Hospital Universitario Miguel Servet, Zaragoza, Spain.
Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
Front Endocrinol (Lausanne). 2023 Feb 23;14:1087958. doi: 10.3389/fendo.2023.1087958. eCollection 2023.
Atrial fibrillation is associated with hyperthyroidism. Within the euthyroid range, it is also associated with high thyroxine (fT4), but not with thyrotropin (TSH). We aim to describe differences in thyroid regulation, measured by the Parametric Thyroid Feedback Quantile-Based Index (PTFQI), between patients with atrial fibrillation and the general population.
Thyroid parameters (PTFQI, TSH, and fT4) of a sample of 84 euthyroid subjects with atrial fibrillation (cases) were compared to a reference sample of euthyroid healthcare patients (controls). We calculated age and sex adjusted ORs for atrial fibrillation across tertiles of these parameters. Also, within cases, we studied thyroid parameters association with clinical characteristics of the atrial fibrillation.
After adjusting for age and sex, fT4 and PTFQI were higher in subjects with atrial fibrillation when compared to the general sample (p<0.01 and p=0.01, respectively). Atrial fibrillation ORs of the third versus the first PTFQI tertile was 1.88(95%CI 1.07,3.42), and there was a gradient across tertiles (p trend=0.02). Among atrial fibrillation patients, we observed that higher PTFQI was associated with sleep apnea/hypopnea syndrome (OSAS) (p=0.03), higher fT4 was associated with the presence of an arrhythmogenic trigger (p=0.02) and with heart failure (p<0.01), and higher TSH was also associated with OSAS (p<0.01).
Euthyroid subjects with atrial fibrillation have an elevation of the pituitary TSH-inhibition threshold, measured by PTFQI, with respect to the general population. Within atrial fibrillation patients, high PTFQI was associated with OSAS, and high fT4 with heart failure. These results hint of the existence of a relationship between thyroid regulation and atrial fibrillation.
心房颤动与甲状腺功能亢进有关。在甲状腺功能正常范围内，它也与高甲状腺素（fT4）有关，但与促甲状腺激素（TSH）无关。我们旨在描述甲状腺调节的差异，通过参数甲状腺反馈分位数基于指数（PTFQI），在心房颤动患者与一般人群之间。
甲状腺参数（PTFQI、TSH 和 fT4）的 84 例甲状腺功能正常的心房颤动患者（病例）的样本与甲状腺功能正常的医疗保健患者（对照组）的参考样本进行比较。我们计算了这些参数三分之一的年龄和性别调整后的心房颤动比值比（OR）。此外，在病例中，我们研究了甲状腺参数与心房颤动临床特征的相关性。
调整年龄和性别后，与一般样本相比，心房颤动患者的 fT4 和 PTFQI 更高（p<0.01 和 p=0.01）。与第三与第一 PTFQI 三分之一相比，心房颤动 OR 为 1.88（95%CI 1.07，3.42），并且存在三分之一之间的梯度（p 趋势=0.02）。在心房颤动患者中，我们观察到较高的 PTFQI 与睡眠呼吸暂停/低通气综合征（OSAS）相关（p=0.03），较高的 fT4 与心律失常触发的存在相关（p=0.02）和心力衰竭（p<0.01），而较高的 TSH 也与 OSAS 相关（p<0.01）。
与一般人群相比，甲状腺功能正常的心房颤动患者的垂体 TSH 抑制阈值升高，通过 PTFQI 测量。在心房颤动患者中，高 PTFQI 与 OSAS 相关，高 fT4 与心力衰竭相关。这些结果提示甲状腺调节与心房颤动之间存在关系。
