Borderline low thyroid function and thyroid autoimmunity. Risk factors for coronary heart disease?

Tièche, M.; Lupi, G; Gutzwiller, Félix; Grob, Peter J.; Studer, H; Bürgi, H

doi:10.1136/hrt.46.2.202

Cited by 95 publications

(48 citation statements)

References 18 publications

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“…First, coronary vascular stenosis is induced by local inflammation from the pathological immune reactivity in thyroid autoimmunity that may be found in most patients with SHT. 16,17 However, this suggestion was not confirmed by other studies. 13,15 Second, previous studies have clearly shown that patients with SHT have left ventricular diastolic dysfunction at rest that is reversible with thyroxine therapy 18,19 and systolic dysfunction on effort, which may result in poor physical exercise capacity.…”

Section: Discussioncontrasting

confidence: 52%

Coronary Flow Reserve Is Impaired in Subclinical Hypothyroidism

Baycan¹,

Erdoğan²,

Çalışkan³

et al. 2007

Clinical Cardiology

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SummaryObjective: Although the cardiovascular system is highly sensitive to thyroid hormones, the cardiovascular effects of subtle thyroid dysfunction such as subclinical hypothyroidism (SHT) remain unclear. Therefore, we investigated coronary flow reserve (CFR) reflecting coronary microvascular function in patients with SHT.Methods: Fifty subjects with SHT and 30 control subjects with normal serum thyroid hormones and TSH levels were included in this study. Coronary diastolic peak flow velocities were measured at baseline and after dipyridamole infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity.Results: Age, gender, diastolic and systolic blood pressure, body mass index (BMI), serum lipid parameters, and thyroid hormone levels were similar between the groups. Heart rate was significantly lower in the SHT group. Left ventricular diastolic filling parameters were significantly different in the SHT group while other echocardiographic parameters were similar. CFR values were significantly lower in subjects with SHT than in the control group (2.38 ± 0.44 vs. 2.98 ± 0.47, p<0.0001).Conclusions: These findings suggest that CFR, which reflects coronary microvascular function, is impaired in patients with SHT.

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Section: Discussioncontrasting

confidence: 52%

Coronary Flow Reserve Is Impaired in Subclinical Hypothyroidism

Baycan¹,

Erdoğan²,

Çalışkan³

et al. 2007

Clinical Cardiology

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“…Notably, in that study, FL was significantly more prevalent in SCH patients than in euthyroid subjects, suggesting a possible role of the increased hepatic fat in the associations (7). With regard to cardiovascular disease, some (10,33), but not all (14,34), published studies have reported associations between SCH and CHD. An interesting recent study by Sert et al (35) has demonstrated that obese adolescents with FL and SHC had a proatherogenic metabolic risk factor profile and a higher carotid intimamedia thickness and left ventricular mass.…”

Section: European Journal Of Endocrinologymentioning

confidence: 82%

“…Taken together, our results and those of other studies (36,37,38,39) strongly suggested that hepatic fat is intimately involved in the pathogenesis of metabolic abnormalities and subclinical atherosclerosis present in subjects with FL. The adverse cardiovascular risk profile found in subjects with SCH plus FL may serve as a marker of long-term cardiovascular risk and may explain some of the previously observed associations between SCH and cardiovascular disease (10,33). …”

Section: European Journal Of Endocrinologymentioning

confidence: 98%

Fatty liver largely explains associations of subclinical hypothyroidism with insulin resistance, metabolic syndrome, and subclinical coronary atherosclerosis

Posadas‐Romero

Jorge‐Galarza

Posadas-Sánchez

et al. 2014

European Journal of Endocrinology

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Background: The association of subclinical hypothyroidism (SCH) with insulin resistance, metabolic syndrome (MS), and coronary atherosclerosis is uncertain. Objective: To investigate the role of increased intrahepatic fat in the association of SCH with insulin resistance, MS, and coronary atherosclerosis. Design, patients, and methods: We conducted a cross-sectional study in a sample of 753 subjects (46% males) aged 35-70 years with no history of diabetes, renal, hepatic, thyroid, or coronary heart disease, and were participants of the Genetics of Atherosclerotic Disease study. SCH was defined as a high serum TSH level with normal free thyroxine concentration. Fatty liver (FL), coronary artery calcification (CAC), and abdominal visceral adipose tissue were assessed by computed tomography. Cross-sectional associations of SCH with and without FL, with MS, insulin resistance, and subclinical atherosclerosis defined as a CAC score O0, were examined in logistic regression models. Results: SCH was observed in 17.7% of the population studied. The prevalence of FL was similar in both euthyroid and SCH subjects (31.8 vs 27.8%, PZ0.371). SCH plus FL subjects were heavier and had more metabolic abnormalities compared with SCH plus normal liver subjects. In multivariate-adjusted logistic regression analyses, SCH plus FL was associated with MS (odds ratio (OR): 2.73, 95% CI: 1.26-5.92), insulin resistance (OR: 4.91, 95% CI: 1.63-14.75), and CAC score O0 (OR: 3.05, 95% CI: 1.20-7.76). SCH without FL showed no associations. Conclusion: SCH with FL is associated with increased odds of MS, insulin resistance, and CAC, independent of potential confounders.

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“…Data from small case-control and cross-sectional studies have indicated a link between subclinical hypothyroidism and coronary artery disease (Tieche et al 1981, Dean & Fowler 1985. A large Dutch study has reported the association between subclinical hypothyroidism and aortic calcification as well as myocardial infarction amongst a cohort of 1149 women living in Rotterdam (Hak et al 2000).…”

Section: Thyroid Hormone and The Heartmentioning

confidence: 99%

Thyroid hormone in health and disease

Boelaert

Franklyn²

2005

Journal of Endocrinology

225

127

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Thyroid disease is common, affecting around 2% of women and 0·2% of men in the UK. Our understanding of the effects of thyroid hormones under physiological circumstances, as well as in pathological conditions, has increased dramatically during the last two centuries and it has become clear that overt thyroid dysfunction is associated with significant morbidity and mortality. Both hypoand hyperthyroidism and their treatments have been linked with increased risk from cardiovascular disease and the adverse effects of thyrotoxicosis in terms of osteoporosis risk are well established. Although the evidence suggests that successful treatment of overt thyroid dysfunction significantly improves overall survival, the issue of treating mild or subclinical hyper-and hypothyroidism remains controversial. Furthermore, the now wellestablished effects of thyroid hormones on neurodevelopment have sparked a whole new debate regarding the need to screen pregnant women for thyroid function abnormalities. This review describes the current evidence of the effects of thyroid hormone on the cardiovascular, skeletal and neurological systems, as well as the influence of thyroid diseases and their treatments on the development of malignancy. Furthermore we will describe some recent developments in our understanding of the relationship between thyroid status and health.

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Borderline low thyroid function and thyroid autoimmunity. Risk factors for coronary heart disease?

Cited by 95 publications

References 18 publications

Coronary Flow Reserve Is Impaired in Subclinical Hypothyroidism

Coronary Flow Reserve Is Impaired in Subclinical Hypothyroidism

Fatty liver largely explains associations of subclinical hypothyroidism with insulin resistance, metabolic syndrome, and subclinical coronary atherosclerosis

Thyroid hormone in health and disease

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