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埃及显性和亚临床甲状腺功能减退症患者的动脉壁僵硬与动脉粥样硬化风险。

ARTERIAL WALL STIFFNESS AND THE RISK OF ATHEROSCLEROSIS IN EGYPTIAN PATIENTS WITH OVERT AND SUBCLINICAL HYPOTHYROIDISM.

出版信息

Endocr Pract. 2020 Feb;26(2):161-166. doi: 10.4158/EP-2019-0322. Epub 2019 Sep 26.

Abstract

Hypothyroidism is associated with an increased risk of atherosclerosis. Pulse wave velocity (PWV) is an index of arterial wall stiffness widely used for noninvasive assessment of early atherosclerosis. We assessed PWV in Egyptian patients with hypothyroidism. The study included 100 Egyptian females aged 18 to 55 years. They were classified into three groups: group I, 40 women with overt hypothyroidism; group II, 40 women with subclinical hypothyroidism; and group III, 20 euthyroid women as a control group. The three groups were age matched. Doppler ultrasonography was used to calculate the heart-femoral PWV. PWV was significantly higher in women with overt and subclinical hypothyroidism as compared with the control group (9.55 ± 1.81 m/s and 9.30 ± 1.28 m/s, respectively vs. 7.82 ± 2.14 m/s; <.001 and <.01, respectively). There was a positive correlation between thyroid-stimulating hormone (TSH) and PWV in women with overt hypothyroidism and in those with subclinical hypothyroidism (<.05 for both). Multivariate regression analysis showed that age and diastolic blood pressure were independent determinants of PWV in women with overt and subclinical hypothyroidism (<.01 for all). TSH was also an independent determinant of PWV in both groups (<.05 for both). PWV is significantly higher in Egyptian women with overt and subclinical hypothyroidism as compared with normal control subjects. This denotes early increase in arterial wall stiffness in patients with hypothyroidism, even in the subclinical phase. The positive correlation between PWV and TSH in both groups of patients suggests that the risk of atherosclerosis is proportionate to the severity of hypothyroidism. = ankle/brachial index; = brachial-ankle pulse wave velocity; = blood pressure; = carotid intima-media thickness; = electrocardiogram; = free thyroxine; = high-density lipoprotein; = heart-femoral pulse wave velocity; = low-density lipoprotein; = pulse transit time; = pulse wave velocity; = subclinical hypothyroidism; = thyroid-stimulating hormone.

摘要

甲状腺功能减退症与动脉粥样硬化风险增加有关。脉搏波速度(PWV)是一种广泛用于无创评估早期动脉粥样硬化的动脉壁僵硬指数。我们评估了埃及甲状腺功能减退症患者的 PWV。该研究纳入了 100 名年龄在 18 至 55 岁之间的埃及女性。她们被分为三组:I 组,40 名甲状腺功能减退症患者;II 组,40 名亚临床甲状腺功能减退症患者;III 组,20 名甲状腺功能正常的女性作为对照组。三组年龄匹配。多普勒超声用于计算心-股 PWV。与对照组相比,甲状腺功能减退症患者的 PWV 明显更高(分别为 9.55±1.81 m/s 和 9.30±1.28 m/s,分别为 7.82±2.14 m/s;<.001 和<.01)。在甲状腺功能减退症患者中,促甲状腺激素(TSH)与 PWV 呈正相关,在亚临床甲状腺功能减退症患者中也是如此(均<.05)。多元回归分析显示,年龄和舒张压是甲状腺功能减退症患者 PWV 的独立决定因素(均<.01)。TSH 也是两组患者 PWV 的独立决定因素(均<.05)。与正常对照组相比,埃及甲状腺功能减退症女性的 PWV 明显更高。这表明甲状腺功能减退症患者的动脉壁僵硬早期增加,即使在亚临床阶段也是如此。两组患者的 PWV 与 TSH 呈正相关,提示动脉粥样硬化的风险与甲状腺功能减退症的严重程度成正比。

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