Hypothyroidism, Sex, and Age Predict Future Thromboembolic Events Among Younger People

Abstract

Purpose Aberrant thyroid function causes dysregulated metabolic homeostasis. Literature has demonstrated hypercoagulability in hypothyroidism, suggesting a risk for thromboembolic events (TEE). We hypothesize that individuals with hypothyroidism will experience more clinically-diagnosed TEE than euthyroid individuals. Methods De-identified patient data from the University of New Mexico Health Sciences Center were retrieved using thyrotropin (TSH; thyroid-stimulating hormone) for case-finding from 2005 to 2007 and ICD billing codes to identify TEE during the follow-up period of 10 to 12 years. Diagnoses affecting coagulation were excluded and 12 109 unique enrollees were categorized according to TSH concentration as Hyperthyroid (n = 510), Euthyroid (n = 9867), Subclinical Hypothyroid (n = 1405), or Overtly Hypothyroid (n = 327). Analysis with multiple logistic regression provided the odds of TEE while adjusting for covariates. Results There were 228 TEEs in the cohort over 5.1 ± 4.3 years of follow-up. Risk of TEE varied significantly across study groups while adjusting for sex, race/ethnicity, levothyroxine, oral contraceptive therapy, and visit status (outpatient vs non-outpatient), and this risk was modified by age. Overt Hypothyroidism conferred a significantly higher risk of TEE than Euthyroidism below age 35, and Hyperthyroidism conferred an increased risk for TEE at age 20. Analysis also demonstrated a higher age-controlled risk for a subsequent TEE in men compared with women (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.02–1.81). Subanalysis of smoking status (n = 5068, 86 TEE) demonstrated that smokers have 2.21-fold higher odds of TEE relative to nonsmokers (95% CI, 1.41–3.45). Conclusions In this retrospective cohort study, Overt Hypothyroidism conferred increased risk of TEE over the next decade for individuals younger than 35 years of age, as compared with Euthyroidism.

Expression patterns of serum MicroRNAs related to endothelial dysfunction in patients with subclinical hypothyroidism

“…Subclinical hypothyroidism (SCH) is an endocrine and metabolic disorder that is characterized by elevated serum thyroid-stimulating hormone (TSH) above the upper limit of reference with normal serum free thyroid hormones (FT4 and FT3) ( 1 ). Recently, several studies have shown that SCH is associated with hypercoagulability ( 2 ), cardiovascular disease ( 3 ), dyslipidaemia ( 4 ), and increased carotid artery atherosclerosis ( 5 ). Atherosclerosis is a chronic inflammatory response with a complex pathological mechanism.…”

Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

“…Firstly, female patients are at higher risk of autoimmune diseases, [30] and there is also a higher risk of having thyroid dysfunction along with other autoimmune diseases. [31] In addition, young and middle-aged women often have an increased risk of VTE due to oral contraceptives or bed rest during pregnancy and lower limb blood stasis. [32] Therefore, we found that women with thyroid dysfunction had a higher risk of VTE than men in the included studies, [19] and further large-scale cohort studies are still needed to evaluate further the association between gender and the risk of VTE after thyroid dysfunction in the future.…”

Association between SSNHL and Thyroid Diseases

“…Deficiencies in antithrombin increases in homocysteine and factor VIII, and cardiovascular risk factors (arterial hypertension, hyperlipidemia, diabetes, and smoking) have previously been reported to be associated with SSNHL [ 30 ]. Hypercoagulability and increased risk of thromboembolism have been reported in hypothyroidism [ 31 ]. Thus, SSNHL patients may be at an increased risk of developing vascular insufficiencies driven by their thyroid diseases.…”