Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
Institute of Automation and Control, Graz University of Technology, Graz, Austria.
Horm Metab Res. 2020 Dec;52(12):850-855. doi: 10.1055/a-1232-7292. Epub 2020 Sep 4.
Resting heart rate (RHR) is associated with increased risk of cardiovascular morbidity and mortality. Thyroid hormones exert several effects on the cardiovascular system, but the relation between thyroid function and RHR remains to be further established. We evaluated whether measures of thyroid hormone status are associated with RHR in patients referred to coronary angiography. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxin (FT4), and RHR were determined in 2795 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Median (25th to 75th percentile) serum concentrations were 1.25 (0.76-1.92) mU/l for TSH, 4.8 (4.2-5.3) pmol/l for FT3 and 17.1 (15.4-19.0) pmol/l for FT4, and mean (±standard deviation) RHR was 68.8 (±11.7) beats/min. Comparing the highest versus the lowest quartile, RHR (beats/min) was significantly higher in the fourth FT4 quartile [3.48, 95% confidence interval (CI): 2.23-4.73; p <0.001] and in the fourth FT3 quartile (2.30, 95% CI: 1.06-3.55; p <0.001), but there was no significant difference for TSH quartiles. In multiple linear regression analyses adjusting for various potential confounders, FT3 and FT4 were significant predictors of RHR (p <0.001 for both). In subgroups restricted to TSH, FT3, and FT4 values within the reference range, both FT3 and FT4 remained significant predictors of RHR (p <0.001 for all). In conclusion, in patients referred to coronary angiography, FT3 and FT4 but not TSH were positively associated with RHR. The relationship between free thyroid hormones and RHR warrants further investigations regarding its diagnostic and therapeutic implications.
静息心率（RHR）与心血管发病率和死亡率的增加有关。甲状腺激素对心血管系统有多种影响，但甲状腺功能与 RHR 之间的关系仍有待进一步确定。我们评估了在接受冠状动脉造影检查的患者中，甲状腺激素状态的测量指标是否与 RHR 相关。在 Ludwigshafen 风险和心血管健康研究（LURIC）中，测定了 2795 名参与者的促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和 RHR。血清浓度中位数（25 至 75 百分位数）分别为 1.25（0.76-1.92）mU/l 用于 TSH，4.8（4.2-5.3）pmol/l 用于 FT3 和 17.1（15.4-19.0）pmol/l 用于 FT4，平均（±标准偏差）RHR 为 68.8（±11.7）次/分钟。比较最高与最低四分位数，第四 FT4 四分位数的 RHR（次/分钟）明显较高[3.48，95%置信区间（CI）：2.23-4.73；p <0.001]和第四 FT3 四分位数（2.30，95%CI：1.06-3.55；p <0.001），但 TSH 四分位数无显著差异。在调整各种潜在混杂因素的多元线性回归分析中，FT3 和 FT4 是 RHR 的显著预测因子（均为 p <0.001）。在 TSH、FT3 和 FT4 值均在参考范围内的亚组中，FT3 和 FT4 仍然是 RHR 的显著预测因子（均为 p <0.001）。总之，在接受冠状动脉造影检查的患者中，FT3 和 FT4 与 RHR 呈正相关，但 TSH 则不然。游离甲状腺激素与 RHR 之间的关系值得进一步研究其诊断和治疗意义。
