 12-14, 11001 Belgrade, Serbia
| | - Sonja Zafirovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, P.O. Box 522, Mike Petrovica Alasa 12-14, 11001 Belgrade, Serbia
| | | | - Esma R. Isenovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, P.O. Box 522, Mike Petrovica Alasa 12-14, 11001 Belgrade, Serbia
| |
Collapse
|