Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, 430022, China.
Curr Med Sci. 2021 Apr;41(2):348-355. doi: 10.1007/s11596-021-2354-x. Epub 2021 Apr 20.
Hyperthyroid heart disease (HHD) is one of the most severe complications of overt hyperthyroidism and increases the risk of mortality in affected patients. Early identification of patients at a higher risk of developing HHD can improve clinical outcomes through active surveillance and management. Connective tissue growth factor (CTGF), a secreted extracellular protein, plays a significant role in cardiac remodeling and dysfunction. We aimed to investigate the association between plasma CTGF level and the risk of HHD in this study. A total of 142 overt hyperthyroid patients without HHD and 99 patients with HHD were included. The plasma CTGF levels were measured using ELISA kits. Routine clinical medical data and echocardiography parameters were recorded for analysis. The plasma CTGF level was significantly higher in patients with HHD than in those without HHD (P=0.002). The plasma CTGF level was positively correlated with free triiodothyronin, tryrotropin receptor antibody, troponin I and lactate dehydrogenase levels and the left atrium diameters, right atrium diameters, and right ventricular end-diastolic diameters (all P<0.05). Logistic regression analysis showed that quartiles 3 and 4 of plasma CTGF levels were significantly associated with the increased risk of HHD (crude OR: 2.529; 95% CI: 1.188-5.387). However, after adjustment for the potentially confounding variables, quartile 4 alone was significantly associated with the higher risk of HHD relative to quartile 1. Hyperthyroid patients with HHD display higher plasma CTGF levels. Furthermore, CTGF is an independent risk factor for HHD. Therefore, the plasma CTGF level may be a potential biomarker for the risk of HHD.
甲状腺功能亢进性心脏病（HHD）是显性甲状腺功能亢进症最严重的并发症之一，增加了受影响患者的死亡率。通过积极监测和管理，早期识别出发生 HHD 风险较高的患者可以改善临床结局。结缔组织生长因子（CTGF）是一种分泌的细胞外蛋白，在心脏重构和功能障碍中发挥重要作用。本研究旨在探讨血浆 CTGF 水平与 HHD 风险之间的关系。共纳入 142 例无 HHD 的显性甲状腺功能亢进症患者和 99 例 HHD 患者。使用 ELISA 试剂盒测量血浆 CTGF 水平。记录常规临床医学数据和超声心动图参数进行分析。HHD 患者的血浆 CTGF 水平明显高于无 HHD 患者（P=0.002）。血浆 CTGF 水平与游离三碘甲状腺原氨酸、促甲状腺素受体抗体、肌钙蛋白 I 和乳酸脱氢酶水平以及左心房直径、右心房直径和右心室舒张末期直径呈正相关（均 P<0.05）。Logistic 回归分析显示，血浆 CTGF 水平的第 3 和第 4 四分位数与 HHD 风险增加显著相关（未经校正的 OR：2.529；95%CI：1.188-5.387）。然而，在校正了潜在的混杂变量后，第 4 四分位数与 HHD 的高风险显著相关，而第 1 四分位数则没有。患有 HHD 的甲状腺功能亢进症患者显示出更高的血浆 CTGF 水平。此外，CTGF 是 HHD 的独立危险因素。因此，血浆 CTGF 水平可能是 HHD 风险的潜在生物标志物。
