Luboshitzky Rafael, Aviv Ariel, Herer Paula, Lavie Lena
Endocrine Institute, Haemek Medical Center, Afula, Israel.
Thyroid. 2002 May;12(5):421-5. doi: 10.1089/105072502760043512.
Overt hypothyroidism may result in accelerated atherosclerosis and coronary heart disease (CHD) presumably because of the associated hypertension, hypercholesterolemia, and hyperhomocysteinemia. As many as 10%-15% of older women have subclinical hypothyroidism (SH) and thyroid autoimmunity. Whether SH is associated with risk for CHD is controversial. We examined 57 women with SH and 34 healthy controls. SH was defined as an elevated thyrotropin (TSH) (>4.5 mU/L) and normal free thyroxine (FT(4)) level (8.7-22.6 nmol/L). None of the patients had been previously treated with thyroxine. In all participants we determined blood pressure, body mass index (BMI), and fasting TSH, FT(4), antibodies to thyroid peroxidase and thyroglobulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, folic acid, vitamin B(12), creatinine, and total plasma homocysteine levels. The SH and control groups did not differ in their total homocysteine values. Mean diastolic blood pressure was increased in SH patients versus controls (82 vs. 75 mm Hg; p < 0.01). Mean values of TC, HDL-C, LDL-C, triglycerides, TC/HDL-C, and LDL-C/HDL-C were not different in patients with SH compared with controls. Individual analysis revealed that the percentage of patients with SH having hypertension (20%), hypertriglyceridemia (26.9%), elevated TC/HDL-C (11.5%), and LDL-C/HDL-C (4%) ratios were higher than the percentages in controls. Hyperhomocysteinemia (> or = 10.98 micromol/L) was observed in 29.4% of SH and was not significantly different from the percentage in controls (21.4%). No significant correlation between TSH and biochemical parameters was detected. We conclude that subclinical hypothyroidism in middle-aged women is associated with hypertension, hypertriglyceridemia, and elevated TC/HDL-C ratio. This may increase the risk of accelerated atherosclerosis and premature coronary artery disease in some patients.
显性甲状腺功能减退可能会导致动脉粥样硬化和冠心病加速发展，推测其原因可能与相关的高血压、高胆固醇血症和高同型半胱氨酸血症有关。多达10% - 15%的老年女性患有亚临床甲状腺功能减退（SH）和甲状腺自身免疫。SH是否与冠心病风险相关存在争议。我们研究了57例SH女性患者和34例健康对照者。SH定义为促甲状腺激素（TSH）升高（>4.5 mU/L）且游离甲状腺素（FT4）水平正常（8.7 - 22.6 nmol/L）。所有患者此前均未接受过甲状腺素治疗。在所有参与者中，我们测定了血压、体重指数（BMI）、空腹TSH、FT4、甲状腺过氧化物酶抗体和甲状腺球蛋白抗体、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）、甘油三酯、叶酸、维生素B12、肌酐以及血浆总同型半胱氨酸水平。SH组和对照组的总同型半胱氨酸值无差异。与对照组相比，SH患者的平均舒张压升高（82 vs. 75 mmHg；p < 0.01）。SH患者的TC、HDL - C、LDL - C、甘油三酯、TC/HDL - C和LDL - C/HDL - C的平均值与对照组无差异。个体分析显示，SH患者中患有高血压（20%）、高甘油三酯血症（26.9%）、TC/HDL - C升高（11.5%）以及LDL - C/HDL - C升高（4%）的患者比例高于对照组。29.4%的SH患者存在高同型半胱氨酸血症（≥10.98 μmol/L），与对照组的比例（21.4%）无显著差异。未检测到TSH与生化参数之间存在显著相关性。我们得出结论，中年女性的亚临床甲状腺功能减退与高血压、高甘油三酯血症以及TC/HDL - C比值升高有关。这可能会增加某些患者动脉粥样硬化加速和冠状动脉疾病过早发生的风险。
