Azo Najeeb Hishyar, Ahmad Qasim Bayar, Ahmad Mohammed Ayad
Department of Medical Chemistry, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
Department of Medicine, College of Medicine, University of Duhok, Azadi Teaching Hospital, Duhok, Iraq.
Ann Med Surg (Lond). 2020 Oct 23;60:92-101. doi: 10.1016/j.amsu.2020.10.034. eCollection 2020 Dec.
Thyroid dysfunction has a negative impact on coronary artery diseases (CAD) through several changes in its risk factors like dyslipidemia, glucose intolerance, and components of metabolic syndrome. Parental history of premature CAD may be an important risk factor for their offspring.
To investigate whether overt and subclinical hypothyroidism and the risk of atherosclerosis are present in adults with parental history of CAD.
This case control study included 135 hypothyroid patients and 100 age-sex matched controls. Data were analyzed regarding CAD risk factors, hormonal and biochemical measures including retinol Binding Protein-4, fasting serum insulin, high-sensitivity C-reactive protein, lipid profile, fasting serum glucose, and serum malondialdehyde.
Parental history of CAD was significantly higher in overt hypothyroidism than subclinical group (P = 0.001). The level of RBP-4 in hypothyroid patients was significantly higher than euthyroid subjects (P = 0.03), and was higher in hypothyroid patients with positive parental history of CAD (p = 0.01). There were positive relationships between RBP-4 and related cardiovascular risk factors and with hypothyroidism, its sensitivity and specificity were 47.9% and 42.5% respectively. The positive predictive value was 60.8% and the negative predictive value was 30.4%. Hypothyroid patients with parental history of CAD had a risk of 3.7 times more than the euthyroid subjects.
In hypothyroidism patients, parental history of CAD is a predictor of future coronary events and the related risk factors. RBP-4 is positively correlated with waist circumference, BMI, lipid profile, High-sensitivity CRP, MDA, fasting serum glucose, fasting serum insulin, HOMA indices and TSH.
甲状腺功能障碍通过其危险因素的多种变化，如血脂异常、葡萄糖耐量异常和代谢综合征的组成成分，对冠状动脉疾病（CAD）产生负面影响。CAD早发的家族史可能是其后代的一个重要危险因素。
调查有CAD家族史的成年人中是否存在显性和亚临床甲状腺功能减退以及动脉粥样硬化风险。
这项病例对照研究纳入了135例甲状腺功能减退患者和100例年龄及性别匹配的对照。分析了有关CAD危险因素、激素和生化指标的数据，包括视黄醇结合蛋白-4、空腹血清胰岛素、高敏C反应蛋白、血脂谱、空腹血糖和血清丙二醛。
显性甲状腺功能减退患者的CAD家族史显著高于亚临床组（P = 0.001）。甲状腺功能减退患者的RBP-4水平显著高于甲状腺功能正常者（P = 0.03），在有CAD家族史阳性的甲状腺功能减退患者中更高（P = 0.01）。RBP-4与相关心血管危险因素及甲状腺功能减退之间存在正相关，其敏感性和特异性分别为47.9%和42.5%。阳性预测值为60.8%，阴性预测值为30.4%。有CAD家族史的甲状腺功能减退患者发生风险是甲状腺功能正常者的3.7倍。
在甲状腺功能减退患者中，CAD家族史是未来冠状动脉事件及相关危险因素的一个预测指标。RBP-4与腰围、体重指数、血脂谱、高敏CRP、丙二醛、空腹血糖、空腹血清胰岛素、HOMA指数及促甲状腺激素呈正相关。
