Cabral M D, Teixeira P F S, Silva N A O, Morais F F C, Soares D V, Salles E, Henriques J M, Leite S P, Montenegro C A B, Vaisman M
Serviço de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Braz J Med Biol Res. 2009 May;42(5):426-32. doi: 10.1590/s0100-879x2009000500005.
Subclinical hypothyroidism (SHT) is a disease for which exact therapeutic approaches have not yet been established. Previous studies have suggested an association between SHT and coronary heart disease. Whether this association is related to SHT-induced changes in serum lipid levels or to endothelial dysfunction is unclear. The aim of this study was to determine endothelial function measured by the flow-mediated vasodilatation of the brachial artery and the carotid artery intima-media thickness (IMT) in a group of women with SHT compared with euthyroid subjects. Triglycerides, total cholesterol, HDL-C, LDL-C, apoprotein A (apo A), apo B, and lipoprotein(a) were also determined. Twenty-one patients with SHT (mean age: 42.4 +/- 10.8 years and mean thyroid-stimulating hormone (TSH) levels: 8.2 +/- 2.7 microIU/mL) and 21 euthyroid controls matched for body mass index, age and atherosclerotic risk factors (mean age: 44.2 +/- 8.5 years and mean TSH levels: 1.4 +/- 0.6 microIU/mL) participated in the study. Lipid parameters (except HDL-C and apo A, which were lower) and IMT values were higher in the common carotid and carotid bifurcation of SHT patients with positive serum thyroid peroxidase antibodies (TPO-Ab) (0.62 +/- 0.2 and 0.62 +/- 0.16 mm for the common carotid and carotid bifurcation, respectively) when compared with the negative TPO-Ab group (0.55 +/- 0.24 and 0.58 +/- 0.13 mm, for common carotid and carotid bifurcation, respectively). The difference was not statistically significant. We conclude that minimal thyroid dysfunction had no adverse effects on endothelial function in the population studied. Further investigation is warranted to assess whether subclinical hypothyroidism, with and without TPO-Ab-positive serology, has any effect on endothelial function.
亚临床甲状腺功能减退(SHT)是一种尚未确立确切治疗方法的疾病。先前的研究表明SHT与冠心病之间存在关联。这种关联是与SHT引起的血脂水平变化有关还是与内皮功能障碍有关尚不清楚。本研究的目的是测定一组SHT女性患者肱动脉血流介导的血管舒张和颈动脉内膜中层厚度(IMT)所衡量的内皮功能,并与甲状腺功能正常的受试者进行比较。同时还测定了甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(apo A)、载脂蛋白B和脂蛋白(a)。21例SHT患者(平均年龄:42.4±10.8岁,平均促甲状腺激素(TSH)水平:8.2±2.7微国际单位/毫升)和21例甲状腺功能正常的对照者参与了研究,对照者在体重指数、年龄和动脉粥样硬化危险因素方面相匹配(平均年龄:44.2±8.5岁,平均TSH水平:1.4±0.6微国际单位/毫升)。血清甲状腺过氧化物酶抗体(TPO-Ab)阳性的SHT患者,其颈总动脉和颈动脉分叉处的血脂参数(高密度脂蛋白胆固醇和载脂蛋白A除外,二者较低)和IMT值较高(颈总动脉和颈动脉分叉处分别为0.62±±0.2和0.62±0.16毫米),而TPO-Ab阴性组(颈总动脉和颈动脉分叉处分别为0.55±0.24和0.58±0.13毫米)。差异无统计学意义。我们得出结论,在所研究的人群中,轻微的甲状腺功能障碍对内皮功能没有不良影响。有必要进一步研究以评估亚临床甲状腺功能减退,无论有无TPO-Ab阳性血清学,是否对内皮功能有任何影响。