FMD and CIMT: Surrogate Markers of Atherosclerosis in Subclinical and Overt Hypothyroidism in Sub Himalyan Region

Kumari, Bandana; Kumar, Bhupender; Gupta, Dalip; Ganju, Neeraj

doi:10.4103/ijem.ijem_247_21

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…It is commonly known that endothelial dysfunction occurs in the early stages of chronic kidney disease, and a decrease in eGFR suggests endothelial dysfunction [24]. SCH is crucial in the development of endothelial dysfunction [25,26], but the emerging evidence supporting it is accumulating in the general population.…”

Section: Discussionmentioning

confidence: 99%

Relationship between subclinical hypothyroidism and endothelial dysfunction in patients with type 2 diabetes: A cross-sectional study

Yu,

Fan

2023

Preprint

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Purpose: To investigate the relationship between subclinical hypothyroidism (SCH) and vascular endothelial function in patients with type 2 diabetes mellitus (T2DM). Methods: The reactive hyperemia index (RHI) as a surrogate marker of endothelial function was measured using a fingertip peripheral arterial tonometry device in 247 T2DM patients with or without SCH. The 75-g oral glucose tolerance test was conducted, and the brachial-ankle pulse wave velocity was measured. Results: Compared with patients with euthyroidism (n=135), patients with SCH (n=112) had a lower RHI (1.60 ± 0.37 vs. 1.75 ± 0.41, P = 0.003), low-density lipoprotein cholesterol level (2.74 ± 0.91 vs. 2.99 ± 0.96 mmol/L, P = 0.037), estimated glomerular filtration rate (93.89 ± 23.23 vs. 100.3 ± 15.41 mL/min/1.73 m2, P = 0.016), and 30-min insulinogenic index (median, 17.76 [interquartile range: 8.72–27.75] vs. 39.40 [22.00–97.89], P < 0.001), and higher body mass index (26.13 ± 4.06 vs. 24.83 ± 3.17 kg/m2, P = 0.006) and area under the insulin curve (764.95 [493.04–1088.49] vs. 563.23 [345.71–887.20] pmol×h/L, P < 0.001). Patients with SCH was at increased risk of endothelial dysfunction (odds ratio = 2.845, 95% confidence interval: 1.090–7.427; P = 0.033), and the interaction between (BMI) and RHI (Pint = 0.02) was stronger in these patients than in patients with euthyroidism. Conclusion: SCH is likely associated with the deterioration of endothelial function in patients with T2DM, and thus, examination of thyroid function is recommended for patients with T2DM. Further research is needed to clarify the mechanism underlying this association.

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Section: Discussionmentioning

confidence: 99%

Relationship between subclinical hypothyroidism and endothelial dysfunction in patients with type 2 diabetes: A cross-sectional study

Yu,

Fan

2023

Preprint

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“…Endothelial dysfunction, by itself, is a major causative factor for atherosclerosis [1]. It impairs vasomotor tone and promotes arterial thrombosis as well as causes migration and proliferation of vascular cells [2].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Vascular Function Assessment and Perioperative Vascular Events in Patients Posted for Elective Non-cardiac Surgeries

Prabhakaran¹,

Gupta²,

Bidkar³

et al. 2022

Cureus

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BackgroundCoronary atherosclerosis is usually asymptomatic until a major cardiac event occurs. Surgery is one of the major stress factors that play a role in hastening vascular deterioration in susceptible patients. Non-invasive tests to detect atherosclerosis and endothelial dysfunction have started gaining popularity nowadays, and of the several options, carotid artery intima-media thickness (IMT) and radial artery flow-mediated dilation (FMD) are two promising tests for detecting cardiovascular impairment. MethodsThis was a pilot study that was undertaken on 100 patients in a tertiary care medical center (Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry) between June 2015 and August 2016 with the aim of studying the prevalence of endothelial dysfunction and early atherosclerosis in the given population, and to find out the predictive power of preoperative vascular functional assessment in the prediction of perioperative cardiovascular events in the same population. We had selected patients who had at least two risk factors for endothelial dysfunction and were posted for elective non-cardiac surgical procedures via convenience sampling. Flow-mediated vasodilatation of the radial artery (FMD) and carotid intima-media thickness (CIMT) were measured on the previous day of surgery, while a fasting lipid profile was collected from the patients on the morning of the surgery. Endothelial dysfunction was defined as FMD<4.5%, while atherosclerosis was defined as CIMT>0.07 cm. Demographic details and baseline hemodynamic parameters of the patients were also noted preoperatively as well as intra-operatively, and patients were followed up for any major clinical adverse cardiovascular event post-operatively till they were discharged from the hospital. ResultsIt was found that the prevalence of endothelial dysfunction was 23%, while the prevalence of early atherosclerosis was 33% in our study population. However, it was found that FMD and CIMT did not correlate with each other significantly, nor did they correlate significantly with perioperative cardiovascular events. The risk factors of the patients also did not correlate with the FMD and CIMT values of the patients in which they were impaired. Moreover, they did not have any significant correlation with the perioperative events that occurred. ConclusionThe prevalence of endothelial dysfunction in our tertiary center was found to be 23%, and the prevalence of atherosclerosis was 33% in patients posted for elective non-cardiac surgery who had multiple risk factors. It was also found that non-invasive preoperative vascular assessment was not quite effective as hypothesized in predicting perioperative cardiovascular events.

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A Study of Carotid Intima Media Thickness as a Marker of Atherosclerosis in Clinical vs Subclinical Hypothyroidism

Patel¹,

Shah²,

Patel³

et al. 2022

IJAR

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Introduction:Hypothyroidism increases the risk of atherosclerosis, which in turn increases the cardiovascular disease risk. Carotid intima media thickness (CIMT)>1 mm is used as a non invasive marker of atherosclerosis. Aim:To nd the prevalence of atherosclerosis in patients with clinical vs subclinical hypothyroidism using CIMT as a marker for atherosclerosis Methods: Type of study: Prospective observational study. 100 patients of clinical or subclinical hypothyroidism of age more than 12 years, were included in the study. Theyunderwent laboratory and radiological investigations (CIMT-Carotid Intima Media thickness).Data analysis was carried out using statistical package for social sciences. Result:54.55% of clinical hypothyroid patients had CIMT>1 mm as compared to 17.86% of subclinical hypothyroidism. Elevated total cholesterol, triglycerides and LDL in clinical hypothyroid patients were 45.46%,68.18% and 40.90% respectively, As compared to subclinical hypothyroidism which had 3.58%, 39.29%, 21.43% respectively. Markers of inammation CRP>3.0 mg/dl, ESR>30 mm and TLC>10,000 were also signicantly higher in patients with clinical as compared to subclinical hypothyroid patients.(40.91%,50% and 40.91% respectively)suggesting possibility of active atherogenesis being signicantly higher in clinical hypothyroidism as compared to subclinical hypothyroidism.

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FMD and CIMT: Surrogate Markers of Atherosclerosis in Subclinical and Overt Hypothyroidism in Sub Himalyan Region

Cited by 3 publications

References 35 publications

Relationship between subclinical hypothyroidism and endothelial dysfunction in patients with type 2 diabetes: A cross-sectional study

Relationship between subclinical hypothyroidism and endothelial dysfunction in patients with type 2 diabetes: A cross-sectional study

Preoperative Vascular Function Assessment and Perioperative Vascular Events in Patients Posted for Elective Non-cardiac Surgeries

A Study of Carotid Intima Media Thickness as a Marker of Atherosclerosis in Clinical vs Subclinical Hypothyroidism

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