Stamatelopoulos Kimon S, Kyrkou Katerina, Chrysochoou Elda, Karga Helen, Chatzidou Sofia, Georgiopoulos Georgios, Georgiou Stellios, Xiromeritis Konstantinos, Papamichael Christos M, Alevizaki Maria
Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Greece.
Thyroid. 2009 Aug;19(8):857-62. doi: 10.1089/thy.2008.0326.
Hashimoto's thyroiditis (HT) is an autoimmune disorder associated with increased cardiovascular risk, mainly as a result of accelerated atherosclerosis. The aim of this study was to determine the effect of HT on carotid atherosclerosis and arterial stiffness, as possible mediators of this vascular impairment. Menopausal status was also considered in this setting since HT is mainly prevalent in women.
Fifty-four women with HT and normal thyroid function (thyrotropin [TSH] < 4.5 mU/L) and 72 healthy controls with comparable age and risk factor prevalence were examined in this cross-sectional study. Intima-media thickness (IMT) in the carotid arteries averaged from six sites and carotid-femoral pulse wave velocity (PWV) were measured.
Although both groups had TSH levels within normal limits, TSH was higher in HT patients (2.1 +/- 1.16 vs. 1.5 +/- 0.8 mU/L, p = 0.001). PWV (7.95 +/- 2.02 vs. 7.21 +/- 1.24 m/s, p = 0.021), but not IMT (0.644 +/- 0.144 vs. 0.651 +/- 0.169 mm, p = 0.798), was significantly higher in HT patients compared to controls. When the women were divided according to menopausal status, only premenopausal women without HT had significantly lower PWV when compared with the three other subgroups (6.51 +/- 1.09 m/s premenopausal controls vs. 7.64 +/- 2.05 m/s premenopausal HT vs. 7.69 +/- 1.11 m/s postmenopausal controls vs. 8.3 +/- 1.97 m/s postmenopausal HT, p < 0.001). By multivariate analysis PWV independently correlated with age (p = 0.042), the presence of HT (p = 0.002), TSH (p = 0.003), and menopause (p < 0.001) in the whole population while HT was an independent determinant of PWV only in premenopausal women.
HT is associated with increased PWV independent of arterial atheromatosis, indicating a direct impact of this disorder on arterial stiffening. This effect may be masked in postmenopausal women possibly due to their heavier cardiovascular risk profile.
桥本甲状腺炎（HT）是一种自身免疫性疾病，与心血管疾病风险增加相关，主要是由于动脉粥样硬化加速所致。本研究的目的是确定HT对颈动脉粥样硬化和动脉僵硬度的影响，这可能是这种血管损伤的介导因素。由于HT主要在女性中普遍存在，因此在本研究中也考虑了绝经状态。
在这项横断面研究中，对54名甲状腺功能正常（促甲状腺激素[TSH]<4.5 mU/L）的HT女性和72名年龄及危险因素患病率相当的健康对照者进行了检查。测量了颈动脉六个部位的平均内膜中层厚度（IMT）和颈股脉搏波速度（PWV）。
尽管两组的TSH水平均在正常范围内，但HT患者的TSH水平更高（2.1±1.16 vs. 1.5±0.8 mU/L，p = 0.001）。与对照组相比，HT患者的PWV显著更高（7.95±2.02 vs. 7.21±1.24 m/s，p = 0.021），但IMT无显著差异（0.644±0.144 vs. 0.651±0.169 mm，p = 0.798）。当根据绝经状态对女性进行分组时，只有未患HT的绝经前女性的PWV显著低于其他三个亚组（绝经前对照组6.51±1.09 m/s vs. 绝经前HT组7.64±2.05 m/s vs. 绝经后对照组7.69±1.11 m/s vs. 绝经后HT组8.3±1.97 m/s，p < 0.001）。通过多变量分析，在整个人群中，PWV与年龄（p = 0.042）、HT的存在（p = 0.002）、TSH（p = 0.003）和绝经（p < 0.001）独立相关，而HT仅在绝经前女性中是PWV的独立决定因素。
HT与PWV增加相关，独立于动脉粥样硬化，表明这种疾病对动脉僵硬度有直接影响。这种影响在绝经后女性中可能被掩盖，可能是由于她们更严重的心血管疾病风险状况。
