Jorde Rolf, Joakimsen Oddmund, Stensland Eva, Mathiesen Ellisiv B
Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Thyroid. 2008 Jan;18(1):21-5. doi: 10.1089/thy.2007.0165.
Increased arterial wall intima-media thickness (IMT) is an early feature of atherosclerosis and has been reported to be altered in patients with thyroid dysfunction. The present study was performed to examine the relation between carotid artery intima-media thickness and possible variations in thyroid function in normal subjects using serum TSH as a surrogate index of thyroid function.
A total of 2034 subjects (974 males) were studied, 1856 or whom were non-users of thyroxine. The subjects not taking thyroxine were classified into three groups, those with a low serum TSH (0.48 mIU/L (2.5 percentile, those with serum TSH from 0.48 to 4.16 mIU/L, and those with high serum TSH of >4.16 mIU/L (97.5 percentile). Carotid ultrasound was performed in each all 2034 subjects to determine IMT.
Among those not taking thyroxine, subjects in the low serum TSH group had a higher mean IMT as compared to those in the normal and high serum TSH groups but the differences were not significant when adjusted for gender, age, smoking status, body mass index, systolic blood pressure and serum cholesterol (0.88 +/- 0.15 mm, 0.84 +/- 0.16 mm, and 0.84 +/- 0.24 mm respectively). Subjects taking thyroxine had significantly higher IMT than those not taking thyroxine (0.89 + 0.20 mm versus 0.84 + 0.17 mm, p<0.01).
No significant relationship between carotid IMT and serum TSH levels was observed in normal, non thyroxine taking, subjects. Carotid IMT was increased in subjects taking thyroxine. Whether the increase in carotid IMT is due to thyroxine ingestion or underlying thyroid disease cannot be answered from the study.
动脉壁内膜中层厚度(IMT)增加是动脉粥样硬化的早期特征,且据报道甲状腺功能障碍患者的该指标会发生改变。本研究旨在以血清促甲状腺激素(TSH)作为甲状腺功能的替代指标,探讨正常受试者颈动脉内膜中层厚度与甲状腺功能可能变化之间的关系。
共研究了2034名受试者(974名男性),其中1856名未服用甲状腺素。未服用甲状腺素的受试者被分为三组,即血清TSH水平低(<0.48 mIU/L,第2.5百分位数)的受试者、血清TSH水平在0.48至4.16 mIU/L之间的受试者以及血清TSH水平高(>4.16 mIU/L,第97.5百分位数)的受试者。对所有2034名受试者均进行了颈动脉超声检查以测定IMT。
在未服用甲状腺素的受试者中,血清TSH水平低的组的平均IMT高于正常血清TSH组和高血清TSH组,但在对性别、年龄、吸烟状况、体重指数、收缩压和血清胆固醇进行校正后,差异无统计学意义(分别为0.88±0.15 mm、0.84±0.16 mm和0.84±0.24 mm)。服用甲状腺素的受试者的IMT显著高于未服用甲状腺素的受试者(分别为0.89 + 0.20 mm和0.84 + 0.17 mm,p<0.01)。
在未服用甲状腺素的正常受试者中,未观察到颈动脉IMT与血清TSH水平之间存在显著关系。服用甲状腺素的受试者的颈动脉IMT增加。本研究无法回答颈动脉IMT增加是由于摄入甲状腺素还是潜在的甲状腺疾病所致。