Sevuk Utkan, Bahadir Mehmet Veysi, Altindag Rojhat, Baysal Erkan, Altintas Bernas, Yaylak Baris, Adiyaman Mehmet Sahin, Ay Nurettin
Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, 3. kat, Uckuyular, 21010, Diyarbakir, Turkey.
Department of General Surgery, Dicle University, Diyarbakir, Turkey.
Acta Neurol Belg. 2015 Dec;115(4):581-7. doi: 10.1007/s13760-015-0435-y. Epub 2015 Feb 12.
Carotid artery plaque ulceration (PU) is known to be associated with cerebrovascular events (CVE). Even within euthyroid ranges, thyroid function has been reported to be associated with carotid atherosclerosis. However, the relationship between thyroid function and carotid PU remains unclear. Our aim was to determine the relationship between thyroid function and PU in patients with internal carotid artery stenosis (ICS). Records of patients with CVE were retrospectively reviewed. A total of 250 consecutive patients with ICS who had computed tomography angiography (CTA) of the carotid arteries following hospitalization were included in the study. CTA was used for the evaluation of carotid artery plaque morphology and ulceration. Plaque morphology was classified as fatty, mixed or calcified. Patients were divided into two groups according to the presence or absence of PU. Subclinical hypothyroidism (SCH) and hypothyroidism were significantly more common in patients with PU (p < 0.001 and p = 0.003, respectively). Patients with PU had higher incidence of low-normal FT4 levels (p = 0.02). Compared with patients who had no PU, patients with PU had decreased FT4 levels and elevated TSH levels (p = 0.001 and p = 0.001, respectively). TSH level (OR 1.33, p = 0.001), SCH (OR 4.2, p = 0.001), hypothyroidism (OR 3.15, p = 0.037), fatty plaque (OR 2.16, p = 0.01) and calcified plaque (OR 0.19, p < 0.001) were independently associated with PU. Our results suggest that SCH and hypothyroidism could be a risk factor for PU and subsequent CVE. Thyroid functions may be useful for risk stratification of patients with ICS.
已知颈动脉斑块溃疡（PU）与脑血管事件（CVE）相关。即使在甲状腺功能正常范围内，也有报道称甲状腺功能与颈动脉粥样硬化有关。然而，甲状腺功能与颈动脉PU之间的关系仍不清楚。我们的目的是确定甲状腺功能与颈内动脉狭窄（ICS）患者的PU之间的关系。对CVE患者的记录进行了回顾性分析。本研究纳入了250例连续住院后接受颈动脉计算机断层血管造影（CTA）的ICS患者。CTA用于评估颈动脉斑块形态和溃疡情况。斑块形态分为脂肪型、混合型或钙化型。根据是否存在PU将患者分为两组。亚临床甲状腺功能减退（SCH）和甲状腺功能减退在PU患者中显著更常见（分别为p < 0.001和p = 0.003）。PU患者FT4水平处于低正常范围的发生率更高（p = 0.02）。与无PU的患者相比，PU患者的FT4水平降低，TSH水平升高（分别为p = 0.001和p = 0.001）。TSH水平（比值比1.33，p = 0.001）、SCH（比值比4.2，p = 0.001）、甲状腺功能减退（比值比3.15，p = 0.037）、脂肪斑块（比值比2.16，p = 0.01）和钙化斑块（比值比0.19，p < 0.001）与PU独立相关。我们的结果表明，SCH和甲状腺功能减退可能是PU及随后CVE的危险因素。甲状腺功能可能有助于ICS患者的风险分层。
