Instituto de Ensino e Pesquisa da Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
Horm Metab Res. 2020 Feb;52(2):85-88. doi: 10.1055/a-1083-6509. Epub 2020 Jan 20.
The association of subclinical hypothyroidism (SCH) with increased cardiovascular risk is controversial when thyroid-stimulating hormone (TSH) concentration is<10 mIU/l, as well as its association with a higher coronary artery calcium score (CACS) in individuals with low cardiovascular risk. This study evaluated coronary artery disease (CAD) by CACS in asymptomatic, low-cardiovascular risk women with SCH and TSH>7 mIU/l and≤10 mIU/l untreated for 5 years after diagnosis. The CACS was obtained for two groups of women with low cardiovascular risk. Group A consisted of 32 women with mild SCH (TSH>7 mIU/l and≤10 mIU/l) who remained untreated for 5 years, and group B consisted of 32 euthyroid women matched for age and body mass index to group A. The CACS ranged from 0 to 350 (median 0, 25-75% interval: 0-10) in group A and from 0 to 280 (median 0, 25-75% interval: 0-0) in group B. Scores>0 and≥10 were significantly more frequent in group A (40.6 vs. 12.5% and 25 vs. 3.1%, respectively). A CACS≥100 was also more frequent in group A (18.75 vs. 3.1%), but the difference was not significant (p=0.1). The results of the study suggest that long-term SCH with TSH>7 mIU/l and ≤ 10 mIU/l is associated with a higher risk of CAD in individuals≤65 years, even in those with low cardiovascular risk.
亚临床甲状腺功能减退症（SCH）与心血管风险增加的相关性存在争议，尤其是当促甲状腺激素（TSH）浓度<10 mIU/l 时，以及在心血管风险较低的个体中与更高的冠状动脉钙评分（CACS）相关时。本研究评估了无症状、心血管风险较低的 SCH 且 TSH>7 mIU/l 和≤10 mIU/l 的女性，在诊断后未经治疗 5 年内的冠状动脉疾病（CAD），通过 CACS 进行评估。对两组心血管风险较低的女性进行了 CACS 检测。A 组包括 32 名轻度 SCH（TSH>7 mIU/l 和≤10 mIU/l）且未经治疗 5 年的女性，B 组包括 32 名年龄和体重指数与 A 组相匹配的甲状腺功能正常的女性。A 组的 CACS 范围为 0 至 350（中位数 0，25-75%区间：0-10），B 组为 0 至 280（中位数 0，25-75%区间：0-0）。A 组的评分>0 和≥10 的比例显著更高（分别为 40.6%比 12.5%和 25%比 3.1%）。A 组 CACS≥100 的比例也更高（18.75%比 3.1%），但差异无统计学意义（p=0.1）。研究结果表明，即使在心血管风险较低的情况下，TSH>7 mIU/l 和≤10 mIU/l 的长期 SCH 与≤65 岁个体的 CAD 风险增加相关。
