Dullaart Robin P F, de Vries Rindert, Roozendaal Carolien, Kobold Anneke C Muller, Sluiter Wim J
Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Clin Endocrinol (Oxf). 2007 Nov;67(5):668-73. doi: 10.1111/j.1365-2265.2007.02943.x. Epub 2007 Jun 26.
The effect of thyroid function on cardiovascular risk may extend to the euthyroid range. In euthyroid subjects, we determined whether carotid artery intima media thickness (IMT), a measure of subclinical atherosclerosis, is related to thyroid function.
Cross-sectional study in a cohort of 78 nonsmoking, predominantly middle-aged, euthyroid subjects (44 men and 34 women, mean age 56 years, TSH between 0.5 mU/l and 4.0 mU/l and FT4 between 11.0 pmol/l and 19.5 pmol/l).
IMT (mean of three segments in both carotid arteries by ultrasonography), clinical factors, insulin resistance (HOMA(ir)), plasma lipids, C-reactive protein (CRP), serum FT4, TSH and thyroid autoantibodies.
In several multiple linear regression models, age- and sex-adjusted IMT was found to be independently related to either pulse pressure and body mass index (BMI), to high density lipoprotein (HDL) cholesterol or to FT4, but not to TSH, thyroid autoantibodies, HOMA(ir), CRP, non-HDL cholesterol and triglycerides. In a subsequent model which included age, sex, pulse pressure, body mass index (BMI), HDL cholesterol and FT4, IMT was independently and positively related to age (beta = 0.43, P < 0.001), male sex (beta = 0.34, P = 0.014), pulse pressure (beta = 0.29, P = 0.002), BMI (beta = 0.24, P = 0.007) and inversely related to FT4 (beta = -0.19, P = 0.046). IMT was also inversely related to FT4 in a model which included HDL cholesterol, non-HDL cholesterol and triglycerides.
In euthyroid subjects, IMT is associated with FT(4), after controlling for clinical factors, lipid levels and thyroid autoantibodies. These findings raise the possibility that, even within the euthyroid range, low normal thyroid function may adversely affect cardiovascular risk.
甲状腺功能对心血管风险的影响可能延伸至甲状腺功能正常范围。在甲状腺功能正常的受试者中，我们确定了作为亚临床动脉粥样硬化指标的颈动脉内膜中层厚度（IMT）是否与甲状腺功能相关。
对一组78名不吸烟、以中年为主的甲状腺功能正常的受试者（44名男性和34名女性，平均年龄56岁，促甲状腺激素（TSH）在0.5 mU/l至4.0 mU/l之间，游离甲状腺素（FT4）在11.0 pmol/l至19.5 pmol/l之间）进行横断面研究。
IMT（通过超声测量双侧颈动脉三个节段的平均值）、临床因素、胰岛素抵抗（稳态模型评估胰岛素抵抗（HOMA(ir)））、血脂、C反应蛋白（CRP）、血清FT4、TSH和甲状腺自身抗体。
在多个多元线性回归模型中，发现年龄和性别校正后的IMT分别独立与脉压和体重指数（BMI）、高密度脂蛋白（HDL）胆固醇或FT4相关，但与TSH、甲状腺自身抗体、HOMA(ir)、CRP、非HDL胆固醇和甘油三酯无关。在随后一个纳入年龄、性别、脉压、体重指数（BMI）、HDL胆固醇和FT4的模型中，IMT独立且正相关于年龄（β = 0.43，P < 0.001）、男性（β = 0.34，P = 0.014）、脉压（β = 0.29，P = 0.002）、BMI（β = 0.24，P = 0.007），且与FT4呈负相关（β = -0.19，P = 0.046）。在一个纳入HDL胆固醇、非HDL胆固醇和甘油三酯的模型中，IMT也与FT4呈负相关。
在甲状腺功能正常的受试者中，在控制临床因素、血脂水平和甲状腺自身抗体后，IMT与FT4相关。这些发现增加了一种可能性，即即使在甲状腺功能正常范围内，甲状腺功能略低于正常也可能对心血管风险产生不利影响。
