Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan; Center for Health Control, Hidaka Hospital, 886 Nakao-machi, Takasaki, Gunma, 370-0001, Japan.
Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Maturitas. 2021 Feb;144:29-36. doi: 10.1016/j.maturitas.2020.10.022. Epub 2020 Nov 4.
There are currently no established cutoff levels for thyrotropin (TSH) within the reference intervals associated with carotid atherosclerosis to prevent the onset of cardiovascular diseases. The present study aimed to determine the TSH cutoff level associated with carotid maximum intima-media thickness (max IMT) in euthyroid premenopausal, perimenopausal and postmenopausal women.
We conducted a cross-sectional study of 468 euthyroid women who had not been treated for or diagnosed with cardiovascular diseases and/or metabolic disorders among 1221 Japanese women who participated in a comprehensive medical examination at the Hidaka Hospital, Japan. Participants' weight, blood pressure, plasma glucose, serum lipoprotein, free thyroxine and TSH were measured and an interview about menstruation was conducted. Carotid ultrasonography was performed to determine max IMT.
Max IMT significantly increased stepwise as menopausal status progressed (p < 0.001). Serum TSH levels were significantly higher in participants with carotid plaques, defined as max IMT ≥1.1 mm (p = 0.038), and were independently associated with the presence of carotid plaque using multivariate logistic regression analysis (β =1.218, p = 0.036). In postmenopausal women, significantly higher carotid max IMT values were observed in women with serum TSH ≥2.5 μIU/mL compared with women with concentrations <2.5 μIU/mL (p = 0.018) without elevated total cholesterol and low-density lipoprotein cholesterol concentrations. These differences were not observed in premenopausal women.
Laboratory finding of serum TSH concentration ≥2.5 μIU/mL may be useful to assess risk of atherosclerosis, especially in postmenopausal women.
目前，尚无确定的促甲状腺激素（TSH）参考区间界值可用于预防颈动脉粥样硬化相关心血管疾病的发生。本研究旨在确定甲状腺功能正常的绝经前、围绝经期和绝经后妇女中与颈动脉最大内-中膜厚度（max IMT）相关的 TSH 界值。
我们对日本日高医院参加综合体检的 1221 名日本女性中的 468 名甲状腺功能正常的绝经前、围绝经期和绝经后妇女进行了横断面研究，这些女性均未接受过心血管疾病和/或代谢紊乱的治疗或诊断。测量了参与者的体重、血压、血浆葡萄糖、血清脂蛋白、游离甲状腺素和 TSH，并进行了关于月经的访谈。进行颈动脉超声检查以确定 max IMT。
随着绝经状态的进展，max IMT 呈阶梯式显著增加（p < 0.001）。颈动脉斑块患者（定义为 max IMT≥1.1mm）的血清 TSH 水平显著升高（p=0.038），并且使用多变量逻辑回归分析发现其与颈动脉斑块的存在独立相关（β=1.218，p=0.036）。在绝经后妇女中，与 TSH<2.5μIU/ml 的女性相比，血清 TSH≥2.5μIU/ml 的女性颈动脉 max IMT 值显著更高（p=0.018），而总胆固醇和低密度脂蛋白胆固醇浓度并未升高。这些差异在绝经前妇女中并未观察到。
血清 TSH 浓度≥2.5μIU/ml 的实验室发现可能有助于评估动脉粥样硬化的风险，尤其是在绝经后妇女中。
