Characterization of Subclinical Thyroid Dysfunction From Cardiovascular and Metabolic Viewpoints  The Suita Study

Takashima, Naoyuki; Niwa, Yasuharu; Mannami, Toshifumi; Tomoike, Hitonobu; Iwai, Naoharu

doi:10.1253/circj.71.191

Cited by 85 publications

(90 citation statements)

References 17 publications

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“…There are some other reports that studied in smaller number of patients with dyslipidemia and reported 6.8% (2.2% and 4.6%, overt hypothyroidism and subclinical hypothyroidism, respectively) in United Kingdom [6], 7.8% (2.5% and 5.3%) in United States [7], and 7.2% (2.8% and 4.4%) in Greece [9]. Thus, the percentage in our study was comparable to previous studies in the subjects with dyslipidemia, but not as high as that in the studies recently reported in Japanese population [25,26]. Several reasons can be described.…”

Section: Discussionsupporting

confidence: 85%

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Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

et al. 2011

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abstract. Hypercholesterolemia is one of the most representative disorders of the common diseases. To evaluate the prevalence of hypothyroidism in the population of adult hypercholesterolemia, we prospectively examined the thyroid function in patients with untreated or treated hypercholesterolemia as a multi-center survey. Subjects were the patients who were treated with some antilipemic agents or the untreated patients whose total cholesterol (TC) was over 220 mg/dL and/or LDL-cholesterol (LDL-C) over 140 mg/dL. Among 737 cases recruited, 725 cases (300 males and 425 females) participated in the survey including the thyroid function test. The patient's backgrounds include hypertension (51%), diabetes mellitus (49%), fatty liver (17%), smoking (15%), and habitual drinking (10%). The 72% of the patients were treated with some antilipemic agents and the mean values of TC, LDL-C, triglyceride (TG), HDL-cholesterol (HDL-C), and LDL-C/HDL-C ratio were 204.5 mg/dL, 119.6 mg/dL, 144.4 mg/dL, 60.7 mg/dL and 2.25, respectively. The primary hypothyroidism was seen in 27 cases (3.7%) (11 males, 16 females) with subclinical hypothyroidism in 17 cases (2.4%) and overt hypothyroidism in 10 cases (1.4%). The central hypothyroidism was seen in 4 cases (0.6%). The prevalence of hypothyroidism was 4.3% in patients with hypercholesterolemia. Taking account of the large number of patients with dyslipidemia and importance of avoiding unnecessary administration and associated adverse effects, evaluation of the thyroid function could be warranted in patients with dyslipidemia although cost-benefit issues waits further investigation.Key words: Hypercholesterolemia, Dyslipidemia, Subclinical hypothyroidism strongly related to atherosclerotic cardiovascular disease. Recently, new therapeutic reagents such as fibrates and statins have been created and primary dyslipidemia is effectively treated with these reagents [1]. However, they are not low priced and may induce rare but serious side effects such as rhabdomyolysis [1]. Hypothyroidism induces secondary hypercholesterolemia that increases the incidence of atherosclerotic cardiovascular events [2], and replacement of low-

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Section: Discussionsupporting

confidence: 85%

“…Several reasons can be described. First of all, we performed multi-center study whose institutions distribute all over Japan, whereas Nagasaki [25] or Suita [26] is a single city. In addition, there are some resources to obtain the clinically important frequency of subclinical hypothyroidism in our study.…”

Section: Discussionmentioning

confidence: 99%

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

et al. 2011

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“…However, 18 of the 29 examined studies considered an upper-limit TSH value of over 4 mU/l. This variability in limits might explain the lack of association between BMI and TSH in 11 (5,9,13,16,19,23,25,28,29,33,40) of the 29 examined studies. Another source of discrepancy is the fact that almost half of the studies did not perform adjustment for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

Association between serum TSH concentration within the normal range and adiposity

Souza

Sichieri²

2011

European Journal of Endocrinology

102

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Background: Overt hypothyroidism is clearly related to body weight gain and greater adiposity, but the range of hormonal change in serum TSH concentration associated with weight gain remains a focus of debate. Aim: The aim of this review was to assess studies that evaluated the relationship between anthropometric measures and serum TSH concentration in euthyroid subjects. Methods: Studies held on the Ovid MEDLINE database were searched and original articles published from 2000 to 2010 were included. The literature search was restricted to studies conducted in humans aged 18 years or older and written in English, Spanish, or Portuguese. Studies that evaluated the association between anthropometric measures and serum TSH within the normal range as the primary objective, as well as additional analysis, were included. Results: A total of 29 studies met the inclusion criteria. Of the 29 studies, 18 showed a positive relationship between measures of adiposity and serum TSH. Despite the plausibility of this association, only two studies reported longitudinal findings. The influence of smoking on the association between serum TSH and anthropometric measures was evaluated in only three studies and remains unclear. Conclusion: Thus, further longitudinal studies are needed to better understand the mechanisms by which TSH concentration might impact body weight.

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“…SCH is defined as a mild elevation of TSH and normal levels of free thyroid hormones. The association between SCH and individual cardiovascular risk factors has also been explored, with discordant results (4)(5)(6). Even more controversial is the association between SCH and insulin resistance (7).…”

Section: Introductionmentioning

confidence: 99%

“…If free thyroxine (FT 4 ) levels are considered, they are generally used only to define normality. Recently, Ross and coworkers reported a significant association between FT 4 levels and the components of the metabolic syndrome (MS) in euthyroid patients (8).…”

Section: Introductionmentioning

confidence: 99%

TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects

García¹,

Alvirde-García²,

López-Carrasco³

et al. 2010

European Journal of Endocrinology

232

194

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Objective: To examine the association between thyroid function and the components of the metabolic syndrome and insulin resistance in an Hispanic population. Design: Cross-sectional study. Methods: Subjects with no history of thyroid disease or diabetes were included. Thyroid function was stratified as euthyroid or subclinical hypothyroidism (SCH) status and subsequently by free thyroxine (FT 4 ) and TSH tertiles. The association of the metabolic syndrome components (defined by 2004 Adult Treatment Panel III criteria) and insulin resistance with thyroid status, TSH, and FT 4 were examined. Results: A total of 3148 subjects were analyzed. The prevalence of SCH was 8.3%. The prevalence of the metabolic syndrome was similar in euthyroid and SCH patients (31.6 vs 32.06%, PZ0.89). Total cholesterol was higher in patients with SCH (5.51G1.19 vs 5.34G1.05 mmol/l, P!0.032). Serum TSH values showed a positive correlation (adjusted for age and sex) with total cholesterol, triglycerides, and waist circumference. In contrast, FT 4 showed a positive correlation with high-density lipoprotein cholesterol, and an inverse correlation with waist circumference, insulin, and HOMA-IR. Conclusion: SCH is not associated with an increased risk for the metabolic syndrome (as conceived as a diagnostic category defined by the National Cholesterol, Education Program, Adult Treatment Panel III criteria). Despite this, low thyroid function (even in the euthyroid state) predisposes to higher cholesterol, glucose, insulin, and HOMA-IR levels. The combined use of TSH and FT 4 , compared with the assessment based on only FT 4 , is a more convenient approach to evaluate the association between thyroid function and metabolic variables.

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Characterization of Subclinical Thyroid Dysfunction From Cardiovascular and Metabolic Viewpoints The Suita Study

Cited by 85 publications

References 17 publications

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

Association between serum TSH concentration within the normal range and adiposity

TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects

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