Association Between Plasma Homocysteine Levels and Subclinical
                    Hypothyroidism in Adult Subjects: A Meta-Analysis

Shou-fa, Zhang; Liu, Lizhi; Zhang, Wei; Guo, Jinrong; Liu, Fangfang; Ma, Kai; Chen, Shaohua; Zhang, Yaqing

doi:10.1055/a-1199-2633

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…Except for this, in this study, no significant correlation was found between SCH with/without LT4 treatment and Hcy level. However, a meta-analysis (27) showed that patients with SCH aged between 18 and 65 years were associated with a slightly increased Hcy level compared with ET controls. A study conducted on pregnant women (10) found that the Hcy levels in the SCH group were markedly higher than those in the EU group.…”

Section: Discussionmentioning

confidence: 98%

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions

Yuan

Sun

Zhao

et al. 2022

Endocrine Connections

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Background: Numerous studies have found that subclinical hypothyroidism (SCH) may increase the adverse pregnancy outcomes; however, the benefit of levothyroxine (LT4) treatment remains controversial.Therefore, the primary goal of this study was to investigate the correlation between thyroid autoantibodies negative-SCH with or without LT4 treatment and adverse pregnancy outcomes. Methods: 1344 women involved the study according the inclusion and exclusion criteria. Assays for thyroid stimulating hormone (TSH), free thyroxine (FT4), anti-thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TGAb) and laboratory indicators were performed. The participants were divided into the euthyroid group (n = 1250) and the SCH group(n=94). The SCH group was further divided into LT4 group (n =40) and non-LT4 group(n=54). The laboratory indicators and pregnancy outcomes were evaluated during follow-ups. Results: There were no significant differences in lipid profile and homocysteine levels between ET and SCH group in the first and third trimester of pregnancy (P<0.05). After adjusting the confounding factors, the non-LT4 group was a risk factor for spontaneous abortion (OR: 3.141, 95% CI: 1.060-9.302). Survival analysis showed that the time of abortion was different between the ET group and SCH group (Log-rank P=0.042). The spontaneous abortion of SCH, especially non-LT4 group mainly occurred in the first trimester of pregnancy. Conclusions: Thyroid autoantibody negative-SCH seems to be associated with increased risk of spontaneous abortions during first trimester of pregnancy. LT4 therapy in this patient population might be beneficial to reduce adverse pregnancy outcomes.

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Section: Discussionmentioning

confidence: 98%

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions

Yuan

Sun

Zhao

et al. 2022

Endocrine Connections

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“…Moreover, these results remained significant after subgroup analysis based on age, sex, and the magnitude of serum TSH elevation. 19 Some basic studies have revealed the underlying mechanisms responsible for the association between serum HCy levels and thyroid dysfunction. The expression and activity of methylene tetrahydrofolate reductase (MTHFR), a key enzyme in folatedependent re-methylation, has been shown to be significantly decreased in thyroidectomy rats, suggesting dysregulation of HCy metabolism in individuals with hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, HCy is currently a recognized risk marker for cardiovascular and metabolic diseases. 17 Previous studies have suggested that hyperthyroidism and hypothyroidism were related to the decrease and increased in HCy, respectively, 18,19 and that HCy also decreased significantly after the administration of levothyroxine to patients with hypothyroidism. 20 Given that fluctuations in thyroid function within the reference range may be independent risk factors for cardiovascular and metabolic diseases, we sought to explore the association between changes in thyroid function within the reference interval and HHCy.…”

Section: Introductionmentioning

confidence: 98%

Association Between Serum Thyroid Measurements and Hyperhomocysteinemia in Euthyroid Subjects: A Retrospective Cross-Sectional Study

Zou,

Wang

2023

DMSO

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The objective of this study was to investigate the association between serum thyroid measurements and homocysteine (HCy) in euthyroid participants. Methods: This retrospective study was based on Hospital Information Systems. After excluding participants with thyroid dysfunction and those who had recently taken medications that affected serum HCy, 775 participants were enrolled. We compared the serum thyroid function measurements of patients with or without hyperhomocysteinemia (HHCy) and analyzed the effect of thyroid indicators on HHCy prevalence and HCy levels. Multivariate regression analysis was utilized to analyze the association of thyroidstimulating hormone (TSH) and thyroid peroxidase (TPOAb) with HCy. Results: The serum TSH level (2.10 ± 1.06 mIU/L) of HHCy patients (n = 98) was significantly higher than controls (n = 677) (1.65 ± 0.90 mIU/L) (p < 0.05), as was the positive rate of TPOAb (19.4% vs 10.0%, p < 0.05). The serum HCy levels in subjects with TSH within the highest quartile were significantly higher than those in the lowest quartile (13.49 ± 7.78 vs 9.81 ± 3.59 μmol/L, p < 0.05). HCy was also significantly higher in TPOAb-positive patients than in negative subjects (14.06 ± 8.89 vs 11.48 ± 5.47 μmol/L, p < 0.05). Among the TSH quartiles, the prevalence of HHCy showed a similar significant upward trend to that described above. The prevalence of HHCy was also significantly higher in TPOAb-positive patients. The results of multivariate regression analysis suggested that both TSH elevation and TPOAb positivity were independent risk factors for HCy elevation and HHCy prevalence. However, we found no definitive association between linear increases in TPOAb titers and HCy concentrations or HHCy prevalence. Conclusion: Patients with HHCy had significantly higher TSH levels and positive rates of TPOAb. Elevated TSH and positive TPOAb levels were independent risk factors for elevated HCy concentrations and HHCy risk.

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“…This may be due to the fact that homocysteine can increase lipid peroxidation, which leads to an increase in low-density lipoprotein oxidation and accelerates the progression of vascular disease. Previous researchers have shown that mRNA expression of vascular endothelial growth factor (VEGF) is increased significantly by increasing the homocysteine concentration, and the increased level of VEGF is significantly associated with the development of DR ( 11 ).…”

Section: Brief Communicationmentioning

confidence: 99%

Subclinical Hypothyroidism Is a Risk Factor for Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

Heidari

Asadzade

2021

Med. J. Islam. Republ. Iran

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Diabetic retinopathy (DR) is one of the most common complications of diabetes. The known risk factors for microvascular complications are uncontrolled diabetes, duration of diabetes, dyslipidemia, and hypertension. In addition to these conventional risk factors, other risk factors, such as hypothyroidism have recently been suggested. Adult patients with type 2 diabetes mellitus (T2DM) were recruited. All patients were evaluated for retinopathy. Various clinical and biochemical parameters, including thyroid function tests, were assessed and compared between groups. In this study, 928 patients with (T2DM) were included. Of all patients, 376 (40.52%) had DR. In patients with retinopathy, 115 (30.58%) had proliferative and 261 (69.42%) had nonproliferative retinopathy. In patients with nonproliferative DR, 34.48%, 32.95%, and 32.57% had mild, moderate, and severe nonproliferative DR, respectively. Of all patients, 91 (9.8%) had subclinical hypothyroidism. There was a significant relationship between subclinical hypothyroidism (SCH) and DR in these patients. In patients with retinopathy, 14.4% and in patients without retinopathy, 6.7% had SCH (p<0.001). In univariate logistic regression analysis, the chance of developing DR in patients with SCH was 2.33 times higher than patients without subclinical hypothyroidism, each unit increase in the thyroid-stimulating hormone significantly increases the chance of developing DR by 13%. The present study showed that in the population of patients with (T2DM), SCH is associated with DR, regardless of the conventional risk factors.

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Association Between Plasma Homocysteine Levels and Subclinical Hypothyroidism in Adult Subjects: A Meta-Analysis

Cited by 10 publications

References 34 publications

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions

Association Between Serum Thyroid Measurements and Hyperhomocysteinemia in Euthyroid Subjects: A Retrospective Cross-Sectional Study

Subclinical Hypothyroidism Is a Risk Factor for Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

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