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[颈动脉内膜中层厚度作为亚临床甲状腺功能减退患者心血管风险的标志物]

[Carotid intima-media thickness as a marker of cardiovascular risk in patients with subclinical hypothyroidism].

作者信息

Almeida Carla A de, Teixeira Patrícia de F Dos S, Soares Débora V, Cabral Mônica D, Costa Sheila M da, Salles Elizabeth F de, O E Silva Nathalie A de, Morais Felipe F C de, Buescu Alexandru, Henriques Jodélia M, Vaisman Mario

机构信息

Serviço de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, RJ, Brasil.

出版信息

Arq Bras Endocrinol Metabol. 2007 Apr;51(3):472-7. doi: 10.1590/s0004-27302007000300017.

Abstract

Subclinical hypothyroidism (SH) has been associated with an increased risk for coronary disease. Carotid intima-media thickness (IMT), as assessed by ultrasonography, is a precise marker of atherosclerotic changes and can be used as an endpoint for cardiovascular events. Aims of this study were to determine carotid IMT in a group of patients with SH and its possible association with an increase in cardiovascular risk. There were no significant differences in mean carotid IMT between patients and controls. Results of both groups were, respectively: common carotid arteries, 0.573 +/- 0.070 mm and 0.576 +/- 0.068 mm (p= 0.904); carotid bifurcation, 0.602 +/- 0.079 mm and 0.617 +/- 0.102 mm (p= 0.714). Similar results were obtained when analyzing subgroups with serum TSH < or > 8 mIU/L and with positive or negative titers of TPOAb. The mean carotid IMT in these subgroups were: TSH 4-8 mIU/L: 0.579 +/- 0.070 mm and 0.586 +/- 0.063 mm; TSH > 8 mIU/L: 0.569 +/- 0.073 mm and 0.616 +/- 0.091 mm; TPOAb+: 0.585 +/- 0.070 mm and 0.621 +/- 0.085 mm; TPOAb-: 0.554 +/- 0.072 mm and 0.571 +/- 0.066 mm. No differences in the lipid profile and in the apoprotein B and lipoprotein (a) levels between the groups were found. These findings suggest that mild SH with no related metabolic changes is not associated with an increase in cardiovascular risk, as assessed by carotid IMT.

摘要

亚临床甲状腺功能减退(SH)与冠心病风险增加有关。通过超声检查评估的颈动脉内膜中层厚度(IMT)是动脉粥样硬化改变的精确标志物,可作为心血管事件的一个终点。本研究的目的是确定一组SH患者的颈动脉IMT及其与心血管风险增加的可能关联。患者与对照组之间的平均颈动脉IMT无显著差异。两组结果分别为:颈总动脉,0.573±0.070毫米和0.576±0.068毫米(p = 0.904);颈动脉分叉处,0.602±0.079毫米和0.617±0.102毫米(p = 0.714)。分析血清促甲状腺激素(TSH)<或>8 mIU/L以及甲状腺过氧化物酶抗体(TPOAb)滴度为阳性或阴性的亚组时,也得到了类似结果。这些亚组的平均颈动脉IMT分别为:TSH 4 - 8 mIU/L:0.579±0.070毫米和0.586±0.063毫米;TSH>8 mIU/L:0.569±0.073毫米和0.616±0.091毫米;TPOAb阳性:0.585±0.070毫米和0.621±0.085毫米;TPOAb阴性:0.554±0.072毫米和0.571±0.066毫米。两组之间在血脂谱、载脂蛋白B和脂蛋白(a)水平方面未发现差异。这些发现表明,经颈动脉IMT评估,无相关代谢变化的轻度SH与心血管风险增加无关。

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