Ye Guojie, Zhang Yingyue, Peng Le, Yu Zhenze, Bai Yunhe, Wu Meishan, Lu Dan, Ding Chunhua
Cardiac Department, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Cardiac Department, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China; Medical School of Chinese PLA, Beijing, China.
Heart Rhythm. 2025 Feb 20. doi: 10.1016/j.hrthm.2025.02.028.
The association of thyroid hormone sensitivity with heart rate remains unclear.
This study aims to elucidate the relationship between impaired thyroid hormone sensitivity and lower heart rate in the euthyroid population.
A total of 550 participants were included. Heart rate and serum biochemicals were measured. Thyroid hormone sensitivity indices were calculated using the thyrotropin index (TSHI), thyrotropin thyroxine resistance index (TT4RI), thyroid feedback quantile-based index (TFQI), Chinese-referenced parametric TFQI (PTFQI), and the ratio of free triiodothyronine to free thyroxine (FT3/FT4 ratio). Logistic regression analyses were applied to explore the relationship between thyroid hormone sensitivity indices and heart rate.
TSHI, TT4RI, TFQI, and PTFQI were higher, and FT3/FT4 ratio was lower in participants with heart rate ≤ 60 beats/min (P < .001 for all). Participants with increased TSHI, TT4RI, TFQI, and PTFQI and reduced FT3/FT4 ratio had lower heart rate (≤60 beats/min) (P for trend < .001 for all). Odds ratios (95% confidence intervals) for TSHI, TT4RI, TFQI, PTFQI, and FT3/FT4 ratio in the highest quartile were 2.090 (1.092-4.000), 2.240 (1.151-4.361), 2.014 (1.043-3.887), 2.163 (1.123-4.166), and 0.498, (0.249-0.996), respectively, as compared with the lowest quartile after adjusting for sex, age, body mass index, smoking, drinking, hypertension, diabetes, coronary artery disease, glycated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, and triglycerides.
Impaired sensitivity to thyroid hormones was associated with lower heart rate in euthyroid participants. Future large-scale studies are needed to confirm our findings.
甲状腺激素敏感性与心率之间的关联尚不清楚。
本研究旨在阐明甲状腺激素敏感性受损与甲状腺功能正常人群心率降低之间的关系。
共纳入550名参与者。测量心率和血清生化指标。使用促甲状腺激素指数（TSHI）、促甲状腺激素甲状腺素抵抗指数（TT4RI）、基于甲状腺反馈分位数的指数（TFQI）、中国参考参数TFQI（PTFQI）以及游离三碘甲状腺原氨酸与游离甲状腺素的比值（FT3/FT4比值）计算甲状腺激素敏感性指标。应用逻辑回归分析来探讨甲状腺激素敏感性指标与心率之间的关系。
心率≤60次/分钟的参与者TSHI、TT4RI、TFQI和PTFQI较高，而FT3/FT4比值较低（所有P均<0.001）。TSHI、TT4RI、TFQI和PTFQI升高且FT3/FT4比值降低的参与者心率较低（≤60次/分钟）（所有趋势P<0.001）。在校正性别、年龄、体重指数、吸烟、饮酒、高血压、糖尿病、冠状动脉疾病、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇和甘油三酯后，最高四分位数的TSHI、TT4RI、TFQI、PTFQI和FT3/FT4比值的优势比（95%置信区间）分别为2.090（1.092 - 4.000）、2.240（1.151 - 4.361）、2.014（1.043 - 3.887）、2.163（1.123 - 4.166）和0.498（0.249 - 0.996）。
甲状腺功能正常的参与者中，甲状腺激素敏感性受损与心率降低有关。未来需要大规模研究来证实我们的发现。
