Miura S, Iitaka M, Suzuki S, Fukasawa N, Kitahama S, Kawakami Y, Sakatsume Y, Yamanaka K, Kawasaki S, Kinoshita S, Katayama S, Shibosawa T, Ishii J
Fourth Department of Internal Medicine, Saitama Medical School, Japan.
Endocr J. 1996 Dec;43(6):657-63. doi: 10.1507/endocrj.43.657.
The aim of this study was to evaluate the relationship between subclinical hypothyroidism and/or autoimmune thyroid disease and coronary heart disease (CHD). Ninety seven patients diagnosed as having CHD by a coronary angiography (CHD group) and 103 healthy subjects matched for age, sex and body mass index (control group) were included in the study. Thyroid function, thyroid autoantibodies and serum lipid concentrations were measured in the CHD and control groups. The CHD group exhibited significantly decreased serum free T3 (FT3) and free T4 (FT4) levels, and significantly increased serum TSH levels as compared with the control group, indicating a significant decrease in thyroid function in the CHD patients. Serum high density lipoprotein cholesterol (HDL-C) levels were significantly decreased in the CHD group. The incidence of subclinical hypothyroidism and thyroid autoantibodies was similar in both two groups. These observations were also true of women even after those who had diabetes mellitus (DM), hypertension (HT) and a smoking habit were excluded. This was not the case, however, in men without DM, HT, or a smoking habit. Patients with CHD had significantly lower serum levels of HDL-C than the control subjects, regardless of gender (P < 0.01). In the group with CHD, there was no difference between the serum lipid levels in patients with subclinical hypothyroidism and those with normal thyroid function. Female patients with CHD had significantly lower serum levels of thyroid hormone and HDL-C, but their subclinical hypothyroidism or thyroid autoimmunity did not seem to be related to the development of CHD.
本研究旨在评估亚临床甲状腺功能减退和/或自身免疫性甲状腺疾病与冠心病(CHD)之间的关系。本研究纳入了97例经冠状动脉造影诊断为冠心病的患者(冠心病组)和103例年龄、性别及体重指数相匹配的健康受试者(对照组)。对冠心病组和对照组进行了甲状腺功能、甲状腺自身抗体及血脂浓度的检测。与对照组相比,冠心病组血清游离T3(FT3)和游离T4(FT4)水平显著降低,血清促甲状腺激素(TSH)水平显著升高,表明冠心病患者甲状腺功能显著减退。冠心病组血清高密度脂蛋白胆固醇(HDL-C)水平显著降低。两组亚临床甲状腺功能减退和甲状腺自身抗体的发生率相似。即使排除患有糖尿病(DM)、高血压(HT)和有吸烟习惯的女性后,这些观察结果仍然成立。然而,在无DM、HT或吸烟习惯的男性中并非如此。无论性别如何,冠心病患者的血清HDL-C水平均显著低于对照组(P<0.01)。在冠心病组中,亚临床甲状腺功能减退患者与甲状腺功能正常患者的血脂水平无差异。冠心病女性患者的甲状腺激素和HDL-C血清水平显著较低,但她们的亚临床甲状腺功能减退或甲状腺自身免疫似乎与冠心病的发生无关。