Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Cardiology, Capital Medical University, Beijing, China.
Horm Metab Res. 2022 Jan;54(1):12-19. doi: 10.1055/a-1718-6283. Epub 2022 Jan 5.
The aim of the work was to explore the correlation between thyroid hormones and coronary atherosclerotic severity. This cross-sectional study included 340 euthyroid patients who underwent diagnostic coronary artery angiography (CAG). Gensini Score (GS) was applied to assess the severity of coronary atherosclerosis. Thyroid hormones and routine biochemical parameters were measured. The associations between thyroid hormones and coronary atherosclerosis severity were analyzed. Thyroid hormones levels or parameters were taken as both continuous variables and tertiles into analysis, and the lowest tertile was usually used as the reference (OR=1) for medium and highest tertiles. Free triiodothyronine (FT3) level was associated with GS≥22 (Median GS) in Model I adjusted for age and sex [Continuous: OR=0.46, 95% CI (0.23, 0.92), p=0.029; Tertile 3: OR=0.54, 95% CI (0.30, 0.97), p=0.038], and Model II adjusted for all known risk factors of coronary artery disease (CAD) [Continuous: OR=0.44, 95% CI (0.20, 0.95), p=0.036; Tertile 3: OR=0.49, 95% CI (0.25, 0.96), p=0.039]. Subjects with highest tertile of FT3 to free thyroxine (FT4) ratio (FT3/FT4 ratio) appeared to have the remarkably decreased risk of CAD in both Non-adjusted Model [OR=0.49, 95% CI (0.24, 0.98), p=0.044] and Model I [OR=0.45, 95% CI (0.22, 0.93), p=0.031]. Higher FT3 level within normal range was independently and negatively associated with severity of coronary atherosclerosis. Besides, FT3/FT4 ratio was remarkably correlated with the prevalence of CAD in euthyroid population.
本研究旨在探讨甲状腺激素与冠状动脉粥样硬化严重程度之间的相关性。该横断面研究纳入了 340 例经诊断性冠状动脉造影（CAG）的甲状腺功能正常患者。采用 Gensini 评分（GS）评估冠状动脉粥样硬化严重程度。检测甲状腺激素和常规生化参数。分析甲状腺激素与冠状动脉粥样硬化严重程度之间的关系。将甲状腺激素水平或参数作为连续变量和三分位数进行分析，最低三分位数通常作为中值和最高三分位数的参考（OR=1）。在调整年龄和性别后的模型 I 中，游离三碘甲状腺原氨酸（FT3）水平与 GS≥22（中位数 GS）相关[连续变量：OR=0.46，95%CI（0.23，0.92），p=0.029；三分位数 3：OR=0.54，95%CI（0.30，0.97），p=0.038]，在调整所有已知冠心病（CAD）危险因素后的模型 II 中[连续变量：OR=0.44，95%CI（0.20，0.95），p=0.036；三分位数 3：OR=0.49，95%CI（0.25，0.96），p=0.039]。FT3/游离甲状腺素（FT4）比值最高三分位数的患者，在未调整模型[OR=0.49，95%CI（0.24，0.98），p=0.044]和模型 I [OR=0.45，95%CI（0.22，0.93），p=0.031]中，CAD 的风险显著降低。正常范围内较高的 FT3 水平与冠状动脉粥样硬化严重程度呈独立负相关。此外，FT3/FT4 比值与甲状腺功能正常人群 CAD 的患病率显著相关。
