Iida Masato, Yamamoto Mitsuru, Ishiguro Yuuko, Yamazaki Masatoshi, Honjo Haruo, Kamiya Kaichirou
Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan.
J Am Soc Hypertens. 2012 Jul-Aug;6(4):261-9. doi: 10.1016/j.jash.2012.04.002. Epub 2012 Jun 2.
Thyroid hormone amplifies hypertrophy of cardiac myocytes. The heart is influenced by the minimal changes of thyroid hormone levels. We hypothesized that thyroid hormone within the normal reference range may be associated with left ventricular (LV) mass in hypertensive subjects. We performed echocardiography to assess LV mass indexed by body surface area (LVMI), and measured thyroid stimulating hormone (TSH), free triiodo-thyronine (fT3), free thyroxine (fT4), and brain natriuretic peptide (BNP) in 318 hypertensive patients without known thyroidal diseases. Glomerular filtration rate (GFR) was estimated using the MDRD formula. Relationship between each thyroid hormone and LVMI in hypertensive patients with euthyroidism were investigated using a multiple linear regression model entering age, gender, height, weight, GFR, log BNP, systolic BP, the use of more than 2 different types of antihypertensive medications, and HbA1c as covariates. Thyroid hormone and TSH levels were within the normal range in 293 patients. In these patients, fT3 (standard β = 0.13) and fT4 (standard β = 0.11) positively, and TSH (standard β = -0.15) inversely correlated with LVMI in the multiple linear regression model. Thyroid hormone may be associated with LV remodeling independent of renal and LV dysfunctions in hypertensive patients with euthyroidism.
甲状腺激素可放大心肌细胞肥大。心脏会受到甲状腺激素水平微小变化的影响。我们推测,正常参考范围内的甲状腺激素可能与高血压患者的左心室(LV)质量有关。我们对318例无已知甲状腺疾病的高血压患者进行了超声心动图检查,以评估体表面积指数化的左心室质量(LVMI),并测量了促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)和脑钠肽(BNP)。使用MDRD公式估算肾小球滤过率(GFR)。采用多元线性回归模型,将年龄、性别、身高、体重、GFR、log BNP、收缩压、使用超过2种不同类型的降压药物以及糖化血红蛋白(HbA1c)作为协变量,研究甲状腺功能正常的高血压患者中各甲状腺激素与LVMI之间的关系。293例患者的甲状腺激素和TSH水平在正常范围内。在这些患者中,多元线性回归模型显示fT3(标准β = 0.13)和fT4(标准β = 0.11)与LVMI呈正相关,而TSH(标准β = -0.15)与LVMI呈负相关。甲状腺激素可能与甲状腺功能正常的高血压患者的左心室重构有关,且独立于肾脏和左心室功能障碍。