甲状腺功能正常患者血清游离三碘甲状腺原氨酸水平低与冠状动脉疾病的存在及严重程度相关：一项观察性研究

Low serum free triiodothyronine levels are associated with the presence and severity of coronary artery disease in the euthyroid patients: an observational study.

作者信息

Ertaş Faruk, Kaya Hasan, Soydinç Mehmet Serdar

机构信息

Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır-Turkey.

出版信息

Anadolu Kardiyol Derg. 2012 Nov;12(7):591-6. doi: 10.5152/akd.2012.187. Epub 2012 Aug 8.

DOI:10.5152/akd.2012.187

PMID:22877896

Abstract

OBJECTIVE

The aim of this study is to investigate the relationship between serum thyroid hormone levels that are within the normal range and the presence and severity of coronary artery disease (CAD) in patients referred for coronary angiography.

METHODS

In this observational study, we enrolled 119 consecutive patients (77 men, mean age 60.7±13.8 years) who underwent coronary angiography. Blood samples were tested for thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) concentrations. Additionally, risk factors, clinical characteristics and angiographic results were obtained. The patients were separated into two groups according to the Gensini score as those with mild or severe atherosclerosis. Statistical analysis was performed using the Chi-square, Mann-Whitney U, correlation and logistic regression tests, and ROC analysis.

RESULTS

FT3 levels were significantly lower in subjects with CAD (4.0±0.7 vs. 4.6±0.6 pmol/L; p<0.001). Moreover, lower FT3 levels were found in patients with severe atherosclerosis (3.9±0.7 vs. 4.5±0.6 pmol/L; p<0.001). Logistic regression analysis demonstrated that the lower FT3 levels were associated with the presence (OR =0.266, 95% CI: 0.097-0.731, p=0.01) and severity (OR=0.238, 95% CI:0.083-0.685, p=0.008) of CAD. In the ROC analysis, a level of FT3 ≤4.2 pmol/L was found to predict the presence of CAD with 69% sensitivity and 71% specificity (AUC:0.744, 95% CI:0.653-0.834, p<0.001); and the severity of CAD with 75% sensitivity and 67% specificity (AUC:0.733, 95% CI:0.642-0.824, p<0.001).

CONCLUSIONS

FT3 levels within the normal range were inversely correlated with the presence and severity of CAD. Moreover, lower FT3 concentrations were correlated with the Gensini score and independently predicted the presence and severity of CAD. Thus, the FT3 levels may be used as the indicator of increased risk for CAD.

摘要

目的

本研究旨在调查冠状动脉造影患者中处于正常范围内的血清甲状腺激素水平与冠状动脉疾病（CAD）的存在及严重程度之间的关系。

方法

在这项观察性研究中，我们纳入了119例连续接受冠状动脉造影的患者（77例男性，平均年龄60.7±13.8岁）。检测血样中的促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）浓度。此外，还获取了危险因素、临床特征和血管造影结果。根据Gensini评分将患者分为轻度或重度动脉粥样硬化两组。使用卡方检验、曼-惠特尼U检验、相关性检验和逻辑回归检验以及ROC分析进行统计分析。

结果

CAD患者的FT3水平显著较低（4.0±0.7 vs. 4.6±0.6 pmol/L；p<0.001）。此外，重度动脉粥样硬化患者的FT3水平更低（3.9±0.7 vs. 4.5±0.6 pmol/L；p<0.001）。逻辑回归分析表明，较低的FT3水平与CAD的存在（OR =0.266，95%CI：0.097 - 0.731，p=0.01）和严重程度（OR=0.238，95%CI：0.083 - 0.685，p=0.008）相关。在ROC分析中，发现FT3≤4.2 pmol/L水平预测CAD存在的敏感度为69%，特异度为71%（AUC：0.744，95%CI：0.653 - 0.834，p<0.001）；预测CAD严重程度的敏感度为75%，特异度为67%（AUC：0.733，95%CI：0.642 - 0.824，p<0.001）。