Risk for Ischemic Heart Disease and All-Cause Mortality in Subclinical Hypothyroidism

Department of Clinical Studies, Radiation Effects Research Foundation, 1-8-6 Nakagawa, Nagasaki 850-0013, Japan.
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.21). 08/2004; 89(7):3365-70. DOI: 10.1210/jc.2003-031089
Source: PubMed


We investigated possible associations between subclinical hypothyroidism and atherosclerotic diseases (ischemic heart disease and cerebrovascular disease) and mortality. Of 2856 participants (mean age 58.5 yr) in a thyroid disease screening between 1984 and 1987, 257 subjects with subclinical hypothyroidism (TSH > 5.0 mU/liter) and 2293 control subjects (TSH range 0.6-5.0 mU/liter) were analyzed. In the baseline cross-sectional analysis, subclinical hypothyroidism was associated with ischemic heart disease independent of age, systolic blood pressure, body mass index, cholesterol, smoking, erythrocyte sedimentation rate, or presence of diabetes mellitus [odds ratio (OR), 2.5; 95% confidence interval (95% CI), 1.1-5.4 in total subjects and OR, 4.0; 95% CI, 1.4-11.5 in men] but not in women. However, there was no association with cerebrovascular disease (OR, 0.9; 95% CI, 0.4-2.4). We were unable to detect an influence of thyroid antibody presence on the association between subclinical hypothyroidism and ischemic heart disease. In a 10-yr follow-up study until 1998, increased mortalities from all causes in yr 3-6 after baseline measurement were apparent in men with subclinical hypothyroidism (hazard ratio, 1.9-2.1) but not in women, although specific causes of death were not determined. Our results indicate that subclinical hypothyroidism is associated with ischemic heart disease and might affect all-cause mortality in men.

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Available from: Shigenobu Nagataki, Oct 04, 2015
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    • "All these factors directly contribute to accelerated atherosclerosis [19]. Some studies show association between hypothyroidism and ischemic heart disease, regardless of age, systolic blood pressure (SBP), body mass index (BMI), and total cholesterol (TC) [20], while some do not show the relationship between increased TSH and heart disease [12]. Hypothyroidism is one of the most common causes of secondary dyslipidemia [21]. "
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    ABSTRACT: The aim of this study was to investigate the effect of levothyroxine (LT4) replacement therapy during three months on some parameters of metabolic syndrome and atherosclerosis in patients with increased thyroid-stimulating hormone (TSH) level. This study included a group of 30 female patients with TSH level >4 mIU/L and 15 matched healthy controls. Intima media complex thickness (IMCT) and peak systolic flow velocity (PSFV) of superficial femoral artery were determined by Color Doppler scan. In hypothyroid subjects, BMI, SBP, DBP, and TSH were significantly increased versus controls and decreased after LT4 administration. FT4 was significantly lower in hypothyroid subjects compared with controls and significantly higher by treatment. TC, Tg, HDL-C, and LDL-C were similar to controls at baseline but TC and LDL-C were significantly decreased by LH4 treatment. IMCT was significantly increased versus controls at baseline and significantly reduced by treatment. PSFV was similar to controls at baseline and significantly decreased on treatment. In this study, we have demonstrated the effects of LT4 replacement therapy during three months of treatment on correction of risk factors of metabolic syndrome and atherosclerosis.
    International Journal of Endocrinology 03/2015; 2015. DOI:10.1155/2015/147070 · 1.95 Impact Factor
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    • "The Rotterdam study reported SH to be a strong independent risk factor for myocardial infarction in elderly women.[16] A study in Japan revealed that the risk of myocardial infarction and angina pectoris is doubled in men with SH, comparing to the general population.[17] In our study, the systolic blood pressure measurements (Table 1) were similar in all participants with no significant difference, while diastolic blood pressure was significantly higher in the studied SH patients as compared to the "
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    ABSTRACT: The aim of this cross-sectional study was to evaluate the cardiovascular risk in patients with subclinical hypothyroidism (SH) and metabolic syndrome (MetS) components. The study included 60 patients with SH and a control group of 60 healthy volunteers, gender and age matched, with normal thyroid-stimulating hormone (TSH) and free thyroxin (FT4) concentration. The following measurements were made in all participants: TSH, FT4, thyroid peroxidase antibodies, anti-thyroglobulin antibodies, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose, total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (TG), TC/HDL cholesterol and LDL/HDL cholesterol ratio, basal insulin level and homeostatic model assessment insulin resistance (HOMA-IR) index. MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The results showed that the following indices were statistically significantly higher in the SH group: BMI (p < 0.05), diastolic blood pressure (p < 0.001), TC (p < 0.05), TG (p < 0.05) and basal insulin level (p < 0.05). Although MetS parameters were present in a higher per cent in the SH group, there was a significantly higher number of patients with hypertension and decreased HDL cholesterol (p < 0.05). More frequently, MetS was diagnosed in SH patients (46.67%) than in the control group (33.33%), although the difference was not statistically significant. These results indicated that the traditional cardiovascular risk factors were more frequently present in SH patients as compared to euthyroid participants. Our results did not confirm significantly higher presence of MetS in SH patients in comparison with euthyroid respondents.
    Biotechnology & Biotechnological Equipment 12/2014; 29(1):157-163. DOI:10.1080/13102818.2014.991136 · 0.30 Impact Factor
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    • "Subclinical hypothyroidism (SCH) is a metabolic disorder characterized by elevated serum concentrations of thyroid-stimulating hormone (TSH) and normal serum concentrations of thyroxin (T4) (1, 2). Its prevalence in general population is 1-10%, but it nearer 15% in women, particularly the elderly (3, 4). "
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    ABSTRACT: Background:Subclinical hypothyroidism (SCH) is a metabolic disorder characterized by elevated TSH level but normal T4 level. Some previous studies suggest that SCH is associated with inflammation.Objectives:The present study aimed to compare lipid serum levels in SCH patients and normal participants, also explore possible association between SCH and the two inflammatory markers hs-CRP and PLA2-IIA.Patients and Methods:This study was performed on 77 women aged 20-45 (39 with SCH and 38 in the control group). TSH and T4 levels were measured by electrochemiluminescenceassay. Lipid profiles were analyzed using enzymatic-colorimetric methods. Hs-CRP and PLA2-IIA were determined using the ELISA method. IBM SPSS 19.0 was used for statistical analysis.Results:Serum levels of TG, cholesterol, and LDL were higher in the SCH group than the control group. However, there was no significant difference between the two groups for HDL level. Likewise, no difference was observed for the serum level of hs-CRP. PLA2-IIA mean value was higher in the SCH group.Conclusions:SCH is associated with increased level of PLA2-IIA, which is independent of BMI. The stronger association of SCH with PLA2-IIA than with hs-CRP indicates that PLA2-IIA is an inducer of inflammation while hs-CRP is not.
    International Journal of Endocrinology and Metabolism 07/2014; 12(3):e16967. DOI:10.5812/ijem.16967
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