Department of Gerontology, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China.
Department of Respiratory and Critical Care Medicine, The People's Hospital of China Three Gorges University & The First People's Hospital of Yichang, Yichang, 443000, Hubei Province, China.
Sci Rep. 2018 Mar 15;8(1):4579. doi: 10.1038/s41598-018-22897-3.
It has been reported that subclinical hypothyroidism (SCH) is closely related to subclinical atherosclerosis. According to the impact of SCH on noninvasive markers of cardiovascular risk, we fulfilled a meta-analysis of included studies to provide an integrated overview. We searched electronic databases and included all relevant studies involving SCH and epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), pulse wave velocity (PWV), flow-mediated dilation (FMD) and glyceryl trinitrate-induced dilation (GNT- induced dilation). The result was calculated in a meta-analysis to assess the impact of SCH on these markers. A total of 27 studies were entered in the final analysis. Compared with euthyroid subjects, SCH patients exhibited a significantly increased CIMT (SMD: 0.369 mm; 95%CI: 0.038, 0.700; P = 0.029) and EAT (SMD: 1.167 mm; 95%CI: 0.869, 1.466; P = 0.000) and increased PWV (SMD: 3.574 m/s; 95%CI: 0.935, 6.213, P = 0.008). We also found significantly lower FMD (SMD: -1.525%, 95%CI: -2.156, -0.894, P = 0.000) and lower GNT-induced dilation (SMD: -0.384%, 95%CI: -0.625, -0.142, P = 0.002). Sensitivity analysis and subgroup analysis confirmed the above results. Our meta-analysis confirmed a significant association of SCH and cardiovascular risk with arterial wall thickening and stiffening and endothelial dysfunction. These findings will help to establish detailed cardiovascular prevention strategies for SCH patients.
据报道，亚临床甲状腺功能减退症（SCH）与亚临床动脉粥样硬化密切相关。根据 SCH 对心血管风险无创标志物的影响，我们对纳入的研究进行了荟萃分析，以提供综合概述。我们搜索了电子数据库，并纳入了所有涉及 SCH 和心外膜脂肪组织（EAT）、颈动脉内膜中层厚度（CIMT）、脉搏波速度（PWV）、血流介导的扩张（FMD）和甘油三硝酸酯诱导的扩张（GNT-诱导的扩张）的相关研究。结果以荟萃分析的方式进行计算，以评估 SCH 对这些标志物的影响。共有 27 项研究进入最终分析。与甲状腺功能正常的受试者相比，SCH 患者的 CIMT（SMD：0.369mm；95%CI：0.038，0.700；P=0.029）和 EAT（SMD：1.167mm；95%CI：0.869，1.466；P=0.000）明显增加，PWV（SMD：3.574m/s；95%CI：0.935，6.213，P=0.008）也增加。我们还发现 FMD 明显降低（SMD：-1.525%，95%CI：-2.156，-0.894，P=0.000），GNT 诱导的扩张明显降低（SMD：-0.384%，95%CI：-0.625，-0.142，P=0.002）。敏感性分析和亚组分析证实了上述结果。我们的荟萃分析证实了 SCH 与心血管风险之间存在显著关联，与动脉壁增厚和僵硬以及内皮功能障碍有关。这些发现将有助于为 SCH 患者制定详细的心血管预防策略。
