Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil.
Hospital Israelita Albert Einstein & School of Medicine, Faculdade Israelita de Ciência da Saúde Albert Einstein, São Paulo, Brazil.
Endocrinology. 2021 Feb 1;162(2). doi: 10.1210/endocr/bqaa205.
Subclinical thyroid disorders have been associated with atherosclerosis and increased cardiovascular risk. As triglyceride-rich lipoprotein particles (TRLPs) have recently emerged as a casual factor for atherogenesis, the aim of this study was to evaluate the relationship between subclinical hypo- and hyperthyroidism and TRLP subfractions. We selected 5066 participants from the ELSA-Brasil cohort with available data of thyroid function and lipid profile measured by nuclear magnetic resonance (NMR) spectroscopy. Individuals were divided into 3 groups by baseline thyroid function (subclinical hypothyroidism, euthyroidism, and subclinical hyperthyroidism). Triglyceride-rich lipoprotein particle subfractions were analyzed through NMR spectroscopy. To examine the association between TRLP subfractions and thyroid function, we conducted univariate and multivariate linear regression models adjusted for demographic characteristics, body mass index, diabetes, smoking status, and alcohol use. Of 3304 individuals, 54% were women, with a mean age of 50.6 ± 8.7 years, 51% white, and 53% with at least a college education. Of these individuals, 92% were euthyroid, whereas 6.8% had subclinical hypothyroidism and 1.2% had subclinical hyperthyroidism. The univariate linear regression showed that very small TRLPs (P = 0.026) and very large TRLPs (P = 0.008) were statistically increased in subclinical hypothyroidism when compared with euthyroidism. In subclinical hyperthyroidism, there was a reduction in total TRLPs (P = 0.003), seemingly driven by reduced very small TRLPs (P = 0.067). The findings were confirmed when adjusted for demographic characteristics, as well as comorbidities. This study suggests that subclinical hypothyroidism is associated with very small and very large TRLPs, which are related to an unfavorable atherogenic profile. Subclinical hyperthyroidism is associated to lower very small TRLPs.
亚临床甲状腺功能障碍与动脉粥样硬化和心血管风险增加有关。由于富含甘油三酯的脂蛋白颗粒（TRLPs）最近被认为是动脉粥样形成的一个偶然因素，本研究旨在评估亚临床甲状腺功能减退症和甲状腺功能亢进症与 TRLP 亚组分之间的关系。我们从 ELSA-Brasil 队列中选择了 5066 名参与者，这些参与者有甲状腺功能和通过核磁共振（NMR）光谱法测量的血脂谱的数据。根据基线甲状腺功能（亚临床甲状腺功能减退症、甲状腺功能正常和亚临床甲状腺功能亢进症）将个体分为 3 组。通过 NMR 光谱法分析富含甘油三酯的脂蛋白颗粒亚组分。为了研究 TRLP 亚组分与甲状腺功能之间的关系，我们进行了单变量和多变量线性回归模型，调整了人口统计学特征、体重指数、糖尿病、吸烟状况和饮酒情况。在 3304 名参与者中，54%为女性，平均年龄为 50.6±8.7 岁，51%为白人，53%至少受过大学教育。这些参与者中，92%为甲状腺功能正常，6.8%为亚临床甲状腺功能减退症，1.2%为亚临床甲状腺功能亢进症。单变量线性回归显示，与甲状腺功能正常相比，亚临床甲状腺功能减退症时非常小的 TRLPs（P=0.026）和非常大的 TRLPs（P=0.008）明显增加。在亚临床甲状腺功能亢进症中，总 TRLPs 减少（P=0.003），似乎是由于非常小的 TRLPs 减少（P=0.067）所致。当调整人口统计学特征以及合并症时，这些发现得到了证实。本研究表明，亚临床甲状腺功能减退症与非常小和非常大的 TRLPs 相关，这与不利的动脉粥样形成特征有关。亚临床甲状腺功能亢进症与较低的非常小的 TRLPs 相关。
