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左心室肥厚与甲状腺功能正常状态下甲状腺激素水平的关系。

Association of left ventricular hypertrophy with the level of thyroid hormone in euthyroid state.

机构信息

Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Department of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

J Endocrinol Invest. 2021 Jan;44(1):111-117. doi: 10.1007/s40618-020-01277-7. Epub 2020 May 7.

Abstract

PURPOSE

It has been demonstrated that variation in thyroid hormone levels even within normal range was associated with increased cardiovascular risk. However, available data are still insufficient on association between left ventricular hypertrophy (LVH) and thyroid hormone levels within euthyroid state.

METHODS

In 69,298 Koreans with euthyroid function, we evaluated association between echocardiographically detected LVH and thyroid hormone levels within the normal range. Study participants were categorized into elderly (age ≥ 40) and younger (age < 40) groups, where subjects were divided into four groups according to quartile levels of thyroxine (FT4), triiodothyronine (FT3), and thyroid-stimulating hormone (TSH). Multivariable adjusted logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence interval (CI) for LVH (adjusted ORs [95% CI]) across quartile levels of thyroid hormones.

RESULTS

In elderly group, adjusted ORs for LVH generally higher in the first quartile group than other quartile groups, despite no statistical significance in some cases (first quartile: reference, second quartile: 0.86 [0.67-1.11] in TSH, 0.75 [0.58-0.95] in FT4 and 0.63 [0.49-0.81] in FT3, third quartile: 0.70 [0.54-0.92] in TSH, 0.79 [0.61-1.02] in FT4 and 0.72 [0.55-0.93] in FT3, fourth quartile: 0.81 [0.65-1.04] in TSH, 0.85 [0.65-1.10] in FT4 and 0.58 [0.44-0.77] in FT3). This finding was similarly found in the younger group, despite discrepancy in some cases.

CONCLUSION

In euthyroid state, low normal levels in FT4, FT3 and TSH were more strongly associated with LVH.

摘要

目的

已有研究表明,即使在正常范围内,甲状腺激素水平的变化也与心血管风险的增加有关。然而,目前关于甲状腺功能正常人群中心室肥厚(LVH)与甲状腺激素水平之间的关联仍缺乏足够的数据。

方法

在 69298 名甲状腺功能正常的韩国人中,我们评估了超声心动图检测到的 LVH 与正常范围内甲状腺激素水平之间的关系。研究对象被分为老年(年龄≥40 岁)和年轻(年龄<40 岁)两组,其中根据甲状腺素(FT4)、三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)的四分位水平,将受试者分为四组。采用多变量校正逻辑回归分析计算 LVH 的优势比(OR)和 95%置信区间(CI)(校正后 OR [95%CI])在甲状腺激素四分位水平上的分布。

结果

在老年组中,尽管在某些情况下无统计学意义,但第一四分位组的 LVH 校正 OR 通常高于其他四分位组(TSH 的第一四分位:参考,第二四分位:0.86 [0.67-1.11],FT4:0.75 [0.58-0.95],FT3:0.63 [0.49-0.81],第三四分位:0.70 [0.54-0.92],TSH:0.79 [0.61-1.02],FT4:0.72 [0.55-0.93],FT3:0.81 [0.65-1.04],TSH:0.85 [0.65-1.10],FT4:0.58 [0.44-0.77])。在年轻组中也发现了类似的结果,尽管在某些情况下存在差异。

结论

在甲状腺功能正常状态下,FT4、FT3 和 TSH 的正常低值与 LVH 有更强的相关性。

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