Hamano Kumiko, Inoue Mariko
Department of Diabetes and Endocrinology, NTT Kanto Hospital, Higashi Gotanda, Tokyo, Japan.
Endocr J. 2005 Feb;52(1):95-101. doi: 10.1507/endocrj.52.95.
Pulse wave velocity (PWV) is known to represent arterial stiffness and is established as a marker for cardiovascular risk and a prognostic factor for mortality in the case of chronic renal failure or hypertension. The application of an automated apparatus for measuring brachial-ankle pulse wave velocity (baPWV) has made PWV measurement non-invasive, easier to screen for cardiovascular risk and as a result, baPWV measurements have become widely applied in clinical practice in recent years. We assessed the baPWV in 7 flank hypothyroidism patients and 28 subclinical hypothyroidism patients. In comparison with age matched healthy controls, 3 hypothyroid patients had advanced values and by replacement therapy, all 7 subjects showed improvement in their baPWV values (1531.2 +/- 242.7 to 1330.2 +/- 208.6 cm/s, p<0.05). In 28 subclinical hypothyroid subjects, 71% also had accelerated baPWV values for their age. Ten subjects (36% of all) had neither hypertension, hyperlipidemia, diabetes nor were taking any medication, and yet 8 patients out of 10 showed advanced baPWV values compared to age matched mean values. The baPWV was not correlated to TSH or total cholesterol levels, and was associated with only age and blood pressure (p = 0.01, <0.001, respectively), which are widely demonstrated as the characteristics for baPWV. In two subclinical hypothyroid subjects, who were normotensive and had no dyslipidemia, thyroxine treatment was performed and the baPWV decreased with unchanged blood pressure and total cholesterol levels. We concluded that the arterial wall stiffness tends to be increased in both overt and subclinical hypothyroid patients, and an appropriate treatment could reverse the abnormalities. It is possible that the initiation of adequate treatment in subclinical hypothyroidism may reduce the cardiovascular risk.
脉搏波速度（PWV）已知可代表动脉僵硬度，并已被确立为心血管风险的标志物以及慢性肾衰竭或高血压患者死亡率的预后因素。用于测量臂踝脉搏波速度（baPWV）的自动化设备的应用使PWV测量变得无创，更易于筛查心血管风险，因此，baPWV测量近年来已在临床实践中广泛应用。我们评估了7例临床甲减患者和28例亚临床甲减患者的baPWV。与年龄匹配的健康对照相比，3例甲减患者的baPWV值升高，通过替代治疗，所有7例受试者的baPWV值均有所改善（从1531.2±242.7降至1330.2±208.6 cm/s，p<0.05）。在28例亚临床甲减受试者中，71%的人baPWV值也随年龄加速升高。10名受试者（占总数的36%）既没有高血压、高脂血症、糖尿病，也未服用任何药物，但与年龄匹配均值相比，10名患者中有8例baPWV值升高。baPWV与促甲状腺激素（TSH）或总胆固醇水平无关，仅与年龄和血压相关（分别为p = 0.01，<0.001），这两点已被广泛证明是baPWV的特征。在2例血压正常且无血脂异常的亚临床甲减受试者中，进行了甲状腺素治疗，baPWV降低，而血压和总胆固醇水平未变。我们得出结论，临床甲减和亚临床甲减患者的动脉壁僵硬度均有增加的趋势，适当治疗可逆转这些异常。在亚临床甲减中开始适当治疗可能会降低心血管风险。
