Centro de Pesquisa Clínica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.
Laboratório de Genética, Instituto do Coração, São Paulo, Brazil.
Clin Endocrinol (Oxf). 2017 Nov;87(5):597-604. doi: 10.1111/cen.13393. Epub 2017 Jul 6.
There is little information about the association between thyrotrophin (TSH) levels and coronary artery calcification (CAC). Our aim was to analyse the association between TSH quintiles and subclinical atherosclerosis measured by CAC, using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
Cross-sectional study.
We excluded individuals using medications that affect thyroid function and who self-reported cardiovascular disease. We included euthyroid subjects and individuals with subclinical hypothyroidism (SCHypo) and subclinical hyperthyroidism (SCHyper). Logistic regression models evaluated CAC >100 Agatston units as the dependent variable, and increasing quintiles of TSH as the independent variable, adjusted for demographic and cardiovascular risk factors.
Our sample included 3836 subjects, mean age 49 years (interquartile range 44-56); 1999 (52.1%) were female, 3551 (92.6%) were euthyroid, 239 (6.2%) had SCHypo and 46 (1.2%) had SCHyper. The frequency of women, White people and never smokers as well as body mass index and insulin resistance increased according to quintiles. The 1st quintile for TSH (0-0.99 mIU/L) was associated with CAC >100, using the 3rd quintile (1.39-1.85 mIU/L) as reference (adjusted OR=1.57, 95% CI: 1.05-2.35, P=.027), but no association was shown for the 5th quintile (2.68-35.5 mIU/L) compared to the 3rd. Restricting the analysis to euthyroid subjects did not change the results. For women, but not for men, we observed a U-shaped curve with 1st and 5th TSH quintiles associated with CAC>100.
Low and low-normal (1st quintile) TSH levels were associated with CAC>100 Agatston units in a sample with subclinical thyroid disorders and euthyroid subjects.
关于促甲状腺素（TSH）水平与冠状动脉钙化（CAC）之间的关系，信息较少。我们的目的是使用巴西成人健康纵向研究（ELSA-Brasil）的基线数据，分析 TSH 五分位数与 CAC 测量的亚临床动脉粥样硬化之间的关系。
横断面研究。
我们排除了使用影响甲状腺功能的药物且自述患有心血管疾病的个体。我们纳入了甲状腺功能正常的受试者以及亚临床甲状腺功能减退症（SCHypo）和亚临床甲状腺功能亢进症（SCHyper）患者。使用 CAC＞100 个 Agatston 单位作为因变量，使用 TSH 五分位数作为自变量，通过调整人口统计学和心血管危险因素，评估 logistic 回归模型。
我们的样本包括 3836 名受试者，平均年龄 49 岁（四分位间距 44-56）；1999 名（52.1%）为女性，3551 名（92.6%）甲状腺功能正常，239 名（6.2%）患有 SCHypo，46 名（1.2%）患有 SCHyper。根据五分位数，女性、白种人、从不吸烟者以及体重指数和胰岛素抵抗的频率增加。以第 3 个五分位数（1.39-1.85 mIU/L）为参考，第 1 个五分位数（0-0.99 mIU/L）与 CAC＞100 相关（调整后 OR=1.57，95%CI：1.05-2.35，P=.027），而与第 5 个五分位数（2.68-35.5 mIU/L）相比，没有相关性。将分析限制在甲状腺功能正常的受试者中并没有改变结果。对于女性，但不是男性，我们观察到一条 U 型曲线，第 1 个和第 5 个 TSH 五分位数与 CAC＞100 相关。
在亚临床甲状腺疾病和甲状腺功能正常的受试者样本中，低和低正常（第 1 个五分位数）TSH 水平与 CAC＞100 Agatston 单位相关。
